Tunnel carpal tunnel syndrome. Symptoms and Treatment, blockade, PCS, gymnastics, folk remedies, the operation

Neuroscientists say that to them are turning people with inflammation of the tunnel channel. People use computers in everyday life, communicating in social networks and playing games, unaware of the danger. They fall into a zone of risk of occurrence of carpal tunnel syndrome.

What is carpal tunnel syndrome

The median nerve passing through the channel at the wrist, is compressed due to various reasons, causing carpal tunnel syndrome (otherwise, carpal tunnel syndrome). The result is a compression channel ischemia (reduced blood supply tissue), leading to temporary or permanent malfunction of the wrist.

It is located in the compound of the brush on the inner side and the forearm. Neurology This syndrome refers to the tunnel. Large pressure on the nerve in the channel leading to a feeling of weakness in the affected arm and sensitivity to disturbance.

The causes of the disease

Tunnel Carpal tunnel syndrome can cause the following factors are listed:

• Narrow wrist. Women are prone to the disease more often than men.
• The wrist injury (broken bones, bruises, dislocations).
• Inflammatory falling ill (synovitis, rheumatoid arthritis, gout, osteoarthritis deformans, arthritis, tuberculosis joints, tenosynovitis).
• Disease acromegaly. It is characterized by the growth of bones, which narrows the space carpal tunnel.
• Any tumors (lipomas, synovioma, chondroma, hygroma) causes compression of the channel and defeat.
• Severe swelling in pregnant women, patients with diabetes mellitus, hypothyroidism, suffering from renal failure, in women during menopause. Oral contraceptives can also cause swelling of the wrist and handing in tissue.
• Communication can also be seen in certain areas. For example, in the profession of carpenter, pianist, packer, cellist much more common than others.

Initial stage tunnel syndrome characterized by damage to the channel of the shell.

With the development of the disease affects the inner layers of the nerve by altering the sensory fiber function, motor and autonomic. Prolonged disturbance of blood flow changes the structure of the nervous tissue, are replaced on a connection. This process is called - degenerative changes. The consequence is a profound violation of the function of the median nerve.

symptoms

Symptoms tend to a gradual build-up. Primarily affects the main hand.

There are defeats and the right and left hand at the same time:

• Paraesthesia - numbness and tingling of the fingers. This is the first sign of carpal tunnel syndrome. It appears in the morning immediately after waking, during the day inconveniences disappear. With the development of a symptom of the disease is enhanced, worried all day. People can not use the affected limb, to keep her subjects impossible. Man is forced to use his good hand.
  
• At the beginning of the affected area appear tingling or burning sensation. Inconveniences occur at night. The patient wakes up in pain and makes no attempt to get rid of her, putting his hand down or shaking, restoring blood flow. The pain subsides when such actions. Painful symptoms are felt in the thumb and middle finger, spreading palm, in advanced cases reach to the elbow. Fuzzy localization difficult to diagnose. One can not fully operate the affected hand.
• Patients complain of a loss of strength in the hand. It becomes difficult to keep small objects and make precise movements. And also there is a decrease in strength in the thumb, he does not depart away from the palm of your hand. It becomes impossible to use your finger to capture a variety of subjects.
• In the latter stages of the median nerve lesions observed decrease in sensitivity in the hand, people do not feel anything in this area, even the needle pricks. Patients report a reaction to cold: there is an unpleasant burning or painful numbness.
• The result of the syndrome becomes atrophy. muscles visually noticeable decrease. In the future, the brush is completely deformed, it becomes like a monkey's paw, the thumb sticks to the palm of your hand.
• The decrease in blood flow in the wrist breaks the power of skin cells. Those tissues which depend on the median nerve becomes lighter toward healthy.

Risk factors

Tunnel syndrome occurs more often in people falling in the risk group:

• with hereditary anatomically narrow carpal tunnel;
• age increases chances of contracting;
• People with excess weight;
• profession, which employs a brush, repeatedly flexing;
• Patients with chronic diseases associated with damage to the nerves;
• People who recover from inflammatory diseases affecting the tendons;
• people keen on computer games and work on the keyboard;

  

• pregnant women or women during menopause, suffering from edema.

Diagnostics

Neurologist holds 4 special tests:

• A man raises his hands up and hold in this position. A few seconds later felt numbness in the fingers. This feature confirms the presence of carpal tunnel syndrome.
• The doctor taps on the narrowest section in the wrist of the palm. If there is tingling in the large, middle and index finger, the Tinel test is considered positive.
• The next step - the patient is severely bends the arm at the wrist, about 1 minute. in the affected area appears numbness and tingling. Test Falena.
• The last test is called the cuff. Wearable cuff sphygmomanometer as in the measurement of pressure parameters, and air is pumped. With a significant compression of the hand feels paresthesia in the fingers, depending on the median nerve.

These tests are simple can be used at home for self-control. If one of the tests gave a positive result - a reason to see a doctor.

Neurologist for further diagnosis will appoint:

• a full analysis of the urine;
• biochemical analysis of blood;
• detailed analysis of blood from a finger;
• thyrotropic blood on hormones;
• Ultrasound, MRI, x-ray.
  
• testing for C-reactive protein.

CZK Treatment: the protection regime

Protection regime - this includes a ban on the carrying of heavy loads, the rejection of the patient hand movements at the wrist joint, until the inflammation does not take place.

The principle of treatment:

• Arm should be protected, not supercool.
• Desirably overlay tires or special fixing bandage.
• Not allowed brush war, the blood must circulate freely.

All these measures are aimed at reducing to a minimum load. Without this, the rest of the treatment is not effective.

Local treatment: compresses

Tunnel carpal tunnel syndrome can be treated by the house warms compresses. Provided that this initial stage.

Mustard with honey

you must:

• flour - 4 tbsp. l .;
• Honey - 2 tbsp. l .;
• mustard - 2st. l .;
• Vodka - 2st. l.

Sequencing:

1. Honey, mustard and vodka mix, stirring constantly in a water bath.
2. When honey melted mixture is removed from the water bath and add flour.
3. From the resulting dough to unroll the cake and put on the brush.
   
4. Then there is a layer of polyethylene, and insulation gauze (old scarf, wool, shawl).
5. You can leave at night.

Alcoholic

you must:

• 40% alcohol;
• oilcloth or plastic bag;
• gauze or cloth made of cotton;
• wool or a scarf;
• bandage.

Sequencing:

1. Gauze or other fabric moisten with alcohol, wring out, put on the sore