Carpal tunnel syndrome
In medicine, a group of peripheral nerve lesions due to prolonged compression or traumatic consequences in the musculoskeletal canals is commonly called tunnel neuropathies or syndromes. The most common of the tunnel neuropathies is carpal tunnel syndrome, which can be described as compression of the median nerve under the transverse wrist ligament. It occurs between the three bony walls and the ligament holding the tendons that flex the hand and fingers.
Causes of carpal tunnel syndrome
According to various statistics, carpal tunnel syndrome occurs among the female population of the planet 3-10 times more often than among the male. It is known that although the disease is observed in different age groups, most of the cases occur in people aged 40 to 60 years. It should also be noted that this pathology is inherent predominantly of the Caucasian race, and among some African peoples it almost never occurs.
This may be due to the fact that the main cause of carpal tunnel syndrome is various situations that provoke inflammation and swelling within the muscles, tendons and the joint of the tunnel. This is work at a typewriter, lengthy piano lessons and, of course, a computer. That is why unofficially this pathology is also called the computer mouse syndrome. In fact, any work that requires frequent repetitive movements can be the cause of the disease.
Other causes of carpal tunnel syndrome include the following, the most common:
- Various rheumatic conditions that affect the area of the wrist and hand, leading to chronic inflammatory processes (for example, rheumatoid arthritis);
- Pregnancy, especially in the last stages;
- The use of oral contraceptives (as in the case of pregnancy, can contribute to fluid retention and, therefore, swelling of the hands);
- Tumor of the median nerve;
- All kinds of injuries to the forearm and hand, such as fractures, bruises and dislocations;
- An abnormal enlargement of the hands called acromegaly;
- Endocrine diseases (for example, thyroid disease, diabetes mellitus, early menopause, etc.);
- Diseases of the internal organs (for example, kidney failure);
- Other activities that require gripping and regular firm squeezing of the wrist.
Experts often note the relationship between exacerbation of carpal tunnel syndrome and the cold season, which indicates that hypothermia also contributes to the development of the disease.
Carpal tunnel syndrome symptoms
The symptoms of carpal tunnel syndrome are quite specific, so that they can sometimes easily determine the presence of this disease in a person. The most common ones are the following:
- Tingling, burning and painful sensations in the hands and forearms;
- Gradual loss of sensation and numbness in the wrist area;
- Movement disorders;
- Signs of impaired microcirculation in the wrists.
Pain in the early stages of carpal tunnel syndrome is typically found in the deep tissues of the index and middle fingers. Painful aching and dull, often passing into the area of the hand and forearm. In most cases, it is accompanied by numbness of the skin of the fingers and hands, especially in the morning after waking up.
Often, numbness leads to a significant decrease or even complete loss of pain sensitivity, first in the palms, and then in the entire arm. This condition usually goes away after a few hours. You can also put your hands down and move your fingers: this helps to eliminate discomfort for a while.
The next symptom of carpal tunnel syndrome is gradual movement disorders. As the disease progresses, it becomes difficult for a person to hold even small objects in his hands, and the strength of their grip with a hand with the help of the thumb is noticeably reduced.
Microcirculatory disorders in the hands are another common symptom of carpal tunnel syndrome. They manifest themselves, first of all, through vasospasm. This is due to the pallor of the skin of the hands in patients, its bluish tint and cold snap, which can be checked by touch. In addition, impaired microcirculation leads to increased or decreased sweating in people with carpal tunnel syndrome, as well as to malnutrition of the skin and nails, which is manifested by a deterioration in their appearance.
Diagnosis and treatment of carpal tunnel syndrome
In addition to the symptoms of the disease described above, it can be determined through diagnostics using some tests. The flexion and extension test helps to identify the presence of the syndrome as follows. In a healthy person, the arm in the position of maximum flexion or extension can be about a minute. However, in patients with this pathology, tingling in the area of the fingers is observed during this time.
Tinnel's test is based on tapping the area of the tunnel, which causes pain and tingling sensations in the fingers. However, it is effective in severe cases of the syndrome.
Treatment of carpal tunnel syndrome can be divided into conservative and surgical, depending on the severity of the disease. Conservative treatment can be divided into three groups:
- Restriction of movement;
- Physiotherapy;
- Treatment with medicines.
Restriction of movements implies a state of rest of the affected hand area for a long time. Sometimes wrist splints are required.
Physiotherapy focuses on creating a magnetic field. With this treatment of carpal tunnel syndrome, acupuncture is often used, which restores metabolic processes in damaged tissues.
Medication most often includes the use of non-steroidal anti-inflammatory drugs to relieve pain, the administration of glucocorticoids, and the use of diuretics to relieve swelling and inflammation. In addition, drugs that restore microcirculation and the function of the median nerve are often prescribed for carpal tunnel syndrome.
Surgical intervention is used when conservative treatment is ineffective. It usually consists in cutting the transverse ligament of the wrist, which relieves pressure on the tendons and median nerve, as well as restores normal microcirculation of the tissues of the hand.
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The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
