Pinched nerve vs carpal tunnel: Pinched Nerve and Carpal Tunnel Syndrome – How to Relate?
Pinched Nerve and Carpal Tunnel Syndrome – How to Relate?
Numbness in the area of the nerve
Sharp or shooting or burning pain
Tingling or needle like sensation
Pinch Nerve Cause
Peripheral neuropathy of any kind, when left untreated, can result in permanent damage or even dangerous operation. Even a small feel, a pinched nerve in fingers or other limbs, is therefore nothing to take lightly. This is why in particular three nerve areas can cause tingling or stunning in your fingers and palms when compressed.
The median nerve, a function and feeling in the thumb, index or long fingers, is located in your wrist. You may develop carpal tunnel syndrome when compressed for too long or injured. If you feel that you can have a pinched nerve on your fingers (thumb, long or forefinger), you may have to treat yourself with a pinched nerve in the wrist for Carpal Tunnel Syndrome.
Pinched Nerve in Neck
At times, a pinned nerve in the neck could make you and your hand suffer from pain, tingling or weakness. This is called cervical radicular disease. The discs lose water and height as the vertebra in your neck age, so the vertebras move closer together. Bone spurs are the answer your body needs to face — they protect the discs — but can also cause nerve compression. This results in cervical radical disease. Not everyone is suffering from compressed nerves, and why others are doing it is unknown.
You may experience cervical radical pathology when you have pain on or down your arm more than just the fingers specific to Carpal Tunnel Syndrome, or if your pain is affected by how you move your neck — but it’s important for the medical profession to make sure that it is a diagnosis.
If you are looking for carpal tunnel surgeon near you, come to us. At Neuroscience Specialists you would get neuro treatments for other problems too.
Carpal Tunnel Syndrome vs.
The carpal tunnel is a structure in the wrist that contains the tendons that control the fingers and then median nerve, which innervates the thumb and first two fingers.
Understanding Hand Pain and Numbness
Learn the symptoms and underlying causes of persistent hand pain and numbness. Read More
When the carpal tunnel is too small and/or inflammation occurs in the tendons that run through it, the median nerve becomes compressed, causing symptoms such as pain, numbness, and tingling in the wrist, hand, and fingers.
Symptoms of Carpal Tunnel Syndrome
Symptoms of carpal tunnel syndrome include, but are not limited to, the following:
- Tingling and numbness in palm, thumb, or first two fingers, especially during the night or in the morning. The sensation may cause people to want to “shake out” the hand.
- Aching pain in the wrist and hand, with occasional shooting pains up the forearm
- Weakness in the hands and fingers and trouble gripping or holding objects
Carpal tunnel syndrome is treated with nonsurgical methods such as splinting, ice therapy, and behavioral modifications. It can also be treated surgically with a procedure called carpal tunnel release.
Watch: Video: How to Make 5 Quick and Easy Ice Packs
In This Article:
Carpal Tunnel Syndrome vs. Cervical Radiculopathy
Carpal tunnel syndrome is not the only condition that can cause numbness and tingling in the hands and wrists. These symptoms can also be caused by problems in the cervical spine.
Watch: Cervical Spine Anatomy Video
Conditions such as a herniated or degenerated disc, cervical stenosis, or cervical osteoarthritis can trigger impingement on the C6 or C7 nerve roots, which originate in the cervical spine and innervate almost the same areas of the hand as the median nerve.
See C6-C7 Treatment
Because they’re both conditions caused by nerve impingement, both carpal tunnel syndrome and cervical radiculopathy cause similar symptoms: dull pain, tingling, and/or numbness, with occasional shooting pains along the nerve path.
See Cervical Radiculopathy Symptoms
A comprehensive neurological evaluation can help identify whether the symptoms are being caused by carpal tunnel syndrome or a cervical spine condition. In fact, sometimes the two conditions are seen together, as nerve compression at the neck can make the nerves lower down more vulnerable. Clinical evaluation, electrodiagnostic testing EMG, and possibly neck imaging can help put together the pieces of the puzzle.
See What Causes Hand Pain and Numbness?
Both carpal tunnel syndrome and the various causes of cervical radiculopathy require treatment to prevent long-term nerve damage. Individuals with numbness and tingling in their hands or wrists should see their physician for diagnosis and treatment.
Carpal Tunnel Vs. Tendonitis: Identifying the Symptoms
For years, you have probably heard about the risk of carpal tunnel or wrist tendonitis for people that spend most of their days typing at a computer. That’s a scary thought as technology is becoming a bigger part of our everyday lives.
Elizabeth King, M.D., an orthopedic surgeon with Henry Ford Health System, says not to worry.
“No studies have been able to demonstrate that carpal tunnel syndrome and wrist tendonitis are caused by typing,” says Dr. King. “Recent studies actually show jobs that require the repetitive use of power tools are more likely to cause these issues.”
The vibrations produced by using these tools are more likely to cause problems with the nerves and tendons in your wrist. Assembly line jobs can also cause issues due to the constant flexing and extending of the wrist. In many cases, age also plays a part on the onset of these conditions. Like arthritis and other related issues, people are more likely to develop carpel tunnel or tendonitis as they get older.
So what is the difference between carpal tunnel syndrome and wrist tendonitis? Here’s the two conditions broken down:
Carpal Tunnel Syndrome
Carpal tunnel syndrome is caused when the median nerve in the wrist becomes pinched. This can lead to numbness or tingling throughout the hand and through the thumb to ring finger. “Many patients experience these symptoms more at night,” Dr. King says. “Sometimes the pain is enough to wake them up.”
