Carpal canal treatment. Carpal tunnel syndrome and its treatment

, is a pinched carpal nerve, resulting in pain, loss of control over the movements of the fingers, as well as a decrease in sensitivity.

What will happen to the brush if you ignore the appearance of the disease?

The median nerve controls all the wrist muscles, it helps to move the fingers and feel any impact from environment. When ignoring pain syndrome due to pinching, loss of flexibility of the hand is possible, the tissues will begin to turn pale, there will be heavy sweating. Everything can end regular numbness and muscle atrophy, so do not start the disease.

Causes

The causes of this disease are very different: anatomical, work-related, health status or even gender.

Who is at risk?

There are several risk factors that increase the chance of developing carpal tunnel syndrome:

1. Received fractures of the wrists, especially those that did not heal properly. The compression of the nerve canal increases, the nerve itself is compressed.
2. Congenital defects in the development of the carpal tunnel.
3. Genetic predisposition: square-shaped wrist, thick transverse ligament.
4. Small carpal tunnel and any of its injuries in women.
5. Diseases that negatively affect nervous system human (diabetes mellitus, sclerosis, etc.).
6. Inflammatory processes in the tendons of the hand.
7. The formation of edema (both external and internal) during gestation or taking contraceptives.
8. Large body weight.
9. Kidney or thyroid disease.
10. Working with heavy weights or injury-prone activities, prolonged work at the computer.

Carpal tunnel syndrome most often characteristic of women over 50 who are engaged in work that requires constant, often repetitive brush movements (secretary, factory assembly line assembler, hairdresser, musician).

Diagnosis of tunnel neuropathy

There are several simple tests, which will help determine the presence of carpal syndrome on their own:

1. Tinel test- gentle tapping in the area of ​​\u200b\u200bthe sore spot. In this case, the pain should intensify, and the limb becomes numb, tingling sensations may occur.
2. Raise your hand up- this test implies the following: stretch straight arms up above your head, you need to stand in this position for about a minute. If there is carpal tunnel syndrome, then small tingling will begin in the hand, it will begin to go numb, and pain will appear.
3. Flexion test- the hand is bent to the stop at the wrist joint for 60 seconds. After performing the test, when the hand is extended, pain and numbness occur.
4. Bottle test- the index and thumb cannot lift and hold the bottle by the neck.

If none of the texts showed numbness of 1-3 fingers, you may have.

Attention! The results obtained during the tests do not guarantee an accurate diagnosis. For diagnosis and treatment, you must always consult a doctor.

Medical diagnostics

In addition to tests that you can do yourself, the doctor prescribes the following types research:

• ENMG (electroneuromyography);
• nerve conduction studies;
• thermal imaging;
• ultrasound procedure;
• x-ray of the wrist joint to rule out other ailments.

The doctor may also perform another test, which involves using a blood pressure monitor. A cuff is put on the arm just above the place where the nerve is presumably pinched, it is inflated to normal level blood pressure and held for 60 seconds. At the same time, paresthesias are noted where the nerve is supplied with food.

Symptoms

Patients diagnosed with "carpal tunnel syndrome" constantly complain of numbness of the hand and unpleasant tingling in the middle, index and ring fingers, objects begin to fall out of the hands, the hand gets tired quickly.

At an early stage, the whole picture of symptoms is temporary, after a while the pain and discomfort go away but then reappear while driving, raising your hand, talking on the phone, or reading a book. The muscle strength of the hand is lost, in some cases there is a complete lack of coordination of movements.

The above sensations of patients are always accompanied by burning pain in the palm or first 3 fingers. In this case, the pain feels like it spreads almost to the forearm.

At night, the symptoms also do not leave patients alone.. Due to the fact that at night the position of the hand is not controlled, the nerve is pinched, pain and stiffness shoot like a current. The person may even wake up. Light waving with a brush or rubbing the palms alleviate pain.

Bilateral canal syndrome is common, but the most common disease is one hand: for lefties it is left hand, for right-handers - right. With a bilateral syndrome, one arm may have more severe lesions than the other, this is also due to the convenience of frequent use of one of the limbs during work.

Patients also complain about the manifestation of vegetative symptoms. The palm and wrist swell, there is a feeling of constriction.

There is either a low or high temperature of the hand, because due to the compression of the nerve canal, the vessels stop working in full.

Maybe even increase perspiration. The brush begins to react sensitively to sudden changes in temperature: the color of the fabrics changes.

Over time, all symptoms of the disease can worsen and become permanent. Muscle weakness and numbness will interfere with work activities, and constant pain will prevent you from doing small work, up to buttoning your shirt and tying your shoelaces.

What are the complications?

If you do not pay attention to the symptoms of carpal tunnel syndrome for a long time and do not carry out treatment, the nerve begins to atrophy, irreversible processes will start in the brush, which can lead to a complete loss of motor function. In most cases, the prognosis for carpal hand syndrome is positive, the disease can be cured conservatively or with surgery.

But if the remission of the disease for a long time alternates with its appearance, then the disease can turn into a chronic form completely, pain symptoms will intensify, and against their background other nervous disorders will arise.

Treatment

Application of conservative methods

No major omissions early stage diseases) and the progression of carpal hand syndrome are indications for the use of conservative methods of treatment. What do they include?

