What are the key differences between carpal tunnel syndrome and arthritis in hands. How can you distinguish between these two conditions that cause hand pain. What are the most effective treatments for carpal tunnel and arthritis.

The Anatomy of Hand Pain: Carpal Tunnel Syndrome vs. Arthritis

Hand pain can significantly impact our daily lives, making simple tasks challenging and uncomfortable. Two common culprits behind this discomfort are carpal tunnel syndrome and arthritis. While both conditions can cause pain in the hands and wrists, they have distinct causes, symptoms, and treatments. Understanding these differences is crucial for proper diagnosis and effective management.

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm to the hand through a narrow passageway called the carpal tunnel, becomes compressed. This compression leads to various symptoms, including:

• Tingling and numbness in the fingers and hand
• Weakness in the hand and a tendency to drop objects
• Pain that may extend from the wrist up the arm
• Discomfort that often worsens at night

What Causes Arthritis in Hands?

Arthritis, on the other hand, is an inflammatory condition affecting the joints. There are several types of arthritis that can affect the hands, with osteoarthritis and rheumatoid arthritis being the most common. Symptoms of arthritis in the hands include:

• Joint pain and stiffness
• Swelling and warmth around the affected joints
• Decreased range of motion
• Joint deformity in advanced cases

Distinguishing Features: How to Tell Carpal Tunnel from Arthritis

While both conditions can cause hand pain, there are several key differences that can help distinguish between carpal tunnel syndrome and arthritis:

Location of Pain

Carpal tunnel syndrome typically affects the thumb, index, middle, and half of the ring finger. Arthritis can affect any joint in the hand, including the knuckles and the base of the thumb.

Nature of Symptoms

Carpal tunnel syndrome often causes tingling, numbness, and a “pins and needles” sensation. Arthritis primarily causes pain, stiffness, and sometimes a grinding feeling in the affected joints.

Onset and Progression

Carpal tunnel symptoms often start gradually and may come and go initially. Arthritis symptoms tend to develop slowly over time and may be more constant.

Diagnosis: Identifying the Root Cause of Hand Pain

Accurate diagnosis is crucial for effective treatment. Healthcare providers use various methods to determine whether a patient is suffering from carpal tunnel syndrome or arthritis:

Physical Examination

A doctor will examine the hand, checking for swelling, warmth, tenderness, and range of motion. They may also perform specific tests to assess nerve function and joint health.

Imaging Tests

X-rays, MRI, or ultrasound may be used to visualize the structures within the hand and wrist. These can help identify joint damage characteristic of arthritis or nerve compression indicative of carpal tunnel syndrome.

Nerve Conduction Studies

These tests measure how well the median nerve is functioning and can help confirm a diagnosis of carpal tunnel syndrome.

Treatment Approaches: Managing Carpal Tunnel and Arthritis

The treatment strategies for carpal tunnel syndrome and arthritis differ significantly, reflecting their distinct underlying causes:

Carpal Tunnel Syndrome Treatments

1. Wrist splinting to keep the wrist in a neutral position
2. Non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief
3. Corticosteroid injections to reduce inflammation
4. Physical therapy exercises to improve nerve gliding
5. Surgical release of the carpal tunnel in severe cases

Arthritis Treatments

1. Pain management with NSAIDs or other pain relievers
2. Disease-modifying antirheumatic drugs (DMARDs) for rheumatoid arthritis
3. Joint protection techniques and assistive devices
4. Physical and occupational therapy
5. In severe cases, joint replacement surgery

Prevention Strategies: Reducing the Risk of Hand Pain

While not all cases of carpal tunnel syndrome and arthritis can be prevented, certain strategies may help reduce the risk or severity of these conditions:

Carpal Tunnel Prevention

• Maintain proper posture and ergonomics when using computers or performing repetitive tasks
• Take frequent breaks and perform hand and wrist stretching exercises
• Use tools designed to reduce strain on the wrists
• Maintain a healthy weight to reduce pressure on the wrists

Arthritis Prevention

• Maintain a healthy weight to reduce stress on joints
• Engage in regular, low-impact exercise to keep joints flexible
• Protect joints from injury during sports and other activities
• Eat a balanced diet rich in anti-inflammatory foods

Living with Hand Pain: Coping Strategies and Lifestyle Adjustments

Regardless of whether you’re dealing with carpal tunnel syndrome or arthritis, there are several strategies that can help you manage your condition and improve your quality of life:

Adaptive Techniques and Tools

Using ergonomic tools and learning new ways to perform daily tasks can help reduce strain on your hands and wrists. For example:

• Use jar openers and electric can openers to reduce twisting motions
• Opt for pens with larger grips to reduce writing strain
• Consider voice-to-text software to reduce typing

Stress Management

Stress can exacerbate both carpal tunnel syndrome and arthritis symptoms. Incorporating stress-reduction techniques into your daily routine can be beneficial:

• Practice mindfulness meditation
• Engage in gentle yoga or tai chi
• Ensure adequate sleep and rest

When to Seek Medical Attention: Red Flags for Hand Pain

While some hand discomfort can be managed at home, certain symptoms warrant immediate medical attention. Seek help if you experience:

• Sudden, severe pain in your hand or wrist
• Visible deformity of the hand or fingers
• Complete loss of sensation in any part of your hand
• Inability to perform basic hand functions like gripping or pinching

Early intervention can prevent long-term complications and improve treatment outcomes for both carpal tunnel syndrome and arthritis.

Future Perspectives: Advancements in Hand Pain Treatment

Research into carpal tunnel syndrome and arthritis continues to evolve, offering hope for improved treatments and management strategies:

Carpal Tunnel Syndrome Innovations

• Minimally invasive surgical techniques for faster recovery
• Nerve regeneration therapies to improve nerve function
• Advanced ergonomic designs for work and home environments

Arthritis Research Developments

• New biologic therapies targeting specific inflammatory pathways
• Stem cell treatments to regenerate damaged cartilage
• Personalized medicine approaches based on genetic profiles

As our understanding of these conditions grows, so too does our ability to provide more effective and personalized treatments.

Empowering Patients: The Importance of Self-Advocacy in Hand Health

Whether you’re dealing with carpal tunnel syndrome, arthritis, or another form of hand pain, being an active participant in your healthcare is crucial. Here are some ways to advocate for your hand health:

Keep a Symptom Journal

Tracking your symptoms, their severity, and any triggers can provide valuable information to your healthcare provider. Note details such as:

• When symptoms occur and how long they last
• Activities that seem to worsen or alleviate symptoms
• Any changes in your symptoms over time

Ask Questions and Seek Clarification

Don’t hesitate to ask your healthcare provider questions about your condition, treatment options, and prognosis. Some important questions to consider:

• What is the likely cause of my hand pain?
• What are my treatment options, and what are the pros and cons of each?
• How can I manage my symptoms at home?
• What should I do if my symptoms worsen?

Explore Complementary Therapies

While traditional medical treatments are crucial, some patients find relief through complementary therapies. Always discuss these options with your healthcare provider before trying them:

• Acupuncture for pain relief
• Massage therapy to improve circulation and reduce muscle tension
• Herbal supplements with anti-inflammatory properties

Remember, what works for one person may not work for another, so it’s important to find the combination of treatments that works best for you.

The Psychological Impact of Chronic Hand Pain

Living with chronic hand pain, whether from carpal tunnel syndrome or arthritis, can have significant psychological effects. It’s important to address these aspects of your health as well:

Depression and Anxiety

Chronic pain can lead to feelings of frustration, helplessness, and even depression. If you’re experiencing these emotions, consider:

• Talking to a mental health professional
• Joining a support group for people with similar conditions
• Practicing relaxation techniques like deep breathing or progressive muscle relaxation

Body Image and Self-Esteem

Visible changes to your hands, particularly with arthritis, can affect your self-image. Strategies to cope with these changes include:

• Focusing on what your hands can do, rather than how they look
• Exploring new hobbies or activities that showcase your abilities
• Seeking support from loved ones or a therapist to work through these feelings

By addressing both the physical and emotional aspects of hand pain, you can develop a more comprehensive approach to managing your condition and improving your overall quality of life.

