Pinched nerve | Sparrow

Overview

A pinched nerve occurs when too much pressure is applied to a nerve by surrounding tissues, such as bones, cartilage, muscles or tendons. This pressure can cause pain, tingling, numbness or weakness.

A pinched nerve can occur in many areas throughout the body. For example, a herniated disk in the lower spine may put pressure on a nerve root. This may cause pain that radiates down the back of your leg. Likewise, a pinched nerve in your wrist can lead to pain and numbness in your hand and fingers (carpal tunnel syndrome).

With rest and other conservative treatments, most people recover from a pinched nerve within a few days or weeks. Sometimes, surgery is needed to relieve pain from a pinched nerve.

Symptoms

Pinched nerve signs and symptoms include:

• Numbness or decreased sensation in the area supplied by the nerve
• Sharp, aching or burning pain, which may radiate outward
• Tingling, pins and needles sensations (paresthesia)
• Muscle weakness in the affected area
• Frequent feeling that a foot or hand has “fallen asleep”

The problems related to a pinched nerve may be worse when you’re sleeping.

When to see a doctor

See your health care provider if the signs and symptoms of a pinched nerve last for several days and don’t respond to self-care measures, such as rest and over-the-counter pain relievers.

Causes

A pinched nerve occurs when too much pressure (compression) is applied to a nerve by surrounding tissues.

In some cases, this tissue might be bone or cartilage, such as in the case of a herniated spinal disk that compresses a nerve root. In other cases, muscle or tendons may cause the condition.

In the case of carpal tunnel syndrome, a variety of tissues may be responsible for compression of the carpal tunnel’s median nerve, including swollen tendon sheaths within the tunnel, enlarged bone that narrows the tunnel, or a thickened and degenerated ligament.

A number of conditions may cause tissue to compress a nerve or nerves, including:

• Injury
• Rheumatoid or wrist arthritis
• Stress from repetitive work
• Hobbies or sports activities
• Obesity

If a nerve is pinched for only a short time, there’s usually no permanent damage. Once the pressure is relieved, nerve function returns to normal. However, if the pressure continues, chronic pain and permanent nerve damage can occur.

Risk factors

The following factors may increase your risk of experiencing a pinched nerve:

• Sex. Women are more likely to develop carpal tunnel syndrome, possibly due to having smaller carpal tunnels.
• Bone spurs. Trauma or a condition that causes bone thickening, such as osteoarthritis, can cause bone spurs. Bone spurs can stiffen the spine as well as narrow the space where your nerves travel, pinching nerves.
• Rheumatoid arthritis. Inflammation caused by rheumatoid arthritis can compress nerves, especially in your joints.
• Thyroid disease. People with thyroid disease are at higher risk of carpal tunnel syndrome.

Other risk factors include:

• Diabetes. People with diabetes are at higher risk of nerve compression.
• Overuse. Jobs or hobbies that require repetitive hand, wrist or shoulder movements, such as assembly line work, increase the likelihood of a pinched nerve.
• Obesity. Excess weight can add pressure to nerves.
• Pregnancy. Water and weight gain associated with pregnancy can swell nerve pathways, compressing your nerves.
• Prolonged bed rest. Long periods of lying down can increase the risk of nerve compression.

Prevention

The following measures may help you prevent a pinched nerve:

• Maintain good positioning — don’t cross your legs or lie in any one position for a long time.
• Incorporate strength and flexibility exercises into your regular exercise program.
• Limit repetitive activities and take frequent breaks when engaging in these activities.
• Maintain a healthy weight.

Diagnosis

Your doctor will ask about your symptoms and conduct a physical examination.