1. Keeping the wrist at rest: it is recommended to wear a special fixative on the brush during sleep, which will not allow squeezing the carpal canal at night. The tire can also be used during the day during traumatic work activities.
2. Application medicines : The doctor may prescribe analgesics ( NSAIDs) to relieve pain.
3. Recommendations for changing jobs to avoid overloading and pinching the carpal nerve.
4. Steroid injections: the drug is injected directly into the nerve canal, gives relief from the symptoms of the disease. With absence positive dynamics within six months from the injection period, surgery is prescribed.

More about treatment methods.

Used to treat a patient alternative methods, For example yoga. Some poses help improve stretching, strengthen joints, and make wrist muscles stronger. You can also try manual therapy and high frequency ultrasound treatment.

If you need to get rid of pain in the joint itself, read the article about. And they will help restore a damaged brush.

Operation

If conservative methods of treatment do not have the appropriate effect, then surgical interventions are prescribed. There are two ways: open and minimally invasive. The first involves cutting the skin over the carpal ligament and decompressing the median nerve, the second is carried out through a mini-incision using video equipment and special tools.

All surgical operations for the treatment of carpal syndrome are carried out on an outpatient basis using local anesthesia.

After the operation, you may experience pain, a feeling of stiffness and swelling. But already on the first day after the intervention, you can start moving your fingers.

To reduce postoperative symptoms, rehabilitation therapy is prescribed to restore hand functionality. Within a few months, all postoperative sensations disappear, during this period it is recommended to stop driving a car, hard work, or simply bending a limb. It is necessary to allow the nerve fibers to recover. Only after the permission of the attending physician can you return to your usual way of life.

IMPORTANT! Relief may not occur immediately after the operation, so you should be patient for a gradual recovery: it can take from a month to a whole year.

The good news is that after the operation, the reviews are mostly positive. Naturally, the effect and degree of canal decompression are different, but in general, patients note only improvement.

Current research in the field of hand treatment

Tunnel syndrome is considered the most common disease among all ailments associated with the upper limbs.

Carpal ligament surgeries are the most common of all wrist surgeries.

463,000 people are operated on in America every year. Studies have shown that it is the carpal tunnel syndrome that is the most common cause excommunication from work, patients need at least a month for rehabilitation.

For some professions, researchers have clearly identified the causes of the disease: for cashiers, this is the constant reading of barcodes, for people working at a computer, this is the wrong position of the brush while typing or using a mouse. Even at the beginning of the century, the incidence of carpal tunnel syndrome among men and women was the same, but now women suffer from this disease twice as often.

There are various devices for the treatment of the syndrome, for example (information about it in the middle of the article).

Prevention

To prevent the occurrence of carpal tunnel syndrome, it is necessary to pay special attention to measures to prevent pinching of the nerve canal. What is recommended to prevent the onset of the disease?

Hand exercises

As preventive measures carpal tunnel syndrome, three sets of physical exercises can be used.

Complex No. 1:

1. It is necessary to rub and heat the palms inside and out.
2. Take right hand and with the help thumb start with the same hand turn down all other fingers and make four clicks on them. The same steps must be repeated for the left hand.
3. Bring the brushes together with the inner sides, connect the fingers with each other, start pressing the fingers of one hand on the fingers of the other, after the end of the exercise, shake the brushes to relax.
4. Several times as slowly as possible squeeze fists, shake arms.
5. Clench your fists a few more times, while unclenching your fingers sharply outward. Shake your hands after finishing the exercise.

Complex №2:

1. You need to raise your hands up and down again 10 times, then shake your hands.
2. Slowly clench your fists and hold them in a tense position for 10 seconds, repeat several times, then relax your hands with shaking.
3. Stretch straight arms in front of you and within 60 seconds begin to quickly move all your fingers.
4. Perform 10-15 rotations with brushes in both directions.

Complex No. 3:

1. Rotate your finger 10 times in both directions, shake your hands after doing the exercise.
2. Put your palms together and press your fingers against each other.

How to organize your workspace?

To prevent tunnel syndrome or after treatment, it is recommended properly equip your workplace . What should be done first?

1. Set the table to the correct height, it should not be too high so that the brushes are not in a bent position during work and do not sag. The hand should lie flat on the table or armrest.
2. Choosing the right office equipment: a computer mouse should be comfortable in the palm of your hand, there are special models of mice in the form of joysticks for those who have undergone surgery, you should definitely choose a good mouse pad with a special elevation for the hand, it is recommended to buy a keyboard with a slope.
3. When typing texts, the monitor screen should be directly in front of your eyes at a distance of 30 centimeters, so you can pick up a special stand for it.
4. Feet should be flat on the floor, not hanging or on toes. The back is straight. To fulfill these recommendations, you need to purchase a chair with which you can change the height.

At the same time, it is important to take breaks from work every hour and a half and perform at least one set of exercises presented above.

Naturally, in order to prevent any disease, it is necessary to conduct healthy lifestyle of life: give up alcohol and nicotine, start exercising, be mindful of your health and try to reduce your consumption harmful products nutrition.

In this case, it is necessary to monitor the position of the hands: they should be located directly in relation to the forearm, the hand should not be suspended or constantly bent. Recommended maintain correct posture: a right angle should form between the hips and the lower back.