Treatment: Depending on the severity of the case, your doctor may recommend a series of different treatments. For most people, wearing a wrist brace, occupational therapy or steroid injections can help alleviate or lessen these symptoms. Your doctor will always try to treat carpal tunnel without invasive methods first, but many serious cases will need surgery. Surgery is used to repair nerve damage to get you back to having normal mobility in your wrist and hand.
Wrist tendonitis can occur when any of the tendons in your wrist become inflamed. “There are about 10 or so tendons that could possibly be affected,” says Dr. King. This condition causes swelling of the wrist. Sometimes, symptoms appear following a wrist injury.
Treatment: If you do experience symptoms, consider taking an over-the-counter anti-inflammatory (think Aleve or ibuprofen) before seeing a doctor. You can even try icing your wrist. Most doctors will recommend you do these things before other treatment is suggested. Like carpal tunnel, wrist tendonitis is treatable through wrist bracing, steroid injections and occupational therapy. However, unlike carpal tunnel, surgery is not used to treat this condition.
Overall, the biggest different between carpal tunnel syndrome and wrist tendonitis is that one affects the nerves and the other affects the tendons.
Unfortunately, there isn’t much that can be done to prevent these conditions from occurring. Despite the fact that typing and other repetitive office tasks may not be the causes of carpal tunnel or tendonitis, they can aggravate the problem and cause more pain. So, it is still best practice to take breaks and practice proper body position to avoid injury.
“If you feel these symptoms at your job, your doctor can make a note that you have a work restriction,” says Dr. King. If your symptoms ever get too bad for you to work or perform daily tasks, seek immediate medical attention.
To find a doctor at Henry Ford, visit henryford.com or call 1-800-HENRYFORD (436-7936).
Dr. Elizabeth King is an orthopedic surgeon, specializing in hand surgery, and sees patients at Henry Ford Hospital and Henry Ford Medical Center – Fairlane.
Do you have Cervical Radiculopathy?
I’m having numbness and tingling in my hand. Sometimes there is pain that runs down my arm and shoulder. I thought I had carpal tunnel syndrome. Someone told me it could be coming from my neck. What does this mean?
Not all hand numbness is carpal tunnel syndrome. The symptoms you describe are typically caused from a nerve injury or irritation. The nerves that go to your arm start at your neck. If the nerve is being irritated or compressed at your neck, this is called cervical radiculopathy.
What causes cervical radiculopathy? I haven’t done anything to my neck.
The nerves that go to your arms exit the spinal cord through the spaces between bones in your neck. The bones have cushions between them called discs. A nerve can be compressed if the disc material is pressing on the nerve or if the bones develop spurs from arthritis, making the opening for the nerve small. Sometimes the joints in the spine can become inflamed and cause nerve irritation.
How can I tell if my symptoms are coming from my neck?
Let’s perform an experiment to see if we can figure it out.
- Notice what you feel in your arm right now. Is it numb? Tingling? Shooting pains? How intense is it?
- Now, look down at your left foot, then look down at your right foot. Any changes in how you feel? Better, worse or no different?
- Look up as if a bird flew over your left shoulder. Now, do the same for the right shoulder. Any change in how you feel? Better, worse or no different?
If the position of your head/neck changes how you feel in your hand, the problem could be coming from your neck. Let’s try one more thing.
- Reach with one arm as if you are the driver of a car reaching behind the passenger seat. Is that better, worse or no different? What if you reach with the other arm in the same way? Any change in how you feel in your hand with that motion?
The nerves in your arm can be stretched by reaching motions and may indicate nerve irritation somewhere along their path – possibly at the neck or down your arm.
If you experience hand numbness, tingling, pain or weakness with motion of your neck or reaching behind you with your arm, an evaluation by a hand surgeon may help to identify if the source is from your neck. A certified hand therapist can teach you ways to reduce nerve compression and tension.
To find a certified hand therapist in your area, simply click on the link below:
Kim Kraft, PT, DPT, CHT is a certified hand therapist and a member of the American Society of Hand Therapists.
Carpal Tunnel & Other Nerve Problems
Carpal Tunnel Syndrome
If you experience intermittent or persistent pain, tingling, weakness, or numbness in your hand, you may have carpal tunnel syndrome. The carpal tunnel is a narrow, rigid passageway on the palm side of your wrist. The median nerve, which controls feeling and movement in the thumb and first three fingers, runs through the carpal tunnel, along with tendons that run from the forearm to the thumb and fingers. Carpal tunnel syndrome occurs when the median nerve is pinched or compressed in this tunnel.
Symptoms of carpal tunnel syndrome tend to develop gradually and often first appear during the night or when waking. Some people sleep with their wrists flexed in a positon that puts pressure on the nerve, making the symptoms worse. The first symptoms are often tingling – that “pins and needles” feeling – and/or numbness that can be alleviated by shaking the hand. As the syndrome progresses, the tingling and numbness may increase and be felt more often throughout the day. Decreased strength and sensitivity may make it difficult to perform manual tasks, such as grasping small objects, working with tools, or buttoning a shirt. Some patients experience pain in the hand and wrist, which may radiate upward into the arm.
Conditions that may contribute to carpal tunnel syndrome include:
- Injury to the wrist
- Rheumatoid arthritis
- Fluid retention during pregnancy
- Repetitive motion that causes pressure or inflammation in the wrist
- Development of a tumor or cyst in or near the carpal tunnel
Women are three times more likely to be affected than men. It can occur in one or both hands, and usually starts in the dominant hand.