Is It Carpal Tunnel or is it Arthritis?

October 06, 2017

If you are having pain in one or both hands, you may be wondering if carpal tunnel syndrome or arthritis are causing you pain. While both conditions can cause pain, there are several key differences between the two. Carpal tunnel syndrome can cause weakness, tingling, or numbness in the hand. Arthritis can also cause pain and make it difficult to grasp things, but for completely different reasons. Carpal tunnel syndrome is caused by nerve compression and arthritis is caused by inflammation and damage to the joint.

Carpal Tunnel Versus Arthritis

If you have ever had a hand or leg “go to sleep” because of pressure that temporarily cuts off the blood supply, you can get an idea of what carpal tunnel can feel like. The prickling, burning sensation can be similar to the numbness caused by compressing the median nerve, which runs in a narrow tunnel like structure formed by the bones and connective tissues from the elbow to the hand. The tendons and median nerve allow the fingers of your hand to flex and extend.

The median nerve carries impulses to and from the palm side of your hand to the index, middle, and ring fingers, as well as your thumb. If the tissues of the tunnel are irritated (often by stress caused by repetitive movements such as typing), they can swell and place pressure on the nerve.

Arthritis of the hand, however, is caused by a different mechanism, often showing up with a specific pattern in the way it attacks the joints. In the case of arthritis, the lining (synovium) of the joint itself becomes inflamed. This can occur because of osteoarthritis (also called wear and tear arthritis), or other inflammatory processes caused by a defect in the immune response, in which the body attacks otherwise healthy tissue. The symptoms of arthritis include stiffness and soreness of the joint, and frequently starts with the smaller joints of the hands.

Treatments for carpal tunnel and arthritis are also very different. Anti-inflammatory medications can help both. Rest and bracing can also help carpal tunnel, but it is not usually effective with arthritis. Carpal tunnel syndrome can often be relieved by surgery. Except for partial and joint replacement, surgery is not usually considered as a standard treatment for arthritis. Treatment for arthritis usually includes medications, exercise, and rehabilitation. Carpal tunnel may include rest, anti-inflammatory medications, surgery, exercise, and rehabilitation.

If you, or a loved one has carpal tunnel syndrome or any form of arthritis, or you would like more information about treatments for carpal tunnel or arthritis, or to schedule an appointment, please contact Orthopaedic Associates at (440) 892-1440 today.

The Difference between Arthritis and Carpal Tunnel

You rely on the use of your hands for almost everything you do on a daily basis. But when you have constant pain and discomfort in your hands and wrists, these simple tasks become more difficult and uncomfortable.

Two big culprits of this type of pain are carpal tunnel syndrome and rheumatoid arthritis (RA) – conditions infamous for the pain and discomfort they cause in hands and wrists. Because they both lead to a similar type of pain, they can be easily confused. However, these conditions aren’t related. Carpal tunnel syndrome and RA are distinctly different when it comes to their causes and how they’re treated.

What is Carpal Tunnel Syndrome?

The carpal tunnel is on the palm side of your wrist, surrounded by bones and ligaments. It protects the main nerve to your hand, known as the median nerve, as well as the nine tendons that bend your fingers. The median nerve provides sensation to the palm side of your thumb and fingers, except your little finger. It also provides nerve signals to move the muscles around the base of your thumb.

Carpal tunnel syndrome stems from anything that crowds, irritates or compresses the median nerve, such as a wrist fracture, swelling or inflammation. This condition causes tingling and numbness in your fingers and hand, often when you’re holding a steering wheel, phone or newspaper. This sensation can even wake you up from sleeping and may extend from your wrist up your arm.

When carpal tunnel syndrome sufferers experience this sensation, they often “shake out” their hands to relieve this symptom. This disorder usually starts gradually, with the numbness and tingling coming and going. As it progresses, the numb feeling may become constant.

With carpal tunnel syndrome, you may also feel weakness in your hand and have a tendency to drop things you’re holding. This symptom can be caused by the numbness or weakness of the thumb’s pinching nerve, which is controlled by the median nerve.

In mild cases of this disorder, you can ease discomfort by taking frequent breaks to rest your hands, avoid activities that worsen your symptoms and even hold cold packs on to reduce any swelling. If these don’t relieve your symptoms within a few weeks, your doctor may recommend additional options such as wrist splinting, medications or surgery depending on how advanced the disorder is.

What is Rheumatoid Arthritis?

RA is an autoimmune disorder characterized by chronic inflammation, typically affecting the small joints in your hands as well as your feet. This condition isn’t caused by wear and tear, but rather it occurs when your immune system mistakenly attacks your own body’s tissues. Specifically, it targets the lining of your joints, leading to painful swelling that can cause severe joint problems.

Symptoms of RA include:

• Stiffness in the morning that may last for hours
• Tender, warm and swollen joints
• Rheumatoid nodules, firm bumps of tissue under the skin on your arms
• Fever, fatigue and weight loss.

In its early stages, RA often affects your smaller joints first, especially the ones that attach your fingers to your hands and your toes to your feet. As it progresses, these symptoms usually spread to wrists, knees, ankles, elbows, hips and shoulders.

In some instances, RA’s inflammation and swelling can actually cause carpal tunnel syndrome.

Although there isn’t a cure for RA, there are medications that reduce joint inflammation to relieve pain and slow joint damage. If you have RA, your rheumatologist may recommend occupational or physical therapy so you can learn to protect your joints and keep them flexible. If RA severely damages joints, surgery may be necessary.

Does Arthritis Cause Carpal Tunnel Syndrome?

Question: For a few years I have had arthritis in my left wrist, and lately I have been experiencing numbness in my fingers and thumb. It is difficult to pick things up or even turn the pages of a book. Is there anything I can do to get the feeling back in these fingers?

A: Numbness in thumb and fingers is a classic symptom of carpal tunnel syndrome, also known as CTS. Other symptoms include a burning pain or tingling in the hand. 
 
To understand CTS, you must first understand the wrist’s anatomy. The bones of the wrist are called the carpal bones and, along with a ligament, they form a tunnel through which the median nerve and several tendons run. The median nerve is the one that supplies sensation to the thumb side of the hand. If the nerve becomes compressed within that tunnel, numbness in the thumb and fingers can occur. 
 
Several factors may have caused your median nerve to become compressed. Your longstanding arthritis could have caused spurs to form on the carpal bones, trapping the nerve and resulting in numbness. Any inflammation from your disease may also cause swelling within the carpal tunnel, which compresses the nerve. In fact, arthritis-related diseases, such as rheumatoid arthritis, gout and pseudogout, are common causes of CTS. 

If you have one of these diseases, the way to treat carpal tunnel syndrome is to treat that underlying disease process. Often, however, CTS occurs in the absence of underlying disease. Sometimes, the cause of carpal tunnel syndrome is simply overuse of the wrist. 

Treatment of carpal tunnel syndrome can include using wrist braces, especially at night; having periodic injections of steroids to reduce swelling; and avoiding activities that aggravate the symptoms. Although these measures generally work for a while and may offer lasting relief in some cases, more severe cases require surgery. An operation that releases the median nerve from entrapment can often relieve the symptoms. 

The best thing you can do is discuss your symptoms and possible treatment options with your physician. 
 
Tim Lambert, MD 

Family Practitioner 

Garland, Texas 

9 Hand & Wrist Exercises

If your job or favorite hobby puts strain on your hands and wrists, you might wonder if you have carpal tunnel syndrome. Maybe you’ve got some symptoms, like tingling or numbness in your fingers, and you want to make sure it doesn’t get worse. The good news is that there’s a lot you can do to protect yourself and prevent your symptoms from getting worse.

Carpal tunnel syndrome is caused by pressure on your median nerve. This nerve gives you feeling in your thumb and all your fingers except your pinky. When the median nerve goes through your wrist, it passes through a narrow path — the carpal tunnel — that’s made of bone and ligament. If you get any swelling in your wrist, this tunnel gets squeezed and pinches your median nerve, which causes your symptoms.

