In medicine, a group of disorders of the peripheral nerves due to prolonged compression or traumatic consequences in musculoskeletal channels called tunnel neuropathies or syndromes. The most common of the tunnel neuropathy is carpal tunnel syndrome, which can be described as a compression of the median nerve under the transverse carpal ligament. It takes between three walls bone and ligaments that hold the tendons that bend the wrist and fingers.
Causes of carpal tunnel syndrome
According to various statistics, carpal tunnel syndrome is found among the female population of the planet is 3-10 times higher than among men. It is known that although the disease occurs in different age groups, the majority of cases occur in people aged 40 to 60 years. It should also be noted that this pathology is characterized by predominantly Caucasian race, and among some African nations, it almost does not occur.
Perhaps this is due to the fact that the main cause of carpal tunnel syndrome are a variety of situations that provoke inflammation and swelling in muscles, tendons and joints of the tunnel. It is the job of the typewriter, long-term training on the piano, and, of course, a computer. That is why this pathology is also informally known as the syndrome of a computer mouse. In fact, the cause of the disease can be any work that requires frequent repeated movements.
Among other causes of carpal tunnel syndrome are the following, the most common:
- Various rheumatic conditions that affect the area of the wrist and hand, leading to chronic inflammation (eg rheumatoid arthritis);
- Pregnancy, especially in the last stages;
- Use of oral contraceptives (as in the case of pregnancy, can promote fluid retention, and hence swelling of hands);
- The swelling of the median nerve;
- All kinds of forearm and hand injuries, such as fractures, bruises and sprains;
- Abnormal increase of the hands, called acromegaly;
- Endocrine disorders (eg, thyroid disease, diabetes, early menopause, and so on. D.);
- Diseases of internal organs (e.g., kidney failure);
- Other activities that require the capture and regular strong compression of the wrist.
Experts often point out the relationship between the aggravation of carpal tunnel syndrome and cold time of the year, which suggests that hypothermia also contributes to the development of the disease.
Symptoms of carpal tunnel syndrome
The symptoms of carpal tunnel syndrome is quite specific, so that it is sometimes possible to easily determine the presence of the disease in man. The most common ones are the following:
- Tingling, burning and pain in the hands and arms;
- Gradual loss of sensation and numbness in the wrist;
- Movement disorders;
- Signs of microcirculation disturbances wrists.
Pain in the early stages of carpal tunnel syndrome is usually observed in the deep tissues of the index and middle fingers. The pain is dull and aching, often turning to the hand and forearm. In most cases, it is accompanied by numbness of the skin of the fingers and hands, especially in the morning the day after waking up.
Often numbness leads to a significant reduction or even total loss of pain sensitivity in a first region of palms, and then throughout the hand. Several hours later, a condition usually passes. You can also put your hands down and move your fingers: it helps to eliminate the discomfort for a while.
The following symptoms of carpal tunnel syndrome are the gradual movement disorders. As the disease becomes difficult to keep the man in the hands of even small objects, and the strength of their capture by using a brush thumb is markedly reduced.
Violation microcirculation in the hands is another common symptom of carpal tunnel syndrome. They appear primarily by vasospasm. This is due to the pallor of the skin of hands of patients, its bluish and cooling, which can be checked by touch. In addition, violation of microcirculation leads to an increase or decrease in sweating in people with carpal tunnel syndrome, as well as malnutrition skin and nails, which is manifested worsening of their appearance.
Diagnosis and treatment of carpal tunnel syndrome
Besides these symptoms, it can be determined by using some diagnostic tests. Test flexion and extension helps detect the presence of the syndrome follows. In a healthy person's hand at maximum flexion or extension may be about a minute. However, patients with this disorder during this time observed near pricking fingers.
Test Tinnelya based on tapping on the field of the tunnel, which causes pain and tingling in the fingers. However, it is effective in cases of severe symptoms.
Treatment of carpal tunnel syndrome can be divided into surgical and conservative, depending on the severity of the disease. Conservative treatment can be divided into three groups:
- Restriction of movement;
- Treatment medicines.
Restriction of movement implies a state of rest in the brush area of the patient for a long time. Sometimes you need to be sanctioned by the tires on the wrist.
Physiotherapy aims to create a magnetic field. Such treatment of carpal tunnel syndrome is often used acupuncture, which restores metabolism in the damaged tissues.
Drug treatment often involves the use of nonsteroidal anti-inflammatory drugs for pain management, administration of glucocorticoids and use of diuretics to relieve swelling and inflammation. In addition, if carpal tunnel syndrome is often prescribed drugs that restore microcirculation and function of the median nerve.
Surgery is used when conservative treatment fails. It usually consists in the dissection of the transverse carpal ligament, thus relieving pressure on the median nerve and tendons as well as to restore normal tissue microcirculation brush.