If you haven’t had the symptoms very long, treatment can begin with immobilizing the wrist in a brace or splint. Ice packs and non-steroidal anti-inflammatory drugs are often recommended to relieve discomfort and inflammation. For severe symptoms, corticosteroids may be recommended. Once the symptoms have abated, your doctor may recommend physical therapy to stretch and strengthen the hand to keep it strong and mobile.
Some cases may require surgery on the ligament overlying the carpal tunnel. Cutting the carpal ligament relieves pressure by enlarging the opening. The surgery is performed under regional anesthesia and sedation in an outpatient facility.
For more information, see the website of the National Institute of Neurological Disorders and Stroke.
Other Nerve Problems
Cubital tunnel syndrome and radial tunnel syndrome aren’t as well-known as carpal tunnel syndrome, but they can cause similar symptoms due to increased pressure on nerves in the hand, wrist or arm. Cubital tunnel syndrome and radial tunnel can cause severe pain, numbness, tingling, and muscle weakness in the hands and arms.
Cubital Tunnel Syndrome
Cubital tunnel syndrome, also known as ulnar neuropathy, is caused by increased pressure on the ulnar nerve, which passes close to the skin’s surface in the area of the elbow commonly known as the “funny bone.” You’re more likely to develop cubital tunnel syndrome if you repeatedly lean on your elbow, or bend your elbow for long periods of time.
Some of the early symptoms of cubital tunnel syndrome include pain and numbness in the elbow, and tingling, especially in the ring and little fingers. More severe symptoms may include weakness affecting the ring and little fingers, decreased ability to pinch the thumb and little finger, decreased overall hand grip, muscle wasting in the hand, and a claw-like deformity of the hand.
Radial Tunnel Syndrome
Radial tunnel syndrome is caused by increased pressure or compression on the radial nerve, which runs by the bones and muscles of the forearm and elbow. The radial nerve is one of three nerves that provide motor and sensory function to the arm.
Conditions that may contribute to radial tunnel syndrome include:
- Noncancerous fatty tumors (lipomas)
- Bone tumors
- Inflammation of surrounding tissue
The most common symptoms of radial tunnel syndrome are cutting, piercing, or stabbing pain at the top of the forearm or back of the hand, especially when you try to straighten your wrist and fingers. The pain is located in the forearm a couple inches below the elbow. Unlike cubital tunnel syndrome and carpal tunnel syndrome, radial tunnel syndrome rarely causes numbness or tingling, because the radial nerve principally affects the muscles.
Mild cases of cubital tunnel syndrome often respond to physical therapies such as, avoiding pressure on the elbow, wearing a protective elbow pad, or wearing a splint. In cases where splinting doesn’t help or nerve compression is more severe, surgery to release pressure on the ulnar nerve may be needed.
Conservative treatments for radial tunnel syndrome include medications such as nonsteroidal anti-inflammatory drugs to reduce soft tissue swelling, corticosteroid injections to relieve inflammation and pressure on the radial nerve, and wrist and/or elbow splints to reduce irritation of the radial nerve.
Some patients also may benefit from ergonomic education to reduce the effects of repetitive stress, nerve-gliding exercises, stretching/strengthening exercises, and other interventions such as heat, cold, and ultrasound. If these conservative measures fail to provide relief after three months, your doctor may consider surgery to reduce pressure on the radial nerve.
In most cases, cubital tunnel syndrome and radial tunnel syndrome can be managed with conservative treatments. But more severe cases may require surgery to reduce pressure on the affected nerve.
For more information about cubital and radial tunnel syndrome, visit the following website: http://www.webmd. com/pain-management/cubital-radial-tunnel-syndrome#3.
Don’t delay treatment for carpal tunnel syndrome
Ignoring symptoms of this carpal tunnel syndrome can lead to permanent nerve damage.
First, you may notice tingling or numbness in your fingers that comes and goes. Over time, the sensations may get worse, lasting longer or even waking you up at night. Eventually the pain and numbness might even make it hard to grip things like a fork, a pen, or other objects.
If you’re having these symptoms, it could be carpal tunnel syndrome, which occurs when the median nerve — which runs down your arm and into your hand — is compressed by a ligament that crosses over it as it passes through a narrow space in the wrist known as the carpal tunnel.
“Carpal tunnel syndrome has classic symptoms, which include numbness and tingling in the thumb, index finger, middle finger, and half of the ring finger,” says Dr. Tamara Rozental, professor of orthopedic surgery at Harvard Medical School and chief of hand and upper extremity surgery at Beth Israel Deaconess Medical Center. Your little finger is typically not affected because a different nerve serves it.
Women at risk
Women tend to be more prone to carpal tunnel syndrome because of risk factors, such as pregnancy, that are specific to their sex. Other risk factors include:
- cysts that encroach on carpal tunnel passageway
- drinking alcohol
- being overweight
- thyroid disease
- arthritis affecting the wrist.
While it used to be thought that repetitive activities such as keyboarding could cause carpal tunnel syndrome, research has found that this is largely not the case, says Dr. Rozental. However, regular use of heavy or vibrating equipment, such as a jackhammer, may predispose you to the condition.
Your doctor can usually diagnose carpal tunnel syndrome based on your symptoms and the findings on physical examination. But in some cases, you may need additional tests to ensure that those symptoms aren’t being caused by another condition, such as arthritis, a pinched nerve in your neck, or neuropathy (nerve disease that can be a complication of diabetes or other conditions), says Dr. Rozental.
One of the tests used to confirm carpal tunnel syndrome, a nerve conduction study and electromyogram (EMG), uses an electrical signal to determine how well the nerve is working. Another test uses ultrasound, which is less invasive than an EMG but requires an experienced technician and is not as widely available.