There’s no one, surefire way to prevent carpal tunnel syndrome. But if you reduce stress and strain on your hands and wrists as much as you can, you may keep it from getting worse.

1. Try a Softer Touch

Often in our daily routines, we get so used to doing things a certain way that we don’t even think about it. Many times, you may use more force than you need to get the job done. For instance, you might grip your tools too tightly when a firm hold is plenty. Or you may pound your computer keyboard when gentle keystrokes will do.

As you go through your day, keep an eye on how tense your hands are and how much pressure you put on them. If you can back off even a little, your hands and wrists will thank you.

2. Give Yourself a Break

Step away from your work to bend or stretch your hands. A 10- to 15-minute break every hour is ideal. This is especially important if you use tools that vibrate or make you apply a lot of force.

3. Stretch Often

When you take those breaks (or any time throughout the day), try this simple stretch:

• Make a fist
• Slide your fingers up until they point straight out
• Repeat 5-10 times

Or this one:

• Make a fist
• Release your fingers and fan them out. Stretch them as far as you can.
• Repeat 5-10 times

4. Stay Neutral

If you can, avoid bending your wrist all the way up or down. When you keep your wrist in a straight, neutral position, it takes the pressure off your median nerve.

Wearing a wrist brace when you sleep can help you do this. It might also help to wear it during activities that trigger your symptoms.

5. Switch It Up

Try to avoid doing the same hand and wrist motions over and over again. For example, if you have a task that you always do with your right hand, do it with your left instead. Or, mix up your tasks as much as you can to give your muscles a break.

6. Watch Your Posture

While it’s natural to focus on your wrist and hands, how you hold the rest of your body can also make a difference. Poor posture may cause you to roll your shoulders forward. This sets off a chain reaction that shortens your neck and shoulder muscles, crunches the nerves in your neck, and makes wrist problems worse.

7. Stay Warm

It sounds simple, but it makes a difference. When you’re cold, pain and stiffness get worse. Even gloves with no fingers can be helpful because they keep your hands and wrists warm and loose.

8. Talk to Your Supervisor

If your work triggers your symptoms, ask you manager about changing up your work space. You may be able to alter anything from your workstation setup to tool handles to how tasks get done to see if it helps your symptoms. You might also be able to trade off with co-workers so you can avoid the same task over and over.

If you work at a computer, try these things:

• Adjust your keyboard position so you don’t have to bend your wrists when you type.
• Keep your elbows close to your side as you type.

9. See an Occupational Therapist

This medical professional may be able to:

• Show you exercises to help stretch and strengthen your hand and wrist muscles
• Show you how to change your routine motions in a way that eases stress on your hands and wrists

Hand Problems: Arthritic Fingers, Carpal Tunnel Syndrome

Medically Reviewed by David E. Lukowski, MD

Carpal tunnel syndrome is one of the most common hand problems treated by McLeod Seacoast Orthopedic Specialist Dr. David Lukowski – but finger joint replacements are becoming more common these days, as well.

Here’s a summary of Dr. Lukowski’s comments:
I’d say the number one problem I treat is carpal tunnel syndrome. Other common problems include trigger finger, tendonitis, arthritis of the hand and wrist, nerve and artery disorders and injuries of the hand and wrist.

Carpal tunnel syndrome is a disorder, where a nerve gets compressed in the hand. It’s the most common nerve compression disorder in the body. It affects a large population of people and the causes are:

• A nerve runs through a small tunnel or channel in the hands and it runs along nine other tendons that move your fingers and your thumb. So, it’s a tight space.
• All those tendons have a lining around them called synovium, which can become thickened over time with repetitive use or due to other diseases such as thyroid disease or diabetes or other conditions.
• As that tendon surrounding synovium thickens, it puts pressure on that nerve.

The most common symptoms are sharp, electrical type pain that shoots into the fingers. Numbness is a common complaint, worse at night in most patients. Also, weakness in the hand is another symptom, if it progresses to that point.

Treatment usually starts with conservative treatments. Especially for the night symptoms, I put everyone in a splint, a brace of one of those Velcro splints you can get at the drugstore. It prevents your hand from flexing down, which usually is what causes the numbness at night. Other treatment options include taking anti-inflammatories, such as Advil or Motrin. Cortisone injections are another effective treatment. And finally, activity modifications. Say if you sit at a computer all day, there are certain things you can to do modify your posture, and the way your hands are positioned while you are typing, which can help.

The final last option is carpal tunnel surgery. It’s a very common surgery that I perform. It’s a very effective last treatment for this condition.

Arthritis occurs in the hand from several different causes. The most common is your degenerative arthritis or osteoarthritis is the technical word for it. It’s just the wear and tear arthritis over time. Your joints experience loss. The ends of the bones have cartilage and that cartilage begins to erode over time, which causes the pain in the joints. Other forms of arthritis are rheumatoid arthritis and other things, such as previous injuries to the hands, can lead to problems with the joints needing replacement.

The way a finger joint replacement differs from the hip and knees, is it’s obviously a smaller joint and the mechanics of the hand are different from the hip and knee. The materials are a little bit different as far was what you place in the hand it quite different from what is used in the knee or hip.

Find an Orthopedic Surgeon specialized in hand and upper extremity surgery.

Find other Orthopedic Specialists from the Midlands to the Coast.

Carpal Tunnel Syndrome: What is it? Symptoms, Causes, & Treatment

Diagnosis of Carpal Tunnel Syndrome

The diagnosis of carpal tunnel syndrome is made in many patients based on their history of symptoms and a physical examination. It is important to know which fingers experience the numbness or tingling and which fingers do not. When performing the physical exam, your hand surgeon will perform sensation testing on the palm side and the back side of the fingers and hand. He or she may also perform sensory testing of the forearm and arm because finding numbness outside the median nerve area may suggest a different problem. The doctor may also perform some tests including the Phalen’s maneuver, the Tinel’s test, and a compression test. These tests are designed to increase pressure on the median nerve to cause your symptoms to appear. Electrodiagnostic studies (EMG) may also be used in the diagnosis. These provide evidence of nerve function or dysfunction. Also, they can help to find other causes of numbness which may have similar symptoms, such as diabetic neuropathy or cervical radiculopathy. Magnetic Resonance Imaging (MRI) and ultrasound studies are anatomic imaging tests that visualize the size of the median nerve and may also be used. Anatomic imaging tests are often helpful when other conditions are suspected like a ligament tear or tendinitis that may contribute to pain.

Therefore, it is possible that your doctor will diagnose you with a condition other than carpal tunnel syndrome. Other conditions that can cause numbness/tingling in the hand include compression conditions in the forearm, elbow, shoulder, or neck, fibromyalgia, myofascial pain syndrome and peripheral neuropathy.

Non-Surgical Treatment

The main goal of treatment is to reduce or remove the causes of increased nerve pressure. This should result in a decrease in symptoms. Some non-surgical treatment options may include:

• Oral anti-inflammatory medicine
• Steroid injection (cortisone shot)
• Wrist splint(s)

Oral medications and injections are more effective when symptoms are present for a short period of time, infrequent and mild. Wrist splinting, mainly at night, keeps the wrist out of a bent position. Wrist splints are most helpful with symptoms that are affected by the hand or wrist position. Splints are also more helpful when the symptoms are mild and when symptoms have been present for a shorter period of time. However, splints have been shown to improve, but not cure symptoms, even when carpal tunnel is severe. It can also be useful to limit activities that bring on numbness and tingling.

Surgical Treatment

Surgical release of the carpal tunnel ligament is one of the most effective treatments. It takes the extra pressure off the nerve immediately and reliably. There are several different surgical techniques to cut the transverse carpal ligament. By opening the ligament, there is more room for the tendons and the nerve to pass through the tunnel without pressure.