If your doctor suspects a pinched nerve, you may undergo some tests. These tests may include:

• Blood tests. You may need tests to measure your fasting blood glucose or thyroid levels.
• Spinal tap (lumbar puncture). This test collects a sample of cerebrospinal fluid (CSF) from the area surrounding your spinal cord. The CSF may be sent to a lab and examined for signs of inflammation or infection.
• X-rays. These images show how the bones are positioned and can indicate whether or not there is any narrowing or damage that could cause a pinched nerve.
• Nerve conduction study. This test measures electrical nerve impulses and functioning in your muscles and nerves through electrodes placed on your skin. The study measures the electrical impulses in your nerve signals when a small current passes through the nerve. Test results tell your doctor whether you have a damaged nerve.
• Electromyography (EMG). During an EMG, your doctor inserts a needle electrode through your skin into various muscles. The test evaluates the electrical activity of your muscles when they contract and when they’re at rest. Test results tell your doctor if there is damage to the nerves leading to the muscles.
• Magnetic resonance imaging (MRI). This test uses a powerful magnetic field and radio waves to produce detailed views of your body in multiple planes. This test may be used if your doctor suspects you have nerve root compression.
• High-resolution ultrasound. Ultrasound uses high-frequency sound waves to produce images of structures within the body. It’s helpful for diagnosing nerve compression syndromes, such as carpal tunnel syndrome.

Treatment

The most frequently recommended treatment for a pinched nerve is rest for the affected area. Your doctor will ask you to stop any activities that cause or aggravate the compression.

Depending on the location of the pinched nerve, you may need a splint, collar or brace to immobilize the area. If you have carpal tunnel syndrome, your doctor may recommend wearing a splint during the day as well as at night because wrists flex and extend frequently during sleep.

Physical therapy

A physical therapist can teach you exercises that strengthen and stretch the muscles in the affected area to relieve pressure on the nerve. The physical therapist may also recommend modifications to activities that aggravate the nerve.

Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), can help relieve pain. Anticonvulsants, such as gabapentin (Neurontin) and tricyclic medications such as nortriptyline (Pamelor) and amitriptyline are often used to treat nerve-related pain.

Corticosteroids, given by mouth or by injection, may help minimize pain and inflammation.

Surgery

If the pinched nerve doesn’t improve after several weeks to a few months with conservative treatments, your doctor may recommend surgery to take pressure off the nerve. The type of surgery varies depending on the location of the pinched nerve.

Surgery may entail removing bone spurs or a part of a herniated disk in the spine, for example, or severing the carpal ligament to allow more room for the nerve to pass through the wrist.

Preparing for an appointment

You’re likely to first see your health care provider. Because there’s often a lot to discuss and time may be limited, it’s a good idea to prepare for your appointment. Here’s some information to help you get ready for your appointment and know what to expect from your doctor.

Prevention

What you can do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there’s anything you need to do in advance, such as restrict your diet or wear loosefitting clothes in the event that you have an imaging exam.
• Write down any symptoms you’re experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Make a list of all medications, vitamins or supplements that you’re taking.
• Take a family member or friend along, if possible. Sometimes it can be difficult to remember all of the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor.

Preparing a list of questions will help you make the most of your time with your doctor. For a suspected pinched nerve, some basic questions to ask your doctor include:

• What’s the most likely cause of my symptoms?
• What kinds of tests do I need?
• Is my condition likely temporary or long lasting?
• What treatment do you recommend?
• What are the alternatives to the primary approach that you’re suggesting?
• I have these other health conditions. How can I best manage these conditions together?
• Are there any activity restrictions that I need to follow?
• Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?

In addition to the questions that you’ve prepared to ask your doctor, don’t hesitate to ask other questions during your appointment.

Preparing for an appointment

What to expect from your doctor

Your doctor is likely to ask you a number of questions. They may include:

• What are your symptoms? Do you feel pain, numbness, tingling or weakness?
• Where, specifically, are you feeling these symptoms?
• How long have you been experiencing these symptoms?
• Have your symptoms been continuous or occasional?
• Is there an activity or a position that triggers your symptoms?
• Is there an activity or a position that relieves your symptoms?
• Do you have a job or hobby that requires you to make repetitive motions?

Content From Mayo Clinic Updated: 01/21/2022

© 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. Terms of Use

Carpal Tunnel Syndrome, Trapped Nerve, Wrists

The nerve passes through the carpal tunnel, a canal in the wrist that carries all the tendons of the hand. If these tendons are swollen, the nerve is squeezed and becomes trapped.