Treating carpal tunnel syndrome
For mild cases of carpal tunnel syndrome, resting your hand and wearing a splint at night might be all it takes to relieve symptoms. Symptoms of carpal tunnel syndrome often occur at night, causing people to wake up and shake or move their hand around until the numbness resolves and it feels better, says Dr. Rozental. Medications, such as aspirin and ibuprofen aren’t a cure, but can help relieve pain. Your doctor may also want to try giving you steroid injections to help relieve symptoms.
If these carpal tunnel treatments aren’t effective, however, it may be time to consider surgery to release the ligament that is placing pressure on the median nerve.
When to get surgery
“The mistake that people often make is waiting too long to get surgery,” says Dr. Rozental. “I see a lot of people who say that their numbness was gradually worsening and now their hand is completely numb and has been for a year.” If the nerve is compressed long enough, the muscle atrophies and the nerve damage becomes permanent, she says.
So, if your carpal tunnel symptoms aren’t responding to other treatments, take action quickly.
The surgery takes 10 minutes under a local anesthetic. Unless you do a job that involves manual labor, you can typically go right back to normal activities, says Dr. Rozental.
“I tell my patients all the time that a carpal tunnel release done at the right time for the correct diagnosis is very successful,” she says.
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Pinched Nerve In or Near the Elbow
A pinched nerve (nerve entrapment) in or near the elbow can cause elbow pain, numbness, tingling, or weakness of the arm, wrist, or hand. The nerve that most commonly gets pinched in or near the elbow is the ulnar nerve. It is located in the elbow area, on the little finger side when the palm is facing up. Less often, the median or the posterior interosseous nerve, a branch of the radial nerve next to the elbow area on the thumb side when the palm is facing up, may get pinched.
Examples of nerve entrapment syndromes that affect the elbow include:
- Cubital tunnel syndrome, which involves the ulnar nerve. Repeated injury to the elbow can cause scar tissue to form over the ulnar nerve as it passes through the groove in the middle of the elbow. The scar tissue pinches the nerve, causing elbow pain and numbness and tingling that can occur down into the ring and little fingers along with a loss of strength in the fingers. This syndrome is similar to carpal tunnel syndrome in the wrist.
- Pronator teres syndrome, which involves the median nerve as it passes beneath the muscles in the forearm at the elbow. The forearm tends to ache, and pain spreads down the forearm toward the wrist, hand, and thumb area.
- Posterior interosseous nerve syndrome, which involves compression of a branch of the radial nerve. Posterior interosseous nerve syndrome does not involve a loss of sensation, such as numbness or tingling, but may cause weakness of the wrist and fingers. This syndrome may be misdiagnosed as tennis elbow because pain is felt on the outside (lateral) part of the elbow in both of these conditions.
Treatment for these nerve entrapment syndromes includes rest, stretching, taking anti-inflammatory medicines, and occasionally surgery.
Current as of:
February 26, 2020
Author: Healthwise Staff
William H. Blahd Jr. MD, FACEP – Emergency Medicine
Adam Husney MD – Family Medicine
Kathleen Romito MD – Family Medicine
Current as of: February 26, 2020
Medical Review:William H. Blahd Jr. MD, FACEP – Emergency Medicine & Adam Husney MD – Family Medicine & Kathleen Romito MD – Family Medicine
Carpal tunnel syndrome
Carpal tunnel syndrome (carpal tunnel syndrome) is a condition of the hands that causes numbness in the fingers of the hand due to a pinched median nerve at the level of the wrist.
The median nerve provides sensitivity to the thumb, middle, and index fingers of the hand. Swelling or a change in the position of tissues in this area can lead to squeezing, as well as irritation of this nerve.
The carpal tunnel is the space at the level of the wrist through which the median nerve passes to the hand.Formed between the bones of the wrist and the carpal ligament.
Typical signs of carpal tunnel syndrome:
tingling sensation, burning sensation, “goose bumps”
numbness of fingers
night pain in the hand
with advanced degrees of atrophy of the muscles of the hand
At the initial stages of the disease, with the appearance of numbness for less than six months, therapeutic anti-inflammatory blockades, physiotherapy, and the manufacture of individual splints are used.
With the ineffectiveness of blockades, as well as with a disease duration of more than 6 months, with clear signs of nerve compression, recorded on ENMG and ultrasound, surgical treatment is indicated.
The essence of the operation is to dissect the carpal ligament, which compresses the nerve. There are many types of incisions for performing the operation – from wide to very small. In our clinic, we use two mini-incisions, each about 1.5 centimeters long. The operation is performed under local anesthesia.
What is needed for treatment in one visit?
Thanks to modern information technologies, the treatment of carpal tunnel syndrome in one day is a very real possibility. To do this, you only need to send photographs of your hands to [email protected]
or on whatsapp by number 8 (996) 766-76-08, describe complaints and answer questions. Our specialists will study the information received and draw up an individual treatment plan.
Most likely, to clarify the diagnosis, it will be necessary to undergo a special examination – electroneuromyography (ENMG). This is the study of muscle contractions depending on the level of electrical stimulation, which helps to objectively determine the place of compression or damage to the nerve.
It is desirable to indicate in the letter:
Full name and year of birth
Contact phone number and city of residence
Does your hand grow numb or do you feel as if your hand was lying down?
Do you experience hand pain, especially at night?
How long has the disease been going on and who made the diagnosis?
Did the disease start gradually or after an injury?