After carpal tunnel release surgery, your surgeon may recommend temporarily avoiding certain activities. Moving the fingers right away and frequently after a surgical procedure helps to limit stiffness, swelling, and adhesions. Adhesions are areas of scar tissue that can form and link the nerve to the tendons it rests on. If adhesions form, the moving tendon will pull on the nerve and may cause symptoms. Early, gentle finger and wrist motion can help avoid adhesions and encourage tendons and nerves to move separately.

The surgical scar and surrounding area may go through some mild changes in color, firmness and tenderness over the first several months. These changes are normal. Most scars won’t change much after four months. You may work with a hand therapist, who will give instructions on exercises and scar massage to get your hand function back to normal. Returning to work after carpal tunnel surgery is dependent upon each person’s symptoms, job demands and employer policies. In patients with less physically demanding jobs, they will be able to return to work in a few days, where other jobs may take weeks to safely return. Your surgeon and therapist will discuss the best recovery plan with you.

After surgery, most patients have very little pain at the incision site. Numerous scientific studies have shown surgical pain can be well-controlled with acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs) (like Ibuprofen), ice, elevation, early gentle finger and wrist motion, and limiting activity to things that are comfortable. Very rarely a patient may require a few doses of a stronger opioid pain medication within the first 2-3 days. It is very important to limit this type of strong pain medication to decrease the chance of becoming dependent on the medicine, having a tolerance build up, or having withdrawal symptoms when trying to stop it. Multiple medical organizations and state licensing boards have established guidelines and policies on safe prescribing of pain medication. Please discuss any concerns with your surgeon prior to any surgery to make sure everyone is on the same page and expectations can be clearly set and understood.

Outcomes After Surgery

Better results will occur when carpal tunnel is recognized and treated earlier. This means seeking treatment when your symptoms are not severe, and they come and go. There will likely be complete return of feeling and muscle use after surgery. Relief may even be immediate.

However, if the symptoms are severe and constant when you seek treatment, the final result may be unknown. Your healing may be slow (six or more months). If there was permanent damage before surgery, you will likely still feel numbness. Unfortunately, there is no test to tell if the symptoms are reversible. If you lost use of your thumb muscle, that will likely persist, at least to some degree.

Visiting a hand surgeon as soon as your symptoms develop is key to receiving the best treatment and outcomes.

© 2021 American Society for Surgery of the Hand.

This content is written, edited and updated by hand surgeon members of the American Society for Surgery of the Hand. Find a hand surgeon near you.

Risk Factors, Symptoms & Treatment

Overview

The carpal tunnel is a space in the wrist that holds tendons and your median nerve. This space is compressed in carpal tunnel syndrome. One symptom of carpal tunnel syndrome is numbness that spreads throughout the hand (see shaded blue area).

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a common condition that causes pain, numbness, tingling, and weakness in the hand and wrist. It happens when there is increased pressure within the wrist on a nerve called the median nerve. This nerve provides sensation to the thumb, index, and middle fingers, and to half of the ring finger. The small finger (the “pinky”) is typically not affected.

Carpal tunnel syndrome was first described in the mid-1800s. The first surgery for the release of the carpal tunnel was done in the 1930s. It is a condition that has been well recognized by orthopaedic surgeons for over 40 years.

What is the carpal tunnel?

The carpal tunnel is a narrow canal or tube in the wrist. Similarly to a tunnel you could travel through by car, this part of the wrist allows the median nerve and tendons to connect the hand and forearm. The parts of this tunnel include:

• Carpal bones: These bones make up the bottom and sides of the tunnel. They are formed in a semi-circle.
• Ligament: The top of the tunnel, the ligament is a strong tissue that holds the tunnel together.

Inside the tunnel are the median nerve and tendons.

• Median nerve: This nerve provides feeling to most of the fingers in the hand (expect the little finger). It also adds strength to the base of the thumb and index finger.
• Tendons: Rope-like structures, tendons connect muscles in the forearm to the bones in the hand. They allow the fingers and thumb to bend.

Does carpal tunnel syndrome only happen to office workers or factory workers?

No. Many people with carpal tunnel syndrome have never done office work or worked on an assembly line. It affects people who use their wrists and hands repeatedly at work and at play. Anyone can get carpel tunnel syndrome, but it is unusual before age 20. The chance of getting carpal tunnel syndrome increases with age.

Who is at risk for carpal tunnel syndrome?

People at risk for carpal tunnel syndrome are those who do activities or jobs that involve repetitive finger use. Motions that can place people at risk of developing carpal tunnel syndrome include:

• High-force (hammering).
• Long-term use.
• Extreme wrist motions.
• Vibration.

Many other factors can also contribute to the development of carpal tunnel syndrome. These factors can include:

• Heredity (smaller carpal tunnels can run in families).
• Pregnancy.
• Hemodialysis (a process where the blood is filtered).
• Wrist facture and dislocation.
• Hand or wrist deformity.
• Arthritic diseases such as rheumatoid arthritis and gout.
• Thyroid gland hormone imbalance (hypothyroidism).
• Diabetes.
• Alcoholism.
• A mass (tumor) in the carpal tunnel.
• Older age.
• Amyloid deposits (an abnormal protein).

Carpal tunnel syndrome is also more common in women than in men.

Symptoms and Causes

What causes carpal tunnel syndrome?

Carpal tunnel syndrome is caused when the space (the carpal tunnel) in the wrist narrows. This presses down on the median nerve and tendons (located inside the carpal tunnel), makes them swell, which cuts off sensation in the fingers and hand.

How often is hand pain caused by carpal tunnel syndrome?

While carpal tunnel syndrome is a common condition, it has a different set of symptoms from many other sources of hand pain. There are actually several similar conditions that cause hand pain. These include:

• De Quervain’s tendinosis: A condition where swelling (inflammation) affects the wrist and base of the thumb. In this condition, you will feel pain when you make a fist and simulate shaking someone’s hand.
• Trigger finger: This condition causes soreness at the base of the finger or thumb. Trigger finger also causes pain, locking (or catching) and stiffness when bending the fingers and thumb.
• Arthritis: This is a general term for many conditions that cause stiffness and swelling in your joints. Arthritis can impact many joints in your body and ranges from causing small amounts of discomfort to breaking down the joint over time (osteoarthritis is one type of degenerative arthritis).

What are the symptoms of carpal tunnel syndrome?

Symptoms usually begin slowly and can occur at any time. Early symptoms include:

• Numbness at night.
• Tingling and/or pain in the fingers (especially the thumb, index and middle fingers).

In fact, because some people sleep with their wrists curled, nighttime symptoms are common and can wake people from sleep. These nighttime symptoms are often the first reported symptoms. Shaking the hands helps relieve symptoms in the early stage of the condition.

Common daytime symptoms can include:

• Tingling in the fingers.
• Decreased feeling in the fingertips.
• Difficulty using the hand for small tasks, like:
  • Handling small objects.
  • Grasping a steering wheel to drive.
  • Holding a book to read.
  • Writing.
  • Using a computer keyboard.

As carpal tunnel syndrome worsens, symptoms become more constant. These symptoms can include:

• Weakness in the hand.
• Inability to perform tasks that require delicate motions (such as buttoning a shirt).
• Dropping objects.

In the most severe condition, the muscles at the base of the thumb visibly shrink in size (atrophy).

Diagnosis and Tests

How is carpal tunnel syndrome diagnosed?

First, your doctor will discuss your symptoms, medical history and examine you. Next, tests are performed, which may include:

• Tinel’s sign: In this test, the physician taps over the median nerve at the wrist to see if it produces a tingling sensation in the fingers.
• Wrist flexion test (or Phalen test): In this test, the patient rests his or her elbows on a table and allows the wrist to fall forward freely. Individuals with carpal tunnel syndrome will experience numbness and tingling in the fingers within 60 seconds. The more quickly symptoms appear, the more severe the carpal tunnel syndrome.
• X-rays: X-rays of the wrist may be ordered if there is limited wrist motion, or evidence of arthritis or trauma.
• Electromyography (EMG) and nerve conduction studies: These studies determine how well the median nerve itself is working and how well it controls muscle movement.

