Syndrome carpal (carpal) channel — symptoms and treatment

What is characteristic of carpal syndrome (carpal) channel

Carpal tunnel syndrome (ICD 10 — G56.0) is a common problem affecting the hand and wrist.

A violation occurs when compression of the nerve inside the wrist.

Any condition that affects the size of the canal or causes the growth of tissue inside it, could trigger manifestations of the syndrome.

What happens if we violate

The wrist is surrounded by bundles of fibrous tissue that perform a supporting function for the joint. The space between these fibrous bands of tissue and bony parts of the wrist carpal tunnel.

The median nerve passing through the wrist, provides sensitivity to the thumb, index and middle fingers.

Any condition that causes swelling or a change of the position of the tissues in the wrist can cause compression and irritation of this nerve.

Irritation of the median nerve leads to tingling and numbness in the thumb, index and middle fingers, and this condition is called «carpal tunnel syndrome».

Causes and risk groups

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The causes of carpal tunnel syndrome:

  1. Swelling due to damage of the forearm and hand.
  2. Tissue swelling during pregnancy, especially late pregnancy, and in women using oral contraceptives.
  3. Chronic inflammation and swelling of the structures of the carpal tunnel at a constant professional trauma.
  4. Tissue swelling as a result of certain diseases of internal organs, endocrine disorders.
  5. The narrowing of the synovial sheaths of tendons and thickening of their walls due to acute or chronic inflammation in systemic connective tissue disorders, metabolic disorders, tuberculosis.
  6. The discrepancy between the size of the channel to the size of its content due to genetically inherited indicators or abnormal growth of bones of the hand and wrist.
  7. A tumor of the median nerve.

To the risks of occurrence are:

  • the use of force;
  • posture;
  • the location of the wrist;
  • the monotony of the action;
  • hypothermia;
  • vibration.
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Risk groups:

  • people with a genetic tendency;
  • people of low growth, over-weight;
  • people suffering from tuberculosis, kidney failure;
  • people with rheumatoid arthritis, problems in the thyroid gland;
  • women in menopause and use of hormonal contraceptives.

Symptoms and signs

Syndrome has these symptoms — gradual numbness in the parts, which controls the sensitivity of the median nerve.

After that, the field of innervation of the pain. Also among the symptoms of carpal tunnel syndrome may be noted that in the brush there is a numbness, especially in the morning after a night’s sleep. Sick all night shaking hands and rubbed them, giving a small improvement.

The pain may climb up to the shoulder and even the neck. With worsening of the disease the muscles of the thumb may stop working, causing awkwardness in the action when you need to take, for example, a Cup.

The patient is difficult to touch the tip of the thumb to the tips of the other fingers, hold different objects.

Diagnostic methods and tests

The doctor will ask about symptoms and medical history, perform examination of the wrist and hands. The examination will consist of test of strength, sensitivity, and signs of irritation or nerve injury.

Additional tests:

  • electrodiagnostic tests;
  • MRI;
  • x-rays;
  • Ultrasound.

Syndrome should be distinguished from anomalies Arnold-Chiari malformation and herniated cervical.

How to treat pathology

Treatment can be conservative or surgical intervention.

Conservative treatment

Should stop performing the activity that causes the symptoms of.

Avoid repetitive movements, strong grasping movements, holding vibrating objects or performing work with the tilt or bending of the wrist.

If you smoke, give up this habit. Lose weight if overweight. Reduce the amount of caffeine.

The bandage on the wrist relieves symptoms in the early stages of the breach. He holds the wrist band alone. When the wrist is in the correct position, the channel has normal volume, therefore, for nerve enough.

The bandage will help to reduce numbness and pain, it does not allow the brush to bend in my sleep. The brace can be worn day in order to alleviate symptoms and ensure quiet tissues of the wrist.

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Moreover, the following exercises:

  1. Shake hands.
  2. Squeeze your hands into fists, hold for 3 seconds, then fully open for 6 seconds. Repeat 10 times.
  3. Stretch the hands in front of you, 5 times to raise and lower them.
  4. Describe your fingertips 10 laps.
  5. 10 times in a row to push with one hand on the fingers of the other hand.

Through these exercises improves blood circulation in the muscles.

It is important that the movements were different.

Note that the CCC — sacs appears in people not only because they perform repetitive movements, but because they do it for a long time.

Medication

Anti-inflammatory drugs can also help to eliminate the swelling and symptoms of damage (ibuprofen, aspirin). Large doses of vitamin B-6 help to neutralize the symptoms.

If simple measures do not help to curb the symptoms, you should consider injections of cortisone into the carpal canal. This tool is used for removing the swelling in the canal, it may relieve symptoms.

Cortisone may help the doctor in diagnosis. If the patient does not easier after the injection, this may indicate a violation that causes these symptoms.

If the symptoms disappear after the injection, then they appeared in the wrist.

Physical therapy

The doctor may refer to a physical therapist or a specialist in occupational health. The leading goal of treatment is to reduce the impact or eliminate the cause of pressure in the wrist.

The physiotherapist can check the place and method of execution of work tasks. It can offer, how best to position the body, and in what position to hold the wrist, to assign the exercise and to suggest how to prevent problems in the future.

Surgical treatment

If the sample is to control the symptoms have failed, the patient may be offered surgery to reduce compression of the median nerve.

There are several different operations to neutralize the pressure on the nerve.

After eliminating the pressure on the nerve is restored the blood supply to the nerve, most patients feel relief. But if the nerve is pinched for a long period of time, it can get thicker, and it may form a scar that will prolong the recovery procedure.

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The most common operation is an open intervention using a local anesthetic that blocks the nerves that are located only in specific parts of the body.

This operation is performed on an outpatient basis, it is possible to leave the hospital immediately.

Complications

Carpal tunnel syndrome does not apply to violations that endanger the life of the patient.

Long suffering people may eventually lose the ability to carry out normal hand or fingers some movement.

And only just started proper treatment can prevent this complication and help to restore the hand.

Preventive measures

Prevention:

  1. To adjust the height of the desktop. The table height should be such that its surface is at level with the armrests of the chair.
  2. Adjust the monitor height so that the text was at eye level.
  3. During operation it is necessary to sit, leaning back in his chair, with relaxed shoulders.
  4. To find a comfortable mouse and keyboard.
  5. Eat less salt and salty food provokes increased swelling.

Insights

Complications of the syndrome are rare and include atrophy and weakness of the muscles at the base of the thumb.

It can become persistent breach if not implemented in time treatment. Such violation affects the motor skills and hand execution of some movements.

As a rule, the prognosis of the disorder is positive, and it turns out to treat him conservatively or operatively.