Carpal tunnel syndrome can happen at any age. It is most common in patients who perform repetitive tasks with the hand and wrist such as computer keyboard and mouse use. One or both hands can be affected and symptoms can be worse at night, disturbing sleep.

Carpal tunnel syndrome symptoms

These can include pain, as well as pins and needles in your hand. You may have aching that can extend up the arm, weakness in the hand and difficulty gripping. Also, you may feel tingling and numbness in the thumb, index and middle fingers.

What causes carpal tunnel syndrome?

The causes of this carpal tunnel syndrome can vary. There may be excess fat or fluid in the canal that causes it to narrow – fluid retention during pregnancy can do this. Or it may have narrowed after a break or arthritis in the wrist. Some work-related tasks, such as those using vibrating tools, can make the condition worse.

We can quickly diagnose the syndrome with a nerve conduction test, which tells us how compressed the nerve is.

Treatment for carpal tunnel syndrome

Wearing a splint on the wrist at night can relieve carpal tunnel syndrome. Short-term relief can also be gained from an injection of a steroid. Using appropriate keyboards and trackball mouse devices while doing computer work can also relieve symptoms. However, if symptoms persist, surgery is the best option for long-term relief.

What happens during carpal tunnel release surgery?

Carpal tunnel release is usually performed using a local anaesthetic so that you feel nothing and a light sedation so you remain relaxed. The procedure takes about twenty minutes. Your surgeon will make a small incision (cut) in your wrist. They will then cut the flexor retinaculum – the ligament that forms the top of the carpal tunnel – relieving the pressure on the median nerve. The incision will be closed using sutures (stitches). Some surgeons will perform this procedure endoscopically – inserting a tiny camera into the incision to examine your wrist and cut the ligament.

After the operation

Carpal tunnel release is usually done on an outpatient basis meaning you will do home the same day as the procedure. You may go home with a splint or heavy bandage on your wrist. Once these are removed you will begin exercises and physiotherapy to regain movement in your wrist and arms. 

Most people make a good recovery and return to normal activities following carpal tunnel release. As with any surgery there can be complications:

• Pain
• Bleeding
• Infection of the surgical site (incision)
• Scarring

Specific complications in carpal tunnel release include:

• Continued numbness in fingers
• Tenderness around scar
• Aching in the wrist
• Return of numbness and pain
• Complex regional pain syndrome – a rare, but chronic (long-term) condition that causes a burning pain in one of the limbs

Tunnel syndrome – Causes and treatment

Tunnel syndrome belongs to the group of compression-ischemic neuropathies – peripheral nerve diseases not associated with infectious and vertebrogenic factors. A pinched median nerve in the carpal tunnel is the result of thickening of the nerve fibers or thickening of the surrounding tendons. The causes of the pathology can be mechanical trauma, inflammation of the joints, tumors, endocrinopathy. During compression of the nerve tissue, the blood supply to the nerve is disrupted. Similar changes are observed with regular overstrain of the same wrist muscles. Carpal tunnel syndrome is an occupational disease of persons who perform the same type of hand movements in the course of work. This pathology affects grocery store cashiers, computer users, artists, hairdressers, violinists, miners, wrappers, guitarists. In women, the disease occurs much more often than in men, which is associated with a relatively small volume of the carpal tunnel. The first clinical signs of the disease occur at the age of 30-45, and its peak occurs at 50-60 years. Carpal tunnel syndrome is a chronic disease with frequent exacerbation and remission, manifested by pain, paresthesia, and motor dysfunction. These clinical signs have varying degrees of severity. The cubital tunnel syndrome belongs to the same group of neuropathies. Injuries to the elbow joint lead to inflammation and damage to the tendon arch. It thickens, the channels narrow. The development of tunnel syndrome of the ulnar nerve is most susceptible to persons who experience constant compression of the ulnar nerve.