Clinical Research in Prevention

Research is being prepared or is already under way to find ways to prevent and treat carpal tunnel syndrome. One of them is comparative analysis between surgery and improvement clinical picture at conservative methods treatment, magnetic resonance imaging is used for the study, patients are selected with moderate or mild involvement of the carpal nerve.

A second prospective study looks at the benefit of wearing a special bracelet to prevent pinched nerves while working with vibration equipment. All research is currently being conducted in America at the University of California.

Carpal Canal and median nerve

The carpal tunnel is a tunnel that is formed by the carpal bones on one side and the transverse carpal ligament on the other. The tendons of the flexor muscles of the hand and the median nerve pass through this tunnel.

The median nerve is the thickest nerve in the area upper limb. Passing in the area of ​​the carpal canal to the hand, it gives branches to the thumb, index, middle and half of the ring finger. In addition, it innervates the muscles of the thumb. The median nerve, passing through the carpal canal, is located above the tendons of the muscles. The tendons of the flexor muscles are covered with a special sheath - synovial sheaths. In these sheaths, the tendons glide during movement.

Carpal syndrome (carpal tunnel syndrome) is one of the most common diseases of the wrist area. It consists in compression of the median nerve in the area of ​​the carpal tunnel. AT broad sense carpal tunnel syndrome occurs under the condition of a decrease in its size or an increase in the volume of tissues inside it.

Carpal tunnel syndrome occurs under any conditions leading to a decrease in its size or an increase in the tissues inside it, which leads to compression of the median nerve.

Causes of carpal tunnel syndrome include:

Injury to the wrist area, which leads to swelling of the tissues in it, the occurrence of hematomas.

A fracture of the bones in the wrist area is most often a fracture of the radius.

Arthritis of the wrist joint.

Tumors in the carpal canal.

Inflammation in the area of ​​the synovial sheaths of the tendons of the flexor muscles.

Pregnancy, while there is a tendency to swelling of soft tissues.

Diabetes mellitus, which is manifested by pathology peripheral nerves- neuropathy.

Decreased thyroid function.

When the median nerve is compressed, the blood supply to it is disrupted. outer shell and even a complete cessation of blood circulation in it. There is ischemia. In the beginning, only the superficial parts of the nerve are affected. But with prolonged ischemia, the lesion also affects the deep layers of the nervous tissue. As a result, scar tissue forms in the nerve. This causes pain and numbness in the fingers.

Manifestations of carpal syndrome

The manifestations of carpal tunnel syndrome are usually bright. This is accompanied by intermittent or constant numbness in the fingers (and palms), tingling and pain, which are noticeably worse at night. Patients repeatedly wake up at night due to pain, are forced to move and knead their stiff and “stiff” fingers, and put their hands down.

In the morning, there is an increase in these symptoms. During the day, patients experience gradual relief, but even after short overloads, deterioration occurs again. Over time, the discomfort gets worse. Sometimes the pain can radiate up to the shoulder. Numbness first captures one or two fingers, then spreads to all the others, sometimes including the little finger. When raising the arm up, the pain intensifies, which is associated with a deterioration in blood flow.

On examination, you can notice some cyanosis and pasty swelling. When feeling in the palm area, pain is determined.

Diagnosis of carpal syndrome

Diagnosis of carpal tunnel syndrome is mainly based on diagnostic tests. They consist in the artificial induction of ischemia of the median nerve and further evaluation of the manifestations. A certain role in the diagnosis of this pathology can be played by radiography, in the case when this syndrome is a consequence of a fracture of the bones of the forearm. In addition, magnetic resonance imaging is performed.

Treatment of carpal syndrome can be either conservative or surgical.

Conservative therapy

The most popular method of conservative treatment of carpal tunnel syndrome is the use of anti-inflammatory drugs. In mild cases, they are taken in the form of tablets. In severe cases of manifestation of this disease, the so-called steroidal anti-inflammatory drugs (hydrocortisone, kenalog, etc.) are used. Steroid medications are given by injection into the carpal tunnel itself. Usually, two injections are given with an interval of about 2 to 3 weeks. In rare cases, a third injection may be required.

Surgery

In the absence of the effect of conservative treatment, surgical treatment is indicated. The operation for carpal tunnel syndrome consists in decompression, that is, reducing pressure in the area of ​​the carpal tunnel, and, accordingly, reducing compression of the median nerve.

Typically, this operation uses general anesthesia, but under certain conditions, conduction anesthesia can also be used. Several methods have been proposed for performing an incision during this operation. An incision is made on the inner surface of the wrist, about 3-4 cm long. The flexor retinaculum ligament, which is one of the walls of the canal, is necessarily dissected. Next, the contents of the canal are examined, abnormal muscles, tumors, hypertrophied synovial membranes, unusual bone protrusions, fibrous cords constricting the nerve, etc.) are detected and eliminated.

Endoscopic surgery

There is also endoscopic method surgical treatment of this syndrome. It requires a minimal skin incision. A special cannula is used, which is inserted into the carpal canal. The doctor examines the canal and makes sure that there are no nearby blood vessels. then a special scalpel in the form of a hook is inserted through the cannula. With its help, the ligament of the carpal tunnel is dissected and compression of the median nerve is eliminated.