Management and Treatment

How is carpal tunnel syndrome treated?

Carpal tunnel syndrome can be treated in two ways: non-surgically or with surgery. There are pros and cons to both approaches. Typically, non-surgical treatments are used for less severe cases and allow you to continue with daily activities without interruption. Surgical treatments can help in more severe cases and have very positive outcomes.

Non-surgical treatments

Non-surgical treatments are usually tried first. Treatment begins by:

• Wearing a wrist splint at night.
• Taking nonsteroidal anti-inflammatory drugs, such as ibuprofen.
• Cortisone injections.

Other treatments focus on ways to change your environment to decrease symptoms. This is often seen in the workplace, where you can make modifications to help with carpal tunnel. These changes might include:

• Raising or lowering your chair.
• Moving your computer keyboard.
• Changing your hand/wrist position while doing activities.
• Using recommended splints, exercises and heat treatments from a hand therapist.

Surgical treatments

Surgery is recommended when carpal tunnel syndrome does not respond to non-surgical treatments or has already become severe. The goal of surgery is to increase the size of the tunnel in order to decrease the pressure on the nerves and tendons that pass through the space. This is done by cutting (releasing) the ligament that covers the carpal tunnel at the base of the palm. This ligament is called the transverse carpal ligament.

If you have surgery, you can expect to:

• Have an outpatient procedure where you will be awake, but have local anesthesia (pain numbing medication). In some cases, your doctor may offer an IV (directly into the vein) anesthetic. This option allows you to take a brief nap and wake up after the procedure is finished. This is not a general anesthetic, like what is used in surgery. Instead, your healthcare team will monitor you during the procedure (called monitored anesthetic care, or MAC). This is also used for procedures like a colonoscopy.
• Be in brief discomfort for about 24 to 72 hours after surgery. People usually experience complete nighttime symptom relief quickly—even the night after surgery.
• Have your stitches removed 10 to 14 days after surgery. Hand and wrist use for everyday activities is gradually restored by using specific exercise programs.
• Be unable to do heavier activities with the affected hand for about four to six weeks. Recovery times can vary depending on your age, general health, severity of carpal tunnel syndrome and how long you had symptoms. You will continue to gain strength and sensation in the following year after surgery.
• Have relief from most carpal tunnel syndrome symptoms.

Prevention

How can carpal tunnel syndrome be prevented?

Carpal tunnel syndrome can be difficult to prevent. The condition can be caused by so many different activities in a person’s daily life that prevention can be challenging. Workstation changes—proper seating, hand and wrist placement—can help decrease some factors that can lead to carpal tunnel syndrome. Other preventative methods include:

• Sleeping with your wrists held straight.
• Keeping your wrists straight when using tools.
• Avoiding flexing (curling) and extending your wrists repeatedly.
• Decreasing repetitive/strong grasping with the wrist in a flexed position.
• Taking frequent rest breaks from repetitive activities.
• Performing conditioning and stretching exercises before and after activities.
• Monitoring and properly treating medical conditions linked to carpal tunnel syndrome.

Outlook / Prognosis

Does carpal tunnel syndrome have a long recovery?

Surgery to repair carpal tunnel syndrome does not have a particularly long recovery. The bandage that covers the stitches after surgery can be removed in a few days. The hand can then be used for light activities. Making a fist is encouraged. Full range of finger motion and early symptom relief is usually seen within two weeks after the stitches have been removed. You can usually return to most activities by six weeks. Your return to work depends on factors such as type of work, how much control you have over your work and workplace equipment.

What is the success rate for carpal tunnel syndrome surgery?

Surgery for carpal tunnel syndrome has a very high success rate of over 90%. Many symptoms are relieved quickly after treatment, including tingling sensation in the hands and waking up at night. Numbness may take longer to be relieved, even up to three months. Surgery won’t help if carpal tunnel syndrome is the wrong diagnosis.

When the carpal tunnel syndrome has become severe, relief may not be complete. There may be some pain in the palm around the incisions that can last up to a few months. Other after-surgery pain may not be related to carpal tunnel syndrome. Patients who complain of pain or whose symptoms remain unchanged after surgery either had severe carpal tunnel syndrome, had a nerve that was not completely released during surgery, or did not really have carpal tunnel syndrome. Only a small percentage of patients do not gain substantial relief from symptoms.

90,000 Arthritis of the wrist joint of the hand – Symptoms, treatment, recovery after arthritis – Traumatology CDB RAS

Arthritis of the wrist joint is characterized by inflammation of the soft tissues surrounding the joint and develops as a result of overuse, injury, or infection. Specialists of the Central Clinical Hospital of the Russian Academy of Sciences remind that timely treatment of a problem in a medical institution is a guarantee of complete restoration of joint functionality and prevention of the development of a chronic form of pathology.

Symptoms

If a patient develops arthritis in the wrist area, the following symptoms may occur (singly or collectively):

• Redness of the skin over the joint;
• Local temperature rise;
• Pain and limited mobility of the joint;

Types of arthritis

Depending on the etiology, the following types of diseases of the right and left wrist joint are distinguished:

• infectious arthritis – is one of the manifestations of such serious diseases as brucellosis, syphilis, tuberculosis, gonorrhea and others;
• nonspecific purulent arthritis – develops in situations when the soft tissues surrounding the joint are affected by bacteria brought by blood from other foci of inflammation, for example, from carious foci, furunculosis, osteomyelitis;
• gouty arthritis – one of the consequences of impaired metabolism;
• rheumatoid arthritis of the wrist joint is a consequence of autoimmune disorders;
• reactive arthritis – a variant of an allergic reaction, for example, to vaccination;
• the so-called arthrosis-arthritis , which combines the signs of both diseases.

Which doctor should I contact?

Depending on the causes of the disease, a specific case of arthritis will be dealt with by an experienced specialist of the Central Clinical Hospital of the Russian Academy of Sciences – a rheumatologist, surgeon, orthopedist, traumatologist.

Diagnostics

To obtain an accurate clinical picture, a patient with suspected wrist arthritis is prescribed the following types of diagnostic procedures:

• laboratory complex – analyzes of urine and blood;
• if there is a purulent process, a sample of synovial fluid can be taken to determine the bacterial strain;
• ultrasound examination of the wrist and hand;
• sighting X-ray of the affected area;
• CT or MRI.

If during the examination there are doubts about the accuracy of the diagnosis, the patient can be referred for additional consultation to narrow specialists of the Central Clinical Hospital of the Russian Academy of Sciences.

Causes of occurrence

Arthritis of the wrist joint can have various etiologies. The most common cause of the development of inflammation in the joint is an excessive load on it. Also arthritis can develop:

• Against the background of an autoimmune disease.
• As a result of problems with metabolic processes in the body.
• Due to joint damage by infection transferred from another organ.
• As a complication of gout
• As a result of a blow or other injury to the wrist joint.

Treatment

In the first and second stages of the disease, the patient is prescribed anti-inflammatory drugs, physiotherapy, pain relievers. Maximum immobilization of the wrist is also shown. If third-degree arthritis is diagnosed, only surgical treatment will be effective.

The orthopedist prescribes treatment based on the stage and cause of arthritis. So, for example, if the disease is represented by an acute pus form, arthrotomy may be prescribed. This is a procedure that involves installing a drain to drain the pus. Based on the bacteriological analysis, the traumatologist identifies the causative agents of the inflammatory process in order to choose the most effective antibiotic. If the patient has exacerbated chronic arthritis, in addition to immobilization, rheumatologists use physiotherapy techniques.Professional massage helps well, facilitates exercise therapy, ultrasound and other hardware techniques. Also, patients suffering from chronic arthritis of the wrist joint should constantly remember about the reasonableness of the load on the sore arm. It is recommended that you stick to your diet and incorporate specific exercise therapy into your lifestyle.