Next, let’s take a closer look at carpal tunnel syndrome, which makes up the vast majority of cases of the disease. There are two types of compression-ischemic neuropathy of the hand:

• primary – an independent pathology that does not depend on other processes occurring in the body. Usually the cause of primary neuropathy is overexertion of the muscles of the wrist, as well as prolonged and excessive impact on the joint;
• secondary – a symptom or complication of any disease of the body. Systemic connective tissue diseases, arthrosis, arthritis are manifested by carpal tunnel syndrome.

Carpal tunnel syndrome was discovered by English surgeon Paget in 1854. He was the first to describe the clinical signs of the disease and the mechanism of its development. Currently, pathology is diagnosed extremely rarely. Its pathogenesis and etiology are poorly understood, so carpal tunnel syndrome is poorly recognized and detected. If this problem is left unattended, negative consequences can develop.

Causes

Carpal tunnel syndrome develops when the size of the carpal tunnel decreases or the volume of tissues inside it increases. The main importance in the development of compression-ischemic neuropathy is given to injuries at home, at work or during sports.

• sprains, dislocations and fractures of the wrist;
• pregnancy and associated soft tissue swelling;
• long-term use of oral contraceptives;
• lactation period;
• diabetes;
• thyroid dysfunction or removal;
• obesity;
• violation of water balance;
• hormonal imbalance;
• acromegaly;
• renal insufficiency;
• dramatic weight loss;
• amyloidosis;
• rheumatoid arthritis;
• gout;
• hematological diseases;
• tumors deforming the wrist;
• hereditary predisposition.

In rare cases, neuropathy develops as a result of acute infectious diseases: typhus or typhoid fever, tuberculosis, syphilis, brucellosis, herpes. Tunnel syndrome can be caused by vascular pathology. Spasm or thrombosis of a blood vessel leads to ischemia of the tissues that supply it with blood, swelling and compression of the nerve in the canal.

• intense exercise;
• repeated repetitive activities;
• hypothermia;
• fever;
• long vibration;
• bad habits.

Hard tissue canal reliably protects the median nerve from exogenous factors. Constant loads on the same area lead to its permanent deformation. In this case, nerve fibers suffer, the trophism of soft tissues is disturbed. The tissues of the tunnel thicken, loosen and swell, there is no free space left in the canal, the pressure on the nerve becomes maximum. At this time, the first clinical signs of the syndrome appear. The body tries to get rid of the disease on its own. Lymph accumulates in the joints of the hand and washes away the inflamed cells. A significant load on the hands leads to stagnation of the lymph and increased inflammation. The joints begin to ache and swell. Another cause of carpal tunnel syndrome is swelling of nerve fibers due to general intoxication of the body with toxic substances. Some drugs used for a long time and in high doses can cause the development of pathology. These include antibiotics, diuretics, vasodilators.

1. persons who, by the nature of their work, perform the same type of hand movements;
2. elderly people;
3. patients with endocrinopathies – dysfunction of the thyroid gland, pancreas or pituitary gland;
4. patients with diseases of bones and joints;
5. people with incurable diseases – vasculitis, rheumatism, psoriasis and gout.

Pathology that has developed against the background of a systemic disease leads to a loss of elasticity of the articular cartilage, their aging, cracking. Over time, the affected cartilage dies, and the articular surfaces grow together. Such deformations violate the fully anatomical structure of the hand.

Symptoms

The symptoms of carpal tunnel syndrome increase as the nerve trunk is compressed.

• clinical signs of the initial stage are discomfort and discomfort in the hand that occurs after a long load on this part of the body. Patients complain of trembling, itching and slight tingling in the limbs. At the initial stage, the symptoms are temporary. When shaking hands or changing the position of the hands, discomfort disappears;
• narrowing of the canal is manifested by acute pain in the hand, aggravated after exertion. The patient’s upper limb becomes numb. Any movement of the wrist in the carpal joint causes unbearable pain. Numbness, tingling and heaviness in the hands become unpleasant and annoying. Pain and paresthesia are localized in the area of ​​the first three fingers of the hand. They occur at night or early in the morning. Numbness and a decrease in the sensitivity of the limb deprives it of mobility;
• significant narrowing of the tunnel is manifested by stiffness of the affected joint, hypotension and hypotrophy of muscle fibers. At the same time, pain and numbness persist and intensify. Patients have common symptoms: insomnia, irritability, depression. Convulsions and constant pain are unsettling. A person can no longer lift a heavy object, dial a number on a cell phone, use a mouse on a computer, or drive a car. Fine motor skills are impaired, skin color changes. Patients have weakness in flexion of the hand, weakness in flexion of the first and second fingers, especially the terminal phalanges. The sensitivity of the palmar surface of the first and second fingers is significantly reduced.