Operational risks and possible complications

As with any surgical intervention, surgical treatment complications of carpal tunnel syndrome may occur.

• Complications associated with anesthesia (for example, allergies and more serious complications).
• Infectious complications - are manifested by pain in the area of ​​​​the surgical wound, redness and swelling. To prevent this complication, postoperative period antibiotics are prescribed.
• Technical errors in the operation - ranging from incomplete dissection of the carpal ligament of the canal to damage to blood vessels and nerves.

• Carpal syndrome - treatment

Carpal tunnel syndrome is pathological condition that results from sedentary office work. Sedentary work can provoke the development various violations, from eye diseases ending with diseases of the musculoskeletal system.

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The site provides background information. Adequate diagnosis and treatment of the disease is possible under the supervision of a conscientious physician. All drugs have contraindications. You need to consult a specialist, as well as a detailed study of the instructions! .

What is carpal tunnel syndrome

Carpal tunnel syndrome is a common neurological pathology.
It is characterized by compression of the median nerve, the appearance of pain and backache in the wrist.

This problem is more often faced by people whose duties include performing routine, monotonous work, which is associated with constant flexion and extension of the hand.

This pathology appears when the tissues that surround the tendons swell and compress the median nerve. These tissues are called synovial membranes. They produce a fluid that lubricates the tendons, facilitating their movement in the sheaths of the tendons.

There are factors that provoke the development of the disease:

• genetic predisposition;
• Hormone imbalance;
• Elderly age;
• Availability systemic diseases, for example, diabetes;
• Profession;
• The presence of addictions: alcohol abuse, smoking;
• Injuries to the wrist, fracture of the hand;
• The presence of neoplasms growing in the area of ​​the carpal tunnel;
• Overweight, obesity.

With a combination of these factors and the constantly repeated load on the hand, chronic inflammation develops. connective tissue, it swells and thickens. At the same time, the amount of fluid produced by the synovial membranes decreases.

Constant friction of the connective tissues of the tendons during hand movements increases their swelling and leads to compression of the median nerve. This nerve contains fibers that provide sensation to the fingers and toes. motor activity thumb.

An increase in pressure between tendon sheaths leads to venous congestion. As a result of these factors, the blood supply to the nerve is disturbed, and this disease develops.

Manifestations of carpal syndrome

One of the first signs of the presence of the disease is numbness in the area of ​​​​the hand. Symptoms can appear at any time, and it does not matter where the person is. You can sit at the computer or lie on the couch, hold an object in your hands or not - it does not matter.

At any time, there may be:

• Pain in the hand;
• Tingling in one or both wrists of varying intensity;
• Feelings of swelling of the fingers;
• Numbness of hands;
• Periodic "lumbago" in the fingers.

Moving the arms or changing their position leads to a decrease in symptoms. At first, the manifestations of the syndrome are not pronounced, they appear and disappear.

Over time, especially if a person does not seek help from doctors and does not take any measures, muscle atrophy may develop.

As the disease progresses, the symptoms will be permanent. Sleep disturbances can join, up to insomnia.

Weakness and awkwardness provokes a restriction in performing the simplest daily manipulations. It is difficult for a person to tie shoelaces or button a jacket. In the future, this is reflected in the work.

Video

Diagnosis of compression of the median nerve

To quickly eliminate the pathology, you need to see a doctor.
A neurologist will conduct a survey and examination.

To additional methods surveys include:

• Electroneuromyography;
• X-ray of the wrist joint;
• Magnetic resonance imaging.

Seeing a doctor at the first signs of the syndrome helps to identify the disease as soon as possible and recover.

Medical treatment of the disease

It will take a long time to treat this disease.

To eliminate the causes of carpal tunnel syndrome, groups of drugs are prescribed:

• Anti-inflammatory;
• Decongestants;
• painkillers;
• Corticosteroids.
• Diuretic to reduce swelling.

Medicines are sufficient for full recovery, but only if the appeal to a specialist was timely. To get rid of carpal tunnel syndrome, in addition to treatment, a change in occupation will be required.

How to treat a disease with folk remedies

The methods of traditional medicine will be effective and efficient only if they are in addition to the traditional drug treatment.
Without drugs, folk remedies will bring temporary relief.

No need to self-medicate.
Before using non-official medicine, consult your doctor.

Healing tincture will help in eliminating the pathology

You will need a few pickles and vodka or rubbing alcohol. Grind the cucumbers, combine them with chopped red pepper, mix well. Fill the mass with 500 milliliters of vodka. Put the container in the cold for fourteen days.

Filter the remedy and rub it into the affected area. This medicine helps to normalize blood circulation and eliminate swelling.

wild rosemary

Pour the dried crushed twigs of the plant apple cider vinegar. Seal the container tightly and leave for seven days in a cool, dry place. Rub this medicine on your fingers.

Pumpkin will help in healing

Cut the pumpkin into small pieces, pour the raw materials into an enameled pan, fill with water and put on fire. Bring to a boil, cool slightly and crush the raw materials to a mushy state.

Apply the finished gruel to the affected area, wrap it with compression paper on top and secure with a bandage. These warming procedures must be done once a day. The duration of treatment is seven days.

The use of salt and ammonia

Dilute a spoonful of table salt in two hundred milliliters of boiled, slightly cooled water. Combine this solution with ammonia and camphor alcohol.