Have you been operated on before? If so, where and when (it is advisable to send a copy of the discharge summary after the operation, and mark the postoperative scar on the photo of the hand with a marker).
Have you had ENMG? If so, send a copy of the opinion.
Indicate the desired dates for the operation (consultation).
Attach photographs of the hand with a highlighted marker or pen of the area of numbness and pain.
In free form, describe the problem (what worries and for how long), to whom you turned for help (what treatment you received and whether there was an effect), what studies were carried out (if any, you must attach copies of medical documents).
In addition, you can simply make an appointment by phone 8 (812) 406-88-88 for an operation for carpal tunnel syndrome without answering questions and sending photos. If there are no contraindications, you may also be offered treatment in one visit.
Hand Surgery Center
Carpal Tunnel Syndrome | Freiburg University Hospital
Carpal tunnel syndrome (carpal tunnel syndrome) is one of the most common diseases caused by pinched nerves.The cause of this disease is the pinching of the median nerve at the level of the wrist in the area of the so-called. carpal tunnel. Typical symptoms include pain at night and tingling in the thumb, index, and middle fingers. Failure to start treatment promptly can lead to weakness and loss of muscle mass in the affected area. The pinching can be effectively removed with a simple endoscopic surgery.
The diagnostic plan is developed by the specialists of our clinic individually within the framework of a thorough examination and taking into account the treatment measures already taken, as well as taking into account aspects of professional and private life.An electrophysiological examination is often done, and in some cases an X-ray or MRI is recommended. At the end of the diagnosis, the patient is recommended conservative or surgical methods of treatment suitable for him.
In nerve surgery, modern endoscopic and microsurgical techniques are used, which make it possible to carry out the most sparing operations that do not require large incisions. As a result, it can reduce swelling and pain and promote quick recovery from surgery.Interventions are generally performed under local or regional anesthesia.
- Operation duration: about 30 minutes
- Stay: outpatient
- Regeneration process: 1 week
A thorough diagnostic evaluation is required to develop an optimal treatment plan. For this reason, we ask you to send us your medical history, X-rays and photographs in advance.Only after examining your documentation and conducting a thorough examination, we can prescribe the most suitable procedures for you. For more accurate analysis, nuclear magnetic resonance spectroscopy (NMR spectroscopy, Nuclear Magnetic Resonance Spectroscopy ) can be assigned.
The intervention is performed on an outpatient basis under local or regional anesthesia.The carpal tunnel is accessed through an incision one to two centimeters long. With the help of an endoscope, the carpal lid is dissected, which makes it possible to expand the carpal canal. One suture is sufficient to close the wound. After the operation is completed, a flexible drainage is installed and a compression bandage is applied.
Drainage tube and compression bandage are removed the day after surgery. After that, it is enough to apply a bandage. The arm should be in an elevated position for several days.You should also avoid stress on the arm. After 3-4 days, you can return to normal life. On the tenth day after the operation, the stitches are removed. A sick leave is issued depending on the type of professional activity, on average for one week. Relief of symptoms occurs in the first days after the intervention.
Tunnel syndrome treatment in Yekaterinburg
Do your hands hurt from the computer mouse?
Do you feel pain in your wrist while working at a computer with a mouse? Uncomfortable to hold the steering wheel of a car? Do your hands hurt during exercise? The orthopedic traumatologist of the Center for Cosmetology and Plastic Surgery will help to find out the cause of the pain. Dmitry Polyakov:
“A very common disease in recent years – carpal tunnel syndrome , or, as it is also called, – tunnel syndrome .Usually those whose work is associated with performing monotonous mechanical movements with their hands bent in their hands suffers from this disease. At risk, in addition to personal computer users, are truck drivers who hold the steering wheel for long hours, cashiers, assembly line workers, musicians and … summer residents. ”
However, not every doctor can correctly diagnose and prescribe the appropriate treatment. This syndrome is essentially a pinched nerve in the tunnel. The median nerve and 9 tendons of the hand muscles pass through the carpal (carpal) canal – a tunnel, hence “tunnel syndrome” .The median nerve provides sensitivity and movement to the first and fourth fingers and palm. The tunnel channel itself is narrow. It is in it that it is compressed, i.e. pinched, median nerve. Hence the appearance of disorders of sensitivity and hand movements.
Pain in the hand and fingers, their numbness, tingling or chills in the middle, index and thumb do not go away by themselves, but intensify. Gradually, a person loses his ability to work for a period from several months to several years.
Treatment can be both conservative and operative. Conservative treatment is effective in mild cases. If one or two courses did not work, you need to think about the surgical release of the nerve. And with severe, long-term, recurring pain, surgery is necessary. Over time, without treatment, the nerve will atrophy.
With the traditional method of surgery, an incision is made on the palmar surface of the wrist with a length of about 10 cm, followed by a long course of treatment and, as a result, scars on the hand.
There is a more modern, efficient and gentle method – endoscopy .The essence of the endoscopic method is to release the median nerve from compression under the control of the optics. Using an endoscope with a camera allows you to restore the function of the hand with minimal surgical intervention. A small incision 1 cm long is made along the skin fold, in the projection of the carpal canal on the wrist, in the transverse direction. The operation is carried out under anesthesia; they remain in the hospital for 2-3 days. The access site is closed with a suture, and a soft bandage is applied. There is no need to apply a plaster cast or splint as in traditional surgery.
It should be borne in mind that there are different techniques for performing endoscopic median nerve release. Usually, first a dilator is inserted into the narrowed canal, then a video camera, which is why the risk of nerve damage is high: part of the operation is “blind”.