Pain syndrome is the main clinical symptom of pathology. Patients complain of burning or tingling in the hands that occur at night and disturb sleep. Patients wake up to shake their hands. Blood flow to the fingers reduces pain. In advanced cases, pain appears not only at night. It torments patients around the clock, which affects their neuropsychic state and leads to impaired performance. The pain is often accompanied by a violation of vegetative and trophic, which is clinically manifested by edema, hyperthermia and hyperemia of the wrist, palm and first three fingers. Carpal tunnel syndrome does not pose a danger to life, but violates its quality. The intensity and duration of pain increases, insomnia and irritability occur, diseases of the nervous system develop.

Diagnostics

Carpal tunnel syndrome is diagnosed and treated by neurologists, as well as doctors of related specialties – traumatologists, orthopedists, endocrinologists, and surgeons. Diagnosis of tunnel syndrome consists in examining the patient and excluding other diseases with similar symptoms.

1. Taking an anamnesis of the disease – the appearance and increase of clinical symptoms. The patient is asked in detail about the causes that caused the disease, past injuries, the nature of pain, the movements that provoke them.
2. Examination – assessment of finger sensitivity and arm muscle strength using a carpal dynamometer.
3. Several functional tests are available to detect damage to the nerve trunk. These include Tinnel’s symptom, cuffs, raised arms. These diagnostic procedures are performed in different ways, but they mean the same thing. If the patient feels numbness and tingling after the test, then carpal tunnel syndrome occurs.
4. Electroneuromyography allows you to accurately determine the location and degree of damage to nerve fibers, the level of damage to the nerve roots that form the carpal joint. Electrodes are inserted into the relaxed muscle of the diseased limb and its contractile activity is measured. The data of the study appear on the monitor in the form of a curve of different amplitudes. With compression of the median nerve, the speed of conduction slows down.
5. MRI, radiography and ultrasound are auxiliary techniques that detect congenital anomalies of the hand, fractures and dislocations due to injuries and allow assessing changes in the tissues of the musculoskeletal system.

Treatment

Treatment of carpal tunnel syndrome is aimed at preventing further damage to the median nerve. Patients are given anti-inflammatory and decongestant therapy, which relieves pain and discomfort. Treatment of the underlying disease, manifested by tunnel syndrome, is a prerequisite, failure to comply with which can lead to frequent relapses and the development of complications.

At the first signs of pathology, it is necessary to fix the wrist. Patients are advised to apply cold to the lesion. If the cause of the pathology was labor activity, it must be changed.

Drug treatment

To eliminate the symptoms of carpal tunnel syndrome, specialists prescribe:

Physiotherapy

• electrophoresis;
• phonophoresis;
• shock wave therapy;
• reflexology;
• transcranial electroanalgesia;
• UHF therapy;
• magnetotherapy;
• laser treatment;
• ozokerite;
• mud treatment;
• neuroelectrostimulation;
• physiotherapy exercises.

Surgical treatment

Surgical intervention consists in excision of the ligament that compresses the median nerve.

• endoscopic surgery is less traumatic and leaves no scars. Through a small size, a video camera and a special device that cuts the ligaments are inserted into the median canal. After surgery, a plaster splint is placed on the wrist.

• open intervention consists in making a large incision in the palm along the line of the median canal. The ligament is cut to relieve pressure on the median nerve. The recovery period after open surgery is much longer.