Mix all the ingredients well and treat the affected joint with this remedy before going to bed. The medicine helps to eliminate pain and numbness.

Black pepper and vegetable oil

Pour 100 grams of ground black pepper with a liter of vegetable oil. Put the composition on fire, wait for it to boil.

Simmer over low heat for thirty minutes. Cool the product and rub it into sore fingers 2 times a day.

Parsley will relieve puffiness

Grind parsley rhizomes and brew 20 g of raw materials in three hundred milliliters of boiled water. Remove the container with the composition in the cold for ten hours. Take a sip of the medicine every 2 hours.

Preparation of a diuretic

Dry and chopped birch leaves, about 15 grams, brew in two hundred milliliters of boiled water. Infuse the product in a dark, cold room for 4 hours. Consume 1/3 cup of the infusion four times a day.

Surgical intervention for pathology

When all attempts to control and reduce symptoms have been in vain, surgery is performed to relieve pressure on the median nerve.

There are several different methods for reducing pressure.

But they have one thing in common - the restoration of the blood supply to the nerve and the improvement of the patient's condition.

Open surgery is one of the most common and effective. During surgery, an anesthetic is used, which provokes a blockage of the nerve of a certain part of the limb. A small incision is made in the palm of the affected limb, usually no more than five centimeters.

In the surgeon's incision, palmar fixation can be seen. The transverse ligament of the wrist is cut.

Stitched only skin covering, and the ends of the bundle remain free. This results in less pressure on the nerve. Gradually, the scar tissue fills the space between the two ends of the ligament.

Such a surgical intervention is performed on an outpatient basis, and after it is completed, the patient can go home. The operation is effective and after 3-4 weeks the patient feels a noticeable improvement.

After surgery, it is important not to strain the arm and limit activities that require repetitive movements.

If you suddenly feel a slight backache or numbness of a limb, you may be developing carpal syndrome. Contacting a specialist early stage will eliminate the disease without resorting to surgery. If left untreated, the consequences will be deplorable, up to the complete loss of limb performance.

Nutrition Features

It is possible to get rid of pathology only with medical treatment or surgical intervention. But for treatment and postoperative rehabilitation gave results, you still need to choose the right nutrition.

The carpal tunnel is located on the wrist, which is surrounded by a large number of bundles fibrous tissue. These same bundles perform a supporting function for the joint. And most of all, calcium helps for healthy joints and tendons. AT daily diet for carpal tunnel syndrome, calcium-fortified foods, fresh vegetables and fruits should be included.

Here is a sample list of such products:

• Sour-milk (cottage cheese, kefir, yogurt, cheese, etc.);
• Pumpkin Dishes;
• Lean fish;
• Legumes, cereals, pasta.

In addition to these products, it will be useful for such a pathology to consume more ice cream, 100 grams of it contains up to 200 mg of calcium.

And it will be useful for such patients to often use pizza with cheese and tomatoes, because with such ingredients, up to 800 mg of a substance necessary for the joints was found in its composition.

Meals should be 4 or 5 times a day, that is, eat food in small quantities and often, so as not to overload the stomach. Now, let's talk about an approximate diet:

1. Breakfast - pumpkin porridge, a sandwich with cheese and sausage, tea with lemon.
2. The second breakfast is kefir, oatmeal cookies and some fruit.
3. Lunch - cabbage soup from fresh white cabbage, boiled pasta with any low-fat fish, fresh vegetable salad, dried fruit compote, 1 orange.
4. Snack - medium-fat cottage cheese, kefir.
5. Dinner - boiled potatoes with fish cake, cheesecake with pumpkin, compote of fresh berries and any fruit.

And remember that with such a problem, food should contain as little salt as possible. Highly salty food retains water in the body, which leads to swelling of the limbs - and the carpal region.

Gymnastics, massage, physiotherapy

If a person has a problem with the wrist, then the doctor, in addition to medication or surgery, may prescribe courses of exercise therapy, massage or physiotherapy.

The task of such methods of treatment is to restore the function of joint mobility, to give strength to atrophied muscles.

It happens that therapeutic exercises are prescribed together with electrical stimulation. Let's talk about some gymnastic exercises of 2 recovery stages.

First stage:

1. We place our hand on the table. We make quick flexion and extension movements with all fingers, and then the same thing, only with each finger.
2. Place your hand on the table surface. We hold the proximal phalanx in one position, the phalanx with a healthy hand, then quickly bend and unbend the interphalangeal joints.
3. We focus with our elbows on the surface of the table, the hands are pressed together and directed upwards. We bring and spread our fingers, but we help with a non-sick hand.
4. With fingertips we reach different points the same palm.
5. In the next exercise, you need to try to grab objects of different sizes with the fingers of a sore hand.
6. With the fingers of a sore hand, roll a small ball on the table in different directions.

All these exercises should be done slowly and repeated up to 8 times.

This gymnastics can be done in the pool, the arm to the shoulder should be completely immersed in water.

The second stage of gymnastic classes:

1. We make finger clicks on various objects, for example, on a soft pillow, a tree, a ball, and so on.
2. We stretch the rubber bands on the fingers.
3. We throw or catch a small ball with the fingers of a sore hand.
4. Throw up the balls.