“We prefer a safer technique: first, we install a video camera over the affected canal, then, under the control of high-resolution optics, we safely dissect the ligament,” says Dr. Polyakov.
By the way, surgery is also very effective in the treatment of ulnar nerve syndrome , a risk group for which professional drivers are. Compression of the ulnar nerve may be indicated by numbness in the fourth and fifth fingers and pain in the elbow area.
“With this surgical method of treating tunnel syndrome, the symptoms disappear quickly, often even on the day of the operation,” says orthopedic traumatologist Dmitry Vladimirovich Polyakov.
If you notice the symptoms described, seek competent advice from a specialist in the treatment of carpal tunnel syndrome Dmitry Vladimirovich Polyakov pdv @ plastic-surgery.ru. You can make an appointment by phone. (343) 228-28-28.
CONTRAINDICATIONS ARE AVAILABLE, SPECIALIST CONSULTATION REQUIRED
Carpal tunnel syndrome – tunnel syndrome
Pain and numbness in the fingers and hands, and sometimes in the forearm, can be signs of carpal tunnel syndrome (also called carpal tunnel syndrome and carpal tunnel syndrome). This condition develops when the median nerve that runs from the shoulder to the fingers is compressed or pinched.Tunnel syndrome is common in people working in assembly, sewing, finishing, harvesting, packaging of meat or fish. Carpal tunnel syndrome is less common in people who work at a computer, but it does happen.
How does carpal tunnel syndrome manifest?
The median nerve is responsible for the thumb, index, middle, part of the ring and part of the palm near the thumb. This is where pain, numbness and / or tingling occurs. Sometimes discomfort can spread throughout the hand and above.Symptoms often appear in both hands, but usually it starts with the leader. The condition may worsen if you bend / unbend your hand or raise your arm. At night, when the hand is at an angle to the forearm for a long time, the pain is so severe that a person even wakes up. Symptoms may worsen while driving, reading, typing, and holding your phone. It happens that at first unpleasant sensations arise sporadically, and then become permanent.
Why does carpal tunnel syndrome occur?
The median nerve runs between the bones of the wrist and the ligament.Pinching can occur in several cases: when
- the tendons that go through the same canal become inflamed;
- the tissues surrounding the ligaments are compacted;
90,016 people hold their hands in a position in which the channel narrows.
It is known that in women, carpal tunnel syndrome occurs more often due to the fact that the space where the median nerve passes is narrower. Also, risk factors are, apparently, overweight, pregnancy, diabetes, rheumatoid arthritis and genetic predisposition.
The sooner you seek medical attention, the lower the risk of median nerve injury and the easier it will be to manage carpal tunnel syndrome.
What awaits you at the doctor’s appointment?
The doctor will ask you about your symptoms and perform an examination. To diagnose carpal tunnel syndrome, use:
- Tinel test. The doctor will tap the median nerve in the wrist with a hammer. If discomfort appears in the fingers, then the test is positive.
- Phalen’s test: the forearms are held parallel to the floor, the hands touch each other with the backs, fingers pointing down. If after a minute numbness or tingling appears in the fingers, then the test is positive.
The doctor may also ask you to hold your hands up or in the position that is most likely to exacerbate symptoms.
If the doctor suspects some other disease (for example, polyneuropathy, radiculopathy or plexopathy), he will conduct more complex studies: a study of nerve conduction and electromyography. The first shows whether the median nerve correctly transmits electrical signals (in the case of the syndrome, this happens more slowly or weaker), the second – whether the muscles respond correctly to electrical signals.
What to do if carpal tunnel syndrome is diagnosed?
If the matter is in rheumatoid arthritis or diabetes mellitus, then first you need to take control of the underlying disease. In other cases, the most effective treatment is complex. First of all, this is a splint applied to the wrist at night so that the wrist is in a neutral position.Such a device is worn for several months – until the symptoms go away. The doctor may also prescribe steroids. An injection of methylprednisolone into the carpal tunnel is given only once, it is more effective than pills. However, they can also be applied. The course of prednisone usually lasts 10-14 days.
- Potentially effective methods include yoga, which focuses on the joints in the upper body.
- Special exercises, ultrasound, electrical stimulation, low-level laser therapy, magnetic therapy, contrast baths and myofascial massage have no proven effectiveness.
- Studies have also shown that non-steroidal anti-inflammatory drugs (ibuprofen, aspirin, etc.), vitamin B6 and diuretics are ineffective, so they should not be used.
If the symptoms of tunnel syndrome last more than six months, and the nerve is severely damaged, the doctor recommends surgery – the ligament that forms the canal is cut. The surgery is performed under local anesthesia and the patient can leave the hospital the same day. The incision does not exceed 5 cm, but endoscopic operations are also performed when only one or two punctures are needed.There are very few relapses after such treatment, but rehabilitation will be required: the wrist becomes weaker due to a cut ligament and special exercises must be performed to restore strength.
If you have pain, numbness, or tingling in your fingers (other than the little finger) and / or palm, it is most likely carpal tunnel syndrome. In this case, it is definitely not worth delaying the visit to the doctor.
Make an appointment with an orthopedic traumatologist or neurologist, for this call +7 (495) 308-39-92 .
Carpal tunnel syndrome – Description of the diagnosis
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The date of the last revision 5/25/2018
Carpal Tunnel Syndrome ›Diseases› Dr.Peter.ru
The computer, on the one hand, made life and work easier for us, on the other, it created new health problems. Especially what spoils our life is a seemingly harmless device – a mouse. Fingers, hands from the wrists and up to the shoulder can experience literally eternal suffering from the use of this working tool. Most often, doctors hear complaints of pain in the wrist joint, this condition has received its official name – carpal tunnel syndrome (carpal tunnel syndrome). Informally, it is called the computer mouse syndrome.