Patients are encouraged to move their fingers the day after surgery. After 1.5 months, physiotherapy and occupational therapy are prescribed. In the rehabilitation period, massage and gymnastics are shown. Patients should rotate their hands, knead their palms and fingers. If necessary, you can take a pain reliever.

1. Clenching fingers into a fist.
2. Rotation with fists to the sides.
3. Compression of the palms, extension of the elbows.
4. The pressure of one hand on the other.
5. Rubber ball compression.

Treatment of carpal tunnel syndrome at home includes not only general and local drug therapy, but also the use of traditional medicine. The most effective and common folk recipes:

• Cucumber tincture relieves numbness in the fingers and normalizes blood circulation. It is used for rubbing sore fingers;
• soar hands in a heated mixture of sea buckthorn berries and water;
• sore wrists are rubbed with ammonia and salt;
• Pepper rub will help cure carpal tunnel syndrome;
• lingonberry decoction is taken orally;
• infusion of parsley root or white birch leaves has a decongestant effect;
• bearberry enhances diuresis and relieves inflammation;
• Shilajit is rubbed into the skin over the lesion daily for several minutes;
• mustard, sage, turpentine baths irritate free nerve endings.

Prevention

• attentive attitude to one’s health;
• maintaining a healthy lifestyle;
• sufficient physical activity – gymnastics, swimming, walking, yoga;
• comfortable sleeping and comfortable workplace;
• periodic change in body position;
• systematic thermal procedures – baths, saunas;
• balanced nutrition;
• prevention and timely treatment of various ailments;
• Seek medical attention when the first signs of pathology appear.

Treatment of carpal tunnel syndrome is aimed at eliminating pain and discomfort, but most importantly – at eliminating the cause of the pathology. It is necessary to treat tunnel syndrome comprehensively in order to permanently get rid of the pathology and prevent relapses. This disease significantly reduces the quality of life of patients. But the prognosis of pathology is currently considered favorable. Diseases of the peripheral nervous system are so diverse that it is not always possible to determine their cause and make an accurate diagnosis. This should be done only by highly qualified specialists. In recent years, the number of patients with carpal tunnel syndrome has increased, due to the strong introduction of computer technology into the life of a modern person.

Carpal tunnel treatment | Dobromed

Tunnel syndrome is a pathology of the peripheral nervous system. Causes of neuropathy: pinched nerve between bones, tendons and muscles; pathological changes in muscle, bone, fibrous tunnels. The compression that has arisen due to the narrowness of the channel through which the nerve trunks pass, provokes a violation of the blood supply. Weakens or completely stops the flow of arterial blood to the connective tissue or organ. The area of ​​the body that has undergone trophic disorders begins to grow numb, loses sensitivity.

Causes of the development of pathology

Tunnel syndrome is a little-known but fairly common diagnosis. The focus of localization of pathology is the joints. Due to increased motor activity, they most often undergo degenerative, traumatic, inflammatory changes. Human activity professional, sports, household leads to frequent macrotraumatization of the nerve trunk. Therapeutic starvation, long-term diets provoke pathology. Subcutaneous fat acts as a shock absorber in the body. The loss of a soft elastic pad leads to a malfunction of the biological system. Tunnel syndrome is attached to the status of occupational diseases of freelancers, programmers, drivers, cashiers, musicians, hairdressers. The risk group includes persons whose activities are associated with monotonous movements. Gamers who spend days and nights playing computer games, in the heat of passion, forget that their passion threatens with serious consequences. They are prone to carpal tunnel syndrome, the most common type of tunnel neuropathy.

Factors that can give impetus to the development of a specific disease are diabetes, gout, arthritis, kidney failure, blood diseases, alcohol and drug addiction. Medical intervention entails damage to the ulnar and median nerves with prolonged intravenous invasions. There is a relationship between the syndrome and endocrine disorders: pregnancy, lactation, menopause, disruption of the thyroid gland, prolonged use of contraceptives. In some cases, a prerequisite for the occurrence of pathology is a genetic predisposition: hereditary narrowness of the channels and increased insecurity of nerve fibers.