And in order for such exercises to give the best result, you need to bandage your hand before going to bed. This ensures a quick recovery, facilitating the labor process up to full recovery joint performance.

And well during carpal tunnel syndrome, brush massage helps.

It is held:

1. First, put your hand in a relaxed position on the table, inside up. We touch with two fingers of a healthy hand to the place where the pulse is felt, and slowly tap, and then we grab this place with a healthy hand and make small turns.
2. We place our hand on the table to the very elbow and stroke it with gentle movements, first with outside, and then from the inside.
3. Then you need to hang your sore hand off the table a little, grab it with a healthy one and make quick circular motions in different directions.
4. We place the hand on the table with the outer side up and make it with the index and middle fingers of a healthy hand.
5. Then we hold the hand in the same position and make small tingling over the entire surface of the hand.
6. At the end of the massage, gently stroke the hand on both sides.

Besides massage and gymnastic exercises, the attending physician sometimes prescribes physiotherapy, which is selected for each individual patient, given the neglect of the disease and the nature of the nerve damage.

Such treatment can be carried out by magnetotherapy, laser therapy, interference pulsed currents, ultrasound, manual therapy. Physical therapy, of course. good way get rid of such a problem, but it is far from suitable for all people, due to the effect on the skin of various devices, some patients often develop allergies.

Consequences and complications

The disease does not pose a great danger to human life. But, if a person’s wrist hurts for a long time, then this leads to a complete loss of strength and sensitivity in it.

Only proper treatment and daily activities can improve the functioning of the hand.

And as a consequence of this disease, there can only be severe damage to the median nerve and disruption of the hand.

Prevention of pathology

1. Make a suitable desktop height. The normal height of the table should coincide with the level of the armrests of the chair, the forearms during work should lie on the armrests, and not hang.
2. Create the desired height of the monitor so that the text being read or written is at eye level. If the monitor is very low, then you will constantly lower your head, and if the monitor is very high, on the contrary, you will raise your head. This will strain the muscles of the neck excessively, which will worsen blood circulation in the cervical region of the spine, worsening blood circulation in the hands.
3. When working at a computer, sit with your back fully touching the back of a chair or armchair and your shoulders relaxed. Sit relaxed, do not pull your head into your shoulders.
4. Use only a comfortable mouse and keyboard. Choose a small computer mouse so that it is completely covered by your hand. And the keyboard should be with a stand so that the keys on it are slightly raised. Joystick-style computer mice are commercially available and are great for people with this wrist problem. Mice do not load the hand at all.

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Carpal tunnel syndrome (CTS) is caused by nerve compression and irritation in the wrist, resulting in pain, numbness, tingling, and/or weakness in the wrist and hand. Repeated sprains and fractures, unusual wrist anatomy, arthritis, and certain other medical conditions can reduce the space in the carpal tunnel, thereby increasing the risk of CTS. From accompanying symptoms you can often get rid of at home, but sometimes for complete cure medical assistance is required.

Steps

Part 1

Try not to pinch the median nerve. The carpal tunnel is a narrow tunnel made up of small carpal bones connected by ligaments. This channel protects the nerves, blood vessels and tendons. The main nerve responsible for the movement of the palm and its sensitivity is called the median. Therefore, activities that compress and irritate the median nerve should be avoided, such as frequent flexing of the wrist, lifting heavy objects, sleeping with crooked wrists, and punching hard surfaces.

• Watch to wrist watch and the bracelets were loose enough on the wrist - if they were too tight around the wrist, it could irritate the median nerve.
• In most cases of CTS, it is difficult to identify a single cause. Typically, CTS is caused by a combination of factors, such as frequent wrist strain combined with arthritis or diabetes.
• The anatomy of the wrist can also contribute - in some people, the bones of the carpal tunnel at the same or not quite the right shape.

1. Stretch your wrists regularly. Stretching your wrists daily can help reduce or eliminate the symptoms of CTS. In particular, stretching the wrists helps expand the median nerve space within the carpal tunnel by stretching the ligaments surrounding the carpal tunnel. The best way to stretch both wrists at the same time is to assume the “prayer pose”. Place your palms together at a distance of about 15 cm from your chest and raise your elbows until you feel a stretch in both wrists. Hold this position for 30 seconds, then lower your elbows again. Repeat the exercise 3-5 times a day.

   Shake your palms. Feeling numb or aching pain in one or both palms (or wrists), shake them well for 10-15 seconds, as if shaking off water from them. In this way, you will achieve a quick, albeit temporary, improvement. This shaking will increase blood circulation and improve blood flow to the median nerve, causing symptoms to temporarily disappear. You can do this exercise, which helps fight the symptoms of CTS, many times a day, literally taking a few seconds off your work.

   • Symptoms of CTS most often appear (and first appear) in the thumb, index and middle fingers, and part of the ring finger. This is why CTS sufferers seem clumsy and often drop objects.
   • Only the little finger is not affected by CTS symptoms, since it is not associated with the median nerve.

2. Wear a special wrist support bandage. This semi-rigid bandage or splint will help avoid symptoms of CTS throughout the day by keeping the wrist in a natural position and preventing it from bending too much. A wrist splint or bandage should also be worn during activities that can aggravate CTS symptoms, such as working at a computer, carrying heavy bags, driving a car, or playing bowling. Wearing a supportive bandage while you sleep can help prevent nighttime symptoms, especially if you have a habit of slipping your palms under you while you sleep.