At first, unpleasant sensations appear in the wrist area, and possibly in the palms and fingers at the same time. Over time, the fingers (thumb, index, middle) and the entire hand weaken, there is a feeling of swelling, pain and heaviness, numbness and tingling. Moreover, pains and numbness are especially disturbing at night, because a person cannot control the position of his hand when he is sleeping, and because of this, sleep is also disturbed.
The hand and fingers become somehow awkward, awkward to such an extent that it becomes difficult to write with an ordinary fountain pen, just as it becomes difficult to hold a heavy object, moreover, when trying to do it, pain occurs.
The wrist is the area where the radius and ulna (the bones of the forearm) and the eight bones of the hand (the small bones of the palm) meet. Through the carpal tunnel, otherwise it is called a tunnel, the tendons of the muscles of the hand, the median nerve, pass. This nerve is responsible for the sensitivity of the surface of the thumb, index, middle, ring fingers from the side of the palm and the back of the tips of these fingers, and it also innervates the muscles that provide movement of the thumb, index and middle fingers.Carpal tunnel syndrome develops when the median nerve in the canal is compressed (pinched), which causes impaired sensitivity and movement of the fingers and hands.
The causes of pinching can range from swelling of the tendons that run near the nerve to swelling of the nerve itself. They have the same result – impaired blood circulation, which means tissue nutrition and the process of excretion of metabolic products, which further increases the swelling and compression of the nerve.
Why is the computer mouse called the culprit for the development of tunnel syndrome? Because there are millions of those who work at the computer all over the world and they more often than, say, people who manually paint carpets or embroider fabrics with patterns, go to the doctor, although they have the same symptoms, and the problem is the same.This problem is a constant static load on the same muscles during repetitive movements when working with a computer mouse (needle), in which the hand bends excessively at the wrist. It has long been known that the body cannot resist constant stress for a long time – at some point it “breaks down”.
When the hand starts to bother you seriously, try to help yourself on your own: near the elbow, in the place of muscle attachment, feel for a small seal on the forearm (usually it is 1.5–2 cm from the elbow joint) and massage it.At the same time, you should feel numbness in the fingers of the kneaded hand. It should pass quickly, and with it – discomfort and pain. If they persist, it means that the problem did not arise suddenly and for a long time it is necessary to consult a specialist (neurologist) who will provide an “ambulance” – he will make an injection that relieves acute pain, and prescribe a comprehensive treatment.
Most often, a consultation with a neurologist is enough to make a diagnosis – he examines the patient and gets to know his lifestyle.In special cases, electromyography (EMG) and electroneuromyography (ENG) are required for differential diagnosis. It allows you to distinguish tunnel syndrome from osteochondrosis or herniated disc in the cervical spine. With these pathologies, the intervertebral disc compresses the nerve root at the level of the neck, which also causes pain and numbness in the hands, including in the area of the hand and wrist.
A few years ago, in 80 percent of cases, it was possible to get rid of the computer mouse syndrome only with the help of an operation to dissect the transverse ligament of the wrist.Today, doctors, and therefore patients, have a much wider choice of treatment methods, preference is given to conservative ones, they resort to surgery only in difficult cases when conservative therapy does not give results.
In the treatment of this syndrome, drug therapy is used (non-steroidal anti-inflammatory drugs, analgesics, hormonal drugs, drugs that improve blood circulation), blockade – injections of corticosteroids in the carpal tunnel, acupuncture, massage, manual therapy, therapeutic gymnastics.Physiotherapy helps to get rid of the syndrome.
It is, of course, impossible to cure tunnel syndrome with proper nutrition, but it is of great importance in providing the body with all vital vitamins and microelements, due to which the effectiveness of treatment is enhanced, and the restoration of working capacity is faster.
Treating carpal tunnel syndrome is useless if you do not change your behavior during the course of treatment.This means that one should not only take medications and perform medical procedures, but also take care of the ergonomics (ergonomics is the science of creating physiological conditions at work and at home) of the workplace and conditions for work and rest at home. Creating physiological conditions is part of the measures that doctors advise to use to prevent the development of carpal tunnel syndrome or to prevent relapses (recurrence) of the disease.
First of all, you need to remove the load from the median nerve.This means that while working at the computer, you should put on a brace on your wrist, if not, you can fix the joint with a regular elastic bandage. It is imperative to replace the mouse pad – special mats with a wrist support (roller) are now on sale, which relieves the median nerve and ligaments in the area of the wrist joint.
When working at the keyboard, the angle of the arm at the elbow should be straight (90 degrees), the right hand, in which the mouse is located, should be straight.It should lie on the table as far from the edge as possible. The chair or chair should be with armrests.
Anyone who spends a lot of time at the computer should do regular exercises to help prevent the development of carpal tunnel syndrome. And the more often you take breaks from work to do them, the more benefit they will do: these exercises improve blood circulation in the muscles of the wrist and help to stretch them .
- Shake your hands from time to time.
- Clench your fingers into fists and unclench at least 10 times in a row.
- Roll your fists.
- Place your hands in front of you, palms facing each other. Press with one hand on the fingers of the other hand from the side of the palm so that the palm and wrist are tilted outward. Then do the same with the other hand.
- Bring your hands together in front of your chest with your palms up and slowly lower them down towards the waist so that they do not spread out to the sides.