Types of carpal tunnel syndrome

Muscle bed syndrome – impaired blood flow in tissues compressed by muscles. Occurs in the fascial cases of the limbs under external influence: Carpal syndrome of the wrist – pinching of the median nerve inside the carpal tunnel. The condition is caused by tissue growth and a decrease in the opening passing from the wrist to the hands. Cubital syndrome is a violation of the hand muscles responsible for the movement of the ring finger and little finger, due to clamping in the cubital canal. Tunnel syndrome of the legs is a compression-ischemic lesion of nerve fibers passing through thigh. Piriformis syndrome – neuropathy of the sciatic nerve caused by involuntary contraction of the piriformis muscle. Neuropathy of the peroneal nerve – acute trauma to the nerve located between the fibula and the muscle.

Symptoms of carpal tunnel syndrome

At the initial stage, carpal tunnel syndrome manifests itself as mild aching pain in the wrist. An unpleasant sensation occurs after a long monotonous work, but a short break helps to cope with the symptom. Pain symptoms and paresthesias are more pronounced at night. Sometimes to the point of being sleep deprived.

Diagnostic measures

A neuropathologist is responsible for diagnosing the pathology. On examination, the specialist evaluates the sensitivity of the fingers. Then, using a dynamometer, he measures the strength of the muscles of the arm.

• Phalen’s test – increased pain when lifting the arms up indicates a pinched nerve in the carpal tunnel;
• opposition test – the impossibility of connecting the thumb with the little finger;
• Tinel test – pain and tingling in the fingers when tapping on the wrist;
• Durkan’s test – a feeling of shooting when clenching the hand into a fist.

electromyography – a diagnostic method that allows you to assess the bioelectrical activity of muscles and nerve endings at rest and in motion; the procedure reveals the sites of muscle damage. nerve conduction analysis – a test that determines the speed and strength of electrical signals in the nerves; slowing of the impulse indicates pinching of the median nerve.

X-ray is prescribed to rule out pathologies similar in their symptoms to carpal tunnel syndrome.

Methods of treatment and their duration

Conservative methods of treatment are used to eliminate pathological changes at the initial stage. After examination by a specialist, the patient undergoes a therapeutic course at home. For use, ointments with anti-inflammatory non-steroidal properties with an analgesic effect, compresses with dimexide, diuretics, vitamin-mineral complexes are shown. The lesions are fixed with bandages, splints or orthoses. Physical activity is limited. After easing the symptoms, simple gymnastic exercises are recommended. If the disease progresses, the patient is hospitalized. Intramuscular and intravenous administration of nonsteroidal drugs is added to the treatment.

Novocaine blockade with simultaneous administration of hydrocortisone is considered an effective remedy in the fight against painful symptoms.

Elimination of exacerbations and complications by the surgical method

If all the actions taken do not give a stable result, the disease periodically worsens, surgical intervention is required. A cardinal measure will prevent a decrease and a complete loss of motor functions. Also, the operation is indicated for the development of the syndrome after a bone fracture with displacement of bone fragments. The operation is performed by orthopedic surgeons, neurosurgeons, and general surgeons. Having anesthetized the surgical field, the specialist makes a dissection of the skin, subcutaneous tissue and ligaments. Carefully examines the carpal tunnel, eliminates compression of the nerve fibers by hypertrophied ligaments, after which the incision is sutured. In addition to the open incision technique, a new technique is used – endoscopic surgery. A small device with a camera equipped with a magnifying lens is inserted into a narrow indentation made on the wrist. Special surgical instruments are inserted into the incision in the palm of your hand. Medical equipment helps the doctor navigate the anatomical structure of the hand and carry out the necessary manipulations with the least possible complications for the patient. The consequences of surgical treatment are long-term rehabilitation. It can take up to 2 months to restore functional abilities.

Daily lifestyle advice

A person’s health depends on their lifestyle. Daily activity, balanced nutrition, proper rest, emotional stability are the handrails that keep the body in good condition. If the biological system has failed, the tactics of behavior should be changed.