   • You may need a support bandage for several weeks (day and night) in order to noticeably reduce the symptoms of CTS. However, in some cases, the supporting bandage has a negative effect.
   • Wrist splints are also helpful if you have CTS and are pregnant, as your hands (and feet) are more likely to swell during pregnancy.
   • Support bandages and wrist splints can be purchased at a pharmacy or health supply store.

3. Consider changing the position in which you sleep. Certain positions can significantly aggravate the symptoms of CTS, reducing sleep duration and quality. The worst posture is one in which your fists are tightly clenched and/or your palms (with arched wrists) are tucked under your body; the posture in which the hands are above the head is also unfavorable. Instead, try to sleep on your back or on your side with your arms close to your body, with your wrists straight and your palms open. Such a posture will ensure normal blood circulation in the wrists and blood supply to the median nerve.

   • As noted above, using supportive bandages while you sleep helps prevent misalignment of the hands and wrists, but it will take some time to get used to.
   • Don't sleep on your stomach with your hands under the pillow, as this will compress your wrists. Sleeping in this position, people upon awakening often experience numbness and tingling in the palms.
   • Most wrist bands are made of nylon and fasten with Velcro, which can irritate your skin. In this case, place a sock or piece of thin cloth under the bandage to reduce skin irritation.

4. Take a look at your workplace. In addition to poor sleep posture, CTS symptoms can be caused or exacerbated by poor workplace layout. If a computer keyboard, mouse, desk, or chair is placed inappropriately and inconsistently with your height and build, it can put strain on your wrists, shoulders, and mid-back. Make sure the keyboard is positioned so that you don't have to bend your wrists all the time while typing. Get an ergonomic keyboard and mouse designed to reduce the strain on your hands and wrists. Your employer may reimburse the costs.

   Take over-the-counter medications. The symptoms of CTS are often associated with inflammation and swelling in the wrist, which further irritates the median nerve and adjacent blood vessels. Therefore, non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil) or naproxen (Aliv) often help reduce symptoms of CTS, at least in the short term. Pain relievers such as paracetamol (Tylenol, Panadol) can also be taken to relieve pain caused by CTS, but they do not reduce inflammation and swelling.

   Part 2

   Medical care for CTS

   1. Make an appointment with a doctor. If you experience any of the symptoms listed above in your wrist/hand for several weeks or more, you should see a doctor. The doctor will examine you and probably prescribe x-ray examination and a blood test to rule out possible diseases and lesions whose symptoms resemble CTS, such as rheumatoid arthritis, osteoarthritis, diabetes mellitus, a stress fracture in the wrist, or problems with the blood vessels.

      See a physical therapist or massage therapist.

      Try corticosteroid injections. To relieve pain, inflammation, and other symptoms of CTS, your doctor may recommend injections of a corticosteroid medication (such as cortisone) into your wrist or the base of your hand. Corticosteroids are a powerful and fast-acting drug that can relieve swelling in the wrist and relieve pressure on the median nerve. They can also be taken orally, but this is considered to be much less effective than injections and also causes more severe side effects.

      • In the treatment of CTS, other steroid drugs such as prednisone, dexamethasone, and triamcinolone.
      • Corticosteroid injections can lead to complications such as local infection, profuse bleeding, tendon weakening, muscle atrophy and nerve damage. Therefore, they are usually made no more than twice a year.
      • If steroid injections do not lead to a significant improvement in the condition, surgery should be considered.

   2. Carpal tunnel surgery should be considered as a last resort. If other treatments have failed to relieve the symptoms of CTS, a doctor may recommend surgery. Surgery is only used as a last resort because there is a risk of worsening the condition even more, although for many patients, surgery helps to completely eliminate the symptoms of CTS. The purpose of this operation is to relieve pressure on the median nerve by cutting the main ligament pressing on it.

1. Vitamin B12. Useful for increasing the body's defenses, reducing paresthesia and chilliness.
2. Vitamin B6. Restores nerve fibers, reducing swelling in the joint area and pain symptoms.
3. Vitamin With. It has an anti-inflammatory and firming effect, enhances the effectiveness of B vitamins.
4. Vitamin D3.
5. Vitamin E.

The most popular complexes:

• "Dihydroquercetin Plus" - contains a valuable natural antioxidant - dihydroquercetin , obtained from the bark of Siberian larch. As part of the drug, the action of dihydroquercetin is enhanced by vitamin C and vitamin E, the combined action of which helps to restore blood microcirculation in the affected area of ​​the hand and wrist.

• "Osteovit" - contains vitamin D3 and drone brood. D3, when combined with B6, is involved in the mineral metabolism of the body.

3. Local treatment- injection of drugs into the joint

Direct injection of the drug into carpal tunnel - most effective method treatment of carpal syndrome. To do this, a mixture of painkillers Lidocaine and Novocaine with the addition of corticosteroids is injected into the carpal tunnel with a special long needle. Most often, after the introduction of the drug into the cavity, the pain will disappear.

In some cases, it may intensify, but after a day or two pass completely. The course of treatment is up to three weeks and consists of two injections.

If the pain syndrome does not go away completely, then the procedure is repeated with a two-week interval.