Proper nutrition is one of the important components of maintaining healthy joints. Thanks to him, the metabolic processes in the joints and muscles proceed physiologically, the body is provided with the necessary trace elements and vitamins for their activity.
© Dr. Peter
/ / /
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Diseases and symptoms
This morning you arrived at your country house.Pulling a heavy and large tool bag out of the trunk of your car, you suddenly felt a very severe, shooting pain in the lower back on the right side. It was not possible to lift the bag and straighten. Probably JAMMED NERVE in the back …
Pinched nerve (compression, compression) often occurs after intense short-term physical activity performed in the “wrong” position. For example, lifting bulky, heavy objects from the floor with their girth and then straightening the back.Moving the refrigerator on the floor. Or a sharp power lift on an outstretched arm of a full kettle of water. Often, the root of the nerve is pinched by slight movement – for example, after coughing, sneezing.
How does a pinched nerve manifest itself?
Intense stabbing or shooting (like an electric shock) pain in the neck, lower back, or chest. The pain can spread to the arm, to the back of the head, along the ribs to the chest, often to the region of the heart, or to the leg. In the compression zone, the muscles are tense, spasmodic, and there may be swelling of soft tissues.Muscle tension leads to a curvature of the spine, on the side of pain, the shoulder, shoulder blade, and hip rise. This “skew” of the back muscles is called pain (algic) posture. If the correct treatment is not prescribed, the pinched nerve can persist for several weeks and significantly impair the patient’s quality of life.
Causes of pinched nerve:
- Osteochondrosis is the most common cause. In this case, the roots of the spinal nerves are pinched in the intervertebral foramen at the site of the protrusion (protrusion) of the intervertebral disc.An additional cause of a pinched nerve is the bony outgrowths of the vertebrae (osteophytes).
- A herniated disc is a complication of osteochondrosis and, as a rule, leads to persistent pinching of the nerve root. In this case, the pain spreads along the arm or leg and is accompanied by a decrease in reflexes, a violation of the sensitivity of the skin, a feeling of “tingling of needles” or weakness in the fingers or toes.
- Constant intense physical activity leads to compression of the nerve between the muscles and tendons.These are the so-called “tunnel” syndromes. They are found in people of certain professions: athletes, tennis players (pinched nerve in the elbow), typists and other “typing” people (compression in the wrist).
What to do if a nerve is pinched?
First of all, it is important to establish the correct diagnosis.
Therefore, it is better not to self-medicate, but to consult a neurologist. In the clinic “Pervaya Neurology”, a professional vertebroneurologist (spine specialist) will examine the patient, prescribe an examination and complex treatment from the moment of contacting the clinic.
What tests are needed for a pinched nerve?
Electromyography (EMG) is an important diagnostic method. It is this study that objectively evaluates the degree of compression (damage) of the nerve. EMG records the conduction of an electrical impulse along the nerves of the arm or leg and gives the doctor an assessment of the state of the peripheral nervous system.
Magnetic resonance imaging (MRI) and computed tomography (CT) allow you to assess the condition of the vertebrae and intervertebral discs, the presence of hernias and protrusions, damage to the spinal cord.
X-ray of the spine
is informative in case of postural disorders – scoliosis, kyphosis, as well as injuries: fractures and subluxations of the vertebrae.
Effective treatment for a pinched nerve
Traditionally, pain relief is carried out: anti-inflammatory pain relievers (NSAIDs), muscle relaxants (drugs that relax muscles), drugs that improve blood circulation, B vitamins, and physiotherapy. These methods reduce symptoms, but do not act on the causes and mechanisms of the disease.
Blocks of pain points and paravertebral blocks are a classic effective method of treating musculoskeletal pain. The doctor purposefully (in the painful “trigger” zone or along the strangulated nerve) introduces a complex of pain medications. Pain relief occurs a few minutes after injection.
An alternative modern method of treatment of osteochondrosis, scoliosis and herniated intervertebral discs is shock wave therapy. The principle of shock wave therapy is the effect of low-frequency sound waves on tense muscles and ligaments, joints, and bones.The acoustic wave reduces inflammation of the pinched nerve, restores blood circulation and initiates the process of cell regeneration. Cases of restoration of the bone structure after the onset of bone necrosis are known.
The clinic “First Neurology” actively uses more than 20 types of treatment for pain syndromes in the back and extremities, as well as headaches. Modern high-tech methods relieve pain after 2-3 sessions and reduce the drug load (the number and duration of taking pain medications).
These methods include, first of all, carboxytherapy. The introduction of small amounts of carbon dioxide into the projection of the spine and joints causes blood flow and stimulates blood circulation in the area of the pinched nerve. Carboxytherapy has a quick analgesic effect, improves trophism (nutrition) of intervertebral discs and nerves. The undoubted advantage of the method is the absence of side effects.
Mesoinjection therapy has been used in the clinic “First Neurology” for more than 10 years.This is a method of injecting drugs into the deep layer of the skin – the mesoderm. Locally – in the projection of the pinched nerve, the neurologist injects muscle relaxants (relaxing muscles) or vascular, anti-inflammatory drugs. The absorption and action of the drug lasts more than 2 weeks, so mesotherapy is performed once every 14 days.
Hi Top Therapy is the treatment of choice for a pinched nerve in an arm or leg. By acting with a pulsed current on the sensitive endings of the peripheral nerve, Hi Top stimulates the nerves, muscles and the spinal cord.
Dosed spinal traction is carried out in the clinic “Pervaya Neurologiya” using a specialized orthopedic complex “ORMED-professional”. The traction eliminates pinching of the spinal nerve, reduces the tone of the back muscles, and quickly relieves pain in the spine.
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