Sign up for a specialist consultation

Arthritis of the joint is a disease that causes severe pain, restricts mobility and deprives a person of the opportunity to lead a normal life.It is not worth starting the pathology, since in the chronic form it is more difficult to treat. If you notice swelling, redness or the slightest discomfort, make an appointment with a traumatologist or rheumatologist of the CEB RAS. If you have already been diagnosed with chronic arthritis of the wrist joint, we will help you get rid of the disease by developing an individual comprehensive program. Call or use the online form to schedule a doctor’s appointment at a convenient time for you.

Recovery

In the process of recovering from arthritis of the wrist joint, the patient can be assigned special gymnastics (exercise therapy), as well as physiotherapy complex procedures: UHF, massage, paraffin therapy, etc.It is also necessary to pay attention to the diet – it is recommended to include in the menu dishes with vitamin E and collagen (jellied meat, aspic, broth).

How is carpal tunnel syndrome treated? + 6 exercises

Fingers go numb and tingle, the hand does not obey. It is impossible to hold a pen and use a computer mouse. At night, a shooting pain in the wrist disturbs and does not allow sleep. These are the symptoms of carpal tunnel syndrome, also called carpal tunnel syndrome.

Tunnel syndrome refers to neurological diseases. In a broad sense, the concept unites a dozen diseases. But we’ll talk about one of them – carpal tunnel syndrome. We will tell you why it is a disease of office workers, what to do for prevention and how to treat carpal tunnel syndrome.

Who is sick

Carpal tunnel syndrome is called a disease of office workers due to long work at the computer. But people of different professions are susceptible to the disease: musicians, e-sportsmen, motorcycle racers, artists, stenographers.Those who have monotonous actions with their hands with constant flexion-extension movements of the hand, or whose work is associated with the assembly of equipment and vibrating mechanisms.

If you look at the structure of the wrist and hand, you can see that at the base of the palm, bones, muscles and tendons form a kind of tunnel – this is the carpal tunnel. Nerves and blood vessels pass through it.

Carpal tunnel syndrome occurs when the median nerve is compressed. Together with the radial and ulnar, the median main nerve of the hand, and is responsible for the sensitivity of the thumb, index, middle, ring fingers.

There can be several reasons for pinching the median nerve, not only professional activity. How to treat carpal tunnel syndrome depends on them.

Causes of the tunnel syndrome

• injury to the wrist resulting in compression of the median nerve;
• metabolic disorders, joint deformity;
• edema in pregnant women and women taking hormonal drugs;
• obesity;
• diseases: arthritis, diabetes mellitus, gout, tuberculosis, renal failure;
• genetic predisposition, anatomically narrow wrist.

Symptoms

Pain. Burning with lumbago. First, with a load on the arm, and subsequently at rest. Pain is often troubling at night. Stops briefly after shaking hands. If carpal tunnel syndrome is left untreated for a long time, the pain will move higher to the elbow and shoulder. Symptoms also include neck pain and headaches.

Numbness. The median nerve is responsible for the sensitivity of the fingers. When its functionality is impaired, tingling occurs or the hand ceases to be felt at all.

Weakness. Everything literally falls out of hand. Neither heavy nor light objects can be held. This is due to severe pain and loss of motor function.

We are against amateur performance, therefore, the first thing we advise you to consult a doctor: a therapist or a neurologist. It is necessary to treat tunnel syndrome by identifying the cause of the disease.

If it is diabetes mellitus or renal failure, then therapy will be directed at their treatment. Plus, pain relievers to relieve symptoms.There are specialized programs for the treatment and prevention of such diseases in the Mashuk Aqua-Therm sanatorium complex. Here we will provide you with comprehensive support in the fight against the disease.

If carpal tunnel syndrome has appeared due to professional activity, then for a while, the load on the arm should be stopped. Also apply a splint or bandage for fixation. This is especially useful at night, since during sleep we do not control our movements and the hand may be in a position that causes pain.

If the symptoms of the disease persist for a long time (from 6 months), then the tunnel syndrome is treated with a surgical method. An operation is performed to open the carpal tunnel.

Exercise can help treat tunnel syndrome after the first symptoms and acute pain have been eliminated. Only under the supervision of specialists who will teach exercises and physiotherapy exercises.

Can be avoided?

You will not need to treat tunnel syndrome if you take care of your hands and take time to exercise.To receive a reminder on how to properly do a warm-up for the joints of the hands, write your mail, and we will send it to you.

We wish you health and remember that everything is in your hands. Take care of them.

Treatment of carpal tunnel syndrome in Yekaterinburg

Carpal tunnel syndrome is a disease in which there are pulling pains, numbness, loss of sensitivity in the area of ​​the hand and wrist. Tunnel syndrome occurs as a result of a pinched median nerve located in the carpal tunnel.Carpal tunnel syndrome is an expensive occupational disease.

The main symptoms

The diagnosis of carpal tunnel syndrome has the following distinctive symptoms according to ICD-10:

• increased tingling sensation;
• Numbness in the fingers, mainly in the thumb, index and middle. The little finger and ring finger do not feel numbness;
• hand weakness;
• inability to hold even light objects in the hand;
• Muscle dysfunction;
• the appearance of pain;
• reflex unclenching of the fingers.

Some symptoms appear in ordinary life when performing some actions, others occur at night. Due to the fact that the patient’s arm hurts, his sleep is disturbed. In such cases, treatment of forearm tunnel syndrome should not be postponed. It is necessary to make an appointment with a doctor at the clinic.

Treatment of the disease

Carpal tunnel syndrome should be treated as soon as it is diagnosed. In some cases, carpal tunnel syndrome of the hands can be cured by normalizing work activity, reducing physical activity, eliminating stress on the joints of the elbows and shoulders.If this technique does not work, the doctor will offer the following services:

• splint pad and sock;
• physiotherapy;
• drug treatment;
• blockade for pain relief of the carpal tunnel of the upper limb;
• surgical intervention.

The first three treatments are suitable for mild forms of the disease. Drug treatment of carpal tunnel syndrome is carried out using non-steroidal drugs to relieve inflammation, as well as corticosteroids or hormones.Sometimes doctors prescribe additional drugs that can relieve swelling.

If complications of the elbow and shoulder joint syndrome appear at the medical center in Yekaterinburg, a referral for surgery may be issued. It can be endoscopic or direct surgery with a large incision in the palm along the median canal.

Causes of the tunnel syndrome

The main causes of the appearance of the ulnar carpal tunnel syndrome are household, industrial and sports injuries, post-traumatic consequences.It is also preceded by dislocations, fractures, sprains of the hand, wrist, swelling caused by pregnancy, various diseases (diabetes, arthritis, gout), hormonal imbalance, obesity, water imbalance, heredity, the appearance of a tumor on the wrist.

It will be possible to relieve oneself from unpleasant sensations, relieve pain in the arm after preliminary diagnostics of neurology. Specialists offer clinical research services, diagnostics by examination, X-ray, electromyography, and nerve conduction analysis.

Make an appointment with a neurologist by phone +7 (343) 363-05-84

Acupuncture and related methods of treating symptoms of carpal tunnel syndrome

Review Question

Do acupuncture and related treatments improve the symptoms of adult carpal tunnel syndrome?

Relevance

Carpal tunnel syndrome (WTS) is a condition that can cause pain, numbness, tingling, and weakness in the arm.It develops when the median nerve, which runs from the forearm to the hand, is compressed as it travels through a structure called the carpal tunnel in the wrist. Patient work can be a factor in the development of CVD, and it can be an additional problem in people with other medical conditions, such as inflammatory arthritis. TSD can be treated with arm exercises, splinting, pain relievers, and injections. Severe TSD can be treated with surgery. People with TSI sometimes choose acupuncture and related therapies to control the symptoms of TSI.Acupuncture uses needles to pierce the skin and stimulate acupuncture points on the body. These acupuncture points lie along the meridian, which is considered to be the pathway for energy to pass through the body. Acupuncture treatments use various methods to stimulate acupuncture points. For example, laser acupuncture uses lasers instead of needles.