4. Non-drug treatment

Apart from medical method effects, doctors use other techniques to achieve good results. As the most common, we can note such options for exposure as: acupuncture, manual therapy and yoga.

5. Treatment of the disease that led to the syndrome

In order for the treatment to be really effective, you should first take care of ridding the patient of the diseases that caused the carpal syndrome (if any). Otherwise, the applied methods will not give any results, and a relapse may occur. Each type of pathology will require individual treatment:

• Treatment of rheumatoid diseases associated with lesions of the hand joint;
• Hypothyroidism involves hormone replacement therapy;
• With menopause is assigned hormone therapy, but provided that the woman is not yet 60 years old and the last menstruation was no later than 10 years ago;
• At diabetes a treatment is used that is aimed at preventing sugar surges in the patient;
• Chronic kidney failure involves helping the patient to improve the process of removing fluid from the body or the end products of protein metabolism;
• At high blood pressure HMF inhibitors are used.

6. Physiotherapy

IMPORTANT: This technique cannot be used for people with contraindications (oncology, heart failure, pregnancy and other problems).

Various procedures are prescribed as physiotherapeutic treatment, for example, electrophoresis or local cryotherapy.

7. Ultraphonophoresis

The procedure is carried out in conjunction with drugs and is a technique in which special ultrasonic vibrations affect the body. This leads to better penetration of drugs into cells, and also allows you to accelerate the flow of blood in the capillaries. With this treatment of the carpal canal, the vessels expand, pain disappears and swelling subsides. As medicinal product dimexide is used.

The procedure is aimed at reducing pain and inflammation in the treatment of carpal tunnel syndrome. One session takes up to 30 minutes, and the treatment course is 8-12 sessions.

8. Shock wave therapy

This method of treating carpal tunnel syndrome has established itself as a fairly effective and proven technique.

UVT has a complex effect on the whole body and promotes break down calcium deposits and uric acid , which narrow the channel at rheumatic diseases. The therapy has a positive effect on the blood supply to the affected area, allowing you to remove swelling and save the patient from pain.

Surgery

Surgery is recommended only when all other methods have failed. Surgery required in case when the form of carpal syndrome is advanced, and the patient has persistent relapses or muscle atrophy.

The operation is a dissection of the carpal ligament, and in some cases, excision of scar tissue. Surgical intervention may be open or endoscopic. The second option is more sparing technique, after which the scar is practically absent.

With an open intervention, the surgeon gets full access to the damaged area, which gives more opportunities to eliminate pressure on the carpal canal.

Such an operation is not considered difficult, so the likelihood of complications is minimal.

As a result of numerous operations, experts came to the conclusion that it is worth giving preference to endoscopic technique under local anesthesia. This approach requires less time for the rehabilitation of the patient.

Diet

Proper nutrition with carpal tunnel syndrome is very important for the patient, because it will make up for the lack of vitamins, minerals and essential trace elements. It is best to supplement the menu with products rich in calcium and vitamin B. This will strengthen the bones and nervous tissue. Fast food should be excluded from the menu, all fatty, fried, spicy and overly salty.

Treatment at home

If you diagnose the problem in a timely manner and start treatment at home, then it is quite possible to exclude the development of irreversible complications. In addition to the methods described, doctors recommend that patients engage in special therapeutic gymnastics for hand training. Excellent results gives a trip to the pool. It is important that the water is warm and covers the entire limb up to the shoulder. Also, experts recommend do yoga, or other types medical techniques aimed at developing the joint.

Even if there are mild symptoms of carpal syndrome, it is important to stop doing the work that caused the disease.

This alone will give you much more than all the pills, believe me. If you work at home (for example, at a computer) and you have problems with the carpal tunnel, break off. Do something that relaxes the tension in the channel:

• Wash the dishes. warm water wonderfully relaxing.
• Do a wet cleaning of the floor. Be sure to use your hands and warm water.
• Wash windows.

And be sure to do regular physical exercise which strengthen the joint and muscles of the wrist.

Folk remedies

Before turning to folk medicine, you should first visit an experienced doctor. Only he will be able to advise on this or that folk recipe. Folk remedies may not give the desired result or even cause complications. If folk recipe can really help, it's worth a try. The most famous are:

1. Tincture from a string. A composition of string, burdock leaves, hop cones, birch leaves, verbena and elder flowers should be brewed in a thermos and infused for 2-3 hours, and then taken 150 ml four times a day.
2. White clay. Dilute white clay water, transfer the gruel to gauze and apply to the affected area of ​​\u200b\u200bthe wrist.
3. Make a compress from fresh goat's milk.
4. Tincture of cucumber and wild rosemary. Grind 2-3 red peppers and 3 cucumbers in a blender, add half a liter of water and let it brew for about a week. Rub her wrist: the tincture will improve blood circulation and relieve the feeling of numbness in the fingers.
5. pumpkin compress. Turn the pumpkin into a mushy state and apply on the wrist, wrapped in cellophane.
6. Sea ​​buckthorn. Grind the berry, pour water and heat. Soak your hands in the broth, then be sure to wipe them so that they do not cool down.
7. Pepper rub. Pour 150 grams of pepper vegetable oil and simmer over low heat for half an hour. Once cool, rub into wrist.