Characteristics of research

We found 12 studies that analyzed 869 people with TSI.Among them, there were 148 men and 579 women (one study did not indicate the gender of the participants). The age of the participants ranged from 18 to 85 years old. The number of patients in each study ranged from 26 to 181. Symptoms of TSD were present for months or years. Studies have compared acupuncture or laser acupuncture with placebo / sham treatments or active treatments such as corticosteroid nerve blocks, oral corticosteroids, ibuprofen, night splints, physical therapy, and vitamin B ₁₂

Key results and certainty of evidence

There is probably little or no evidence of any difference between acupuncture or laser acupuncture and placebo or sham treatment for CHD symptoms.We cannot say whether acupuncture and related interventions are more or less effective when compared to other treatments for TSD symptoms. The studies we found were small and there may have been problems with doing them. There was little information about each comparison. Research has found some of the side effects of acupuncture, such as pain and bruising. They weren’t serious. However, not all studies provided information on side effects.We do not have enough information from current research to be confident about the effects of acupuncture and related treatments for CVD. We need larger, better quality studies to understand whether acupuncture and related interventions have any effect on TSD symptoms.

This review is current as of November 13, 2017 for English databases and April 30, 2018 for Chinese and Korean databases.

Comments of KSMU specialists: take care of your hands

Neurologist about the occupational disease of office workers, welders, milkmaids and violinists

“Two active Internet users are talking.”How are you?” One asks. “Everything is fine, only the fingers hurt,” the second responds. “Why all of a sudden?” – “Yes, yesterday we met with friends in the chat, so they shouted songs all night.” One of the characters in this old anecdote suffers from a disease that is quite common nowadays with the beautiful name “tunnel syndrome”. Rustem Gaifutdinov, associate professor of the Department of Neurology and Neurosurgery, KSMU, tells more about him in an article for “BUSINESS Online”.

NOT ALL CREWS ARE EQUALLY USEFUL

Perhaps everyone knows the sensation of “lying down” or “sitting out a leg” – numbness, tingling, the so-called goose bumps.If this happens quite often and is accompanied by pain and loss of sensitivity in the first three fingers of the hand, most likely we are dealing with tunnel syndrome, or rather, with carpal tunnel syndrome. This disease has received the status of a professional o – it affects those who, due to their duty, are forced to make monotonous movements with their hands: drivers, welders, milkmaids, musicians and, of course, office workers who all day long clicking the mouse or typing on the keyboard.

The fact is that in the carpal canal (in another way it is called the tunnel) the median nerve passes, which is responsible for the sensitivity of the thumb, index, middle and partially ring fingers.As a result of monotonous movements, the nerve is compressed by muscles or tendons. Pain appears, characteristic nocturnal paresthesias occur – those same goosebumps. A person can wake up, he has to shake his hand, knead the brush so that sensitivity is restored.

Pathology can progress – then paresthesias appear already in the daytime, it is worth a person, for example, to stand for a while, holding the handrail in the transport. Pain can spread to the forearm, shoulder.In addition, the median nerve contains vegetative fibers that provide our skin, muscles and nails with nutrients. This violation is accompanied by severe vegetative pain – sympathetic. This is a special burning pain in which pronounced vegetative-vascular and trophic disorders occur. The skin becomes thinner, the nails become fragile, crumble. Muscles also become thinner and thinner. And over time, the hand and fingers can become so clumsy and awkward that it will be difficult for a person to write with a regular pen.

Unfortunately, women are more susceptible to this disease, especially pregnant women or during menopause, when fluid is retained in the body, including in the synovial membranes (the inner layer of the joints), again causing compression of the nerve. Often, the development of tunnel syndrome is provoked by rheumatoid arthritis, endocrinological diseases such as hypothyroidism ( a disease caused by an insufficient content of thyroid hormones in the body, – approx.ed. ), diabetes mellitus.

With mild lesions of the nerve, its superficial myelin sheath suffers. The speed of conduction of nerve impulses in the body depends on it: the thicker it is, the faster signals are transmitted from one neuron to another. Despite the opinion that nerve cells do not regenerate I, this membrane is capable of regeneration. So if you periodically give the affected arm a rest, the disease can recede. In more serious cases, the axon, the long cylindrical process of the nerve cell, is damaged.It takes the body much longer to restore it. In advanced cases, surgical intervention is required in order, for example, to sew the ends of the nerve.

FROM MOSQUE TO HOSPITAL

Another similar disorder, ulnar neuropathy, is sometimes encountered. Then the patient’s ring finger and little finger become numb, for the innervation of which he is responsible.Most often this happens with injuries, when the patient is forced to wear a cast or a tight bandage. More serious consequences can be caused by damage to the radial nerve, which innervates the back of the arm and is responsible for flexion and extension of the arm at the elbow and wrist joint. Deep sleep aggravates the situation – for example, when a person is intoxicated or under the influence of sleeping pills. If you have a normal physiological sleep, you can turn on the other side in time, change the position of your body.It happens that newlyweds sleep on each other’s shoulder and a nerve is damaged. In my practice, there was a case when my grandmother was afraid to wake up her beloved grandchildren, who slept sweetly on her arm, and after two hours the arm did not bend or unbend. These disorders are also referred to as tunnel syndromes. However, not everything is so bad – if brain cells begin to die within five minutes after the cessation of oxygen access, our peripheral nervous system is more resilient. Its limit is 2 hours.Remember, if we apply a tourniquet in case of damage to large vessels, after 1.5 – 2 hours it must be released to prevent damage to the nerves.

Tunneling syndromes of the extremities quite regularly occur with osteochondrosis of the spine. Previously, it was believed that such pains are associated with radiculitis, that is, inflammation of the root of one of the spinal nerves 90,269. And back in the 60s, the founder of the vertebro-neurologist of the school in our country, professor of our department Yakov Popelyansky showed that these pains can be associated with reflex-tonic syndromes of osteochondrosis, when a spasmodic muscle begins to conflict with a nearby nerve.For example, a patient experienced pain in the shoulder – the doctor was able to prove that this is due to the problem of the pectoralis minor muscle, which conflicts with the nerve. Popelyansky performed novocaine blockade of the muscle, relieved the spasm, and the patient’s pain immediately disappeared. In some cases, carpal tunnel syndrome is treated in a similar way.

Very often we are faced with lumbosacral pain in the lower back. This is due to the piriformis syndrome, in which the sciatic nerve is traumatized.There are breaking pains in the perineum, radiating along the back of the thigh and lower leg; On examination, the doctor may find a painful fibrous cord in the gluteus muscle. Knowing the places of attachment of these muscles, a chiropractor can also relieve tension from them.

Damage to the peroneal nerve is possible when squatting, for example, with welders, gardeners. I remember that among the patients there was a student who got a job at Gorzelenkhoz in the summer, planted flowers, decorated our city. Apparently, she tried very hard and did not pay attention to the unpleasant sensations in the lower leg.In the evening, when the pain had already become unbearable, she was brought to us. There was a young man who knelt in a mosque for several hours and then faced the same problems. In this case, we again apply novocainization, we relax the spasmodic muscle.

“SOMETIMES YOU NEED TO ESTABLISH A VACATION WITH A HAND THAT Clicks the MOUSE”

Let’s go back to our “manual” problems.There is an easy way to tell if you have carpal tunnel syndrome. You need to connect the backs of both hands and stretch your arms down. In this case, the elbows should be directed to the sides, and the wrists should be bent at right angles. If you feel pain within a minute, you should see a neurologist. In general, if hand pains bother you for more than a week, and gymnastics brings only temporary relief, you should make an appointment with a doctor.

If your work is somehow connected with a computer, or if you have to make constant brush movements during the working day, you need to take five-minute breaks at least once an hour.Sometimes you need to arrange a vacation for a hand that constantly clicks the mouse. There are simple exercises to prevent tunnel syndrome.

1. Squeeze and unclench your fists, opening your palm as much as possible – repeat 10 times.
2. Clench your fists and rotate your wrists clockwise and counterclockwise.
3. Shake each finger, rotate it in one direction and the other.
4. Connect your palms, take your fingers back as far as possible for 5 seconds, then lock your fingers into the lock and squeeze hard for 5 seconds.
5. Connect your hands in the lock and straighten your fingers, “twist” your hands outward.
6. Connect your palms in front of your chest, press hard with one palm on the other, then vice versa. Repeat 10 times.

What do we doctors do in such cases? We are trying to restore blood flow, nerve nutrition, prescribe vasodilating drugs , drugs that improve nervous trophism – the same vitamins. In the early stages of the disease, corticosteroids are injected into the canals – carpal tunnel, Guyon’s canal, which have a powerful anti-inflammatory anti-edema effect.A good effect is given by ultrasound treatment, acupuncture ( acupuncture – approx. Ed. ), hydrotherapy. If this does not help, an operation is scheduled. This is a simple surgical procedure in which the transverse wrist ligament is dissected, which is involved in the formation of the carpal tunnel. 80 – 90% of patients then completely get rid of pain. In some cases, during the operation, cicatricial and altered tissue around the nerve is excised – neurolysis.An elderly general practitioner at our hospital has been suffering from severe pain in her hand in recent years. She had to take strong hormonal drugs for months, although the course of treatment usually lasts 5-7 days. As a result, after a small operation and physiotherapeutic procedures, she got rid of these painful sensations.

Let me remind you: to avoid any of these unpleasant tunnel syndromes, you need to be careful about your body. Take care not only of hair and nails, but also of muscles, including the muscles of the spinal column.As I already said, osteochondrosis and everything connected with it is our payback for upright walking, a person cannot hide from osteochondrosis. Unfortunately, the nutrition of the intervertebral discs through small vessels stops after 20 years, the necessary substances begin to flow to the spine only when we move. If we sit at the computer all day, our spine “starves”. Therefore, it is imperative to do a warm-up from time to time, walk more and exercise a couple of times a week, swim in the pool, visit a fitness club.

source http: //www.business-gazeta

Treatment of carpal tunnel syndrome, treatment of carpal tunnel syndrome – MEDSI

Tunnel syndrome is a strong pain in the hands caused by long and monotonous work. Most often, people who work at a computer or are driving for a long time are susceptible to it.

The tissues around the tendons swell and press on the nerve, causing tingling in the hands, numbness and shooting in the fingers, swelling, and muscle weakness.

Specialists of the MEDSI clinics diagnose tunnel syndrome at the earliest stages and treat it without surgery. Highly qualified surgeons will develop an individual physiotherapy program, a course of medications, and select the appropriate joint fixator to keep the hand in a neutral position during sleep and work.

Carpal tunnel syndrome, or tunnel syndrome, is one of the most modern diseases of mankind.The disease was first described as “typist syndrome” and today is known as a disease of programmers, office workers, writers, drivers, hairdressers, photographers, musicians. If your field of activity implies a constant static load on the hand, its tension, uncomfortable position, long monotonous flexion-extension movements of the fingers, then be careful, you are at risk!

Carpal tunnel syndrome affects the ability to work and significantly reduces the quality of life.With severe pain, muscle weakness and limited movement that accompanies the disease, it becomes difficult to cope with working on a computer, driving a car, holding various objects in your hands, from a book to a cup, buttoning up buttons and tying shoelaces. It is worth contacting a doctor if you suspect a hand disease as early as possible, because it is much easier to avoid serious consequences than to treat them. Qualified neuroscientists of MEDSI are ready to advise you about disturbing symptoms, choose a competent conservative or surgical treatment for tunnel syndrome.

Fingers Go Numb: Treatment for Carpal Tunnel Syndrome

Should you worry if your hands or fingers become numb after exercise or if this area becomes uncomfortable? The reasons for this can be a wide variety of factors, especially if we consider that the hand has a complex anatomical structure and each of its elements can “fail”. One of the problems can be narrowing of the carpal tunnel, which contains the main vessels and nerves that are responsible for the normal functioning of the hand and fingers.

In carpal tunnel syndrome, the median nerve is damaged, which runs in this anatomical formation. This nerve is responsible for the sensitivity and function of the fingers of the hand (especially the first three). The disease is characterized by a decrease in the volume of the canal due to some pathological process, compression of the median nerve and a violation of its blood supply, which leads to the development of specific symptoms. The disease is characterized by a slow and gradual course.

Often, patients do not pay attention to the first signs and do not seek medical help.At the moment when carpal tunnel syndrome becomes pronounced, restricts movement and leads to the development of complications, effective treatment is already very difficult. The doctor has to use complex surgical operations that require long-term rehabilitation and do not always allow to fully restore the functions of the hand. To avoid such consequences, it is necessary to promptly seek qualified medical help at the first symptoms of the disease.

Why does carpal tunnel syndrome develop

As already noted, the main cause of the development of the disease is the narrowing of the carpal tunnel.This pathological process can be a consequence of other diseases and conditions, among which are noted:

• Inflammatory lesions of the wrist. These include arthritis, synovitis, rheumatoid arthritis, osteoarthritis, tendovaginitis, gout, etc.
• Injuries to the wrist. As a result of bruises, dislocations, fractures, the carpal tunnel can narrow not only due to displacement of bones, but also due to tissue edema.
• Professional activity. Increased trauma to the wrist is noted in carpenters, cellists, pianists and other people whose work is associated with prolonged flexion and extension of the hand.In addition, the increased risk of developing carpal tunnel syndrome is noted in people who work on a computer for a long time, namely, typing on a keyboard.
• Other causes associated with tissue edema. This can be long-term use of oral contraceptives, endocrine diseases, kidney disease, pregnancy, etc.
• Acromegaly. In this neuroendocrine disease, excessive bone growth is noted, due to which the hands become disproportionate. Carpal tunnel syndrome is one of the most common signs of acromegaly.

The disease can also develop in completely healthy people in whom the carpal tunnel is narrow from birth. For the same reason, carpal tunnel syndrome is most often detected in women, since they have it narrower by nature.

How carpal tunnel syndrome manifests itself

The main symptoms of the disease are numbness, as well as pain in the area of ​​the hand and fingers. In the initial forms, these manifestations are not very pronounced, but as the narrowing of the carpal tunnel increases, they gradually increase.Pain can spread along the median nerve to the forearm or fingers. It is characterized by an increase at night. In this case, the pain is more pronounced on the limb that is more active. Painful sensations may be reduced by rubbing the hands, lowering them down, or shaking them.

If the treatment of carpal tunnel syndrome is not promptly carried out, then more serious symptoms appear in the clinical picture, which are associated with movement disorders. The patient’s thumb function may be impaired, which makes it difficult to perform the simplest household actions (hold a book or mobile phone with one hand, drive a car, write).There is also a decrease in the accuracy and coordination of movements, there are complaints of a cold snap or a feeling of heat in the area of ​​the hand, the skin in the affected area may have a pale or reddish tint.

Methods for the diagnosis and treatment of carpal tunnel syndrome

The examination begins with an examination and consultation with a neurologist. The specialist can detect a decrease in muscle strength, assess reflexes, determine the area of ​​impairment or loss of sensitivity, and additional tests and functional tests are used to help confirm the diagnosis.Carpal tunnel syndrome can be similar to other neurologic diseases, so a more in-depth examination may be required to distinguish one disease from another, which may include the following:

• electromyography;
• X-ray of the wrist joint;
• in some cases it is possible to carry out ultrasound and MRI of the wrist joint;
• blood tests to detect general inflammation, rheumatoid factor, deficiency of important trace elements for conducting impulses along nerves.

Effective treatment involves the elimination of the causes that led to the narrowing of the carpal tunnel. For this, various methods can be prescribed – anti-inflammatory drugs, physiotherapy, the introduction of pain medications directly into the carpal tunnel (blockade).
If conservative therapy is ineffective, an operation is prescribed, the essence of which is to dissect the carpal tunnel ligament, due to which additional space appears in the wrist. Such an intervention can be carried out in an open way, or with the use of endoscopic instruments.After the operation, it is necessary to undergo rehabilitation, the duration of which is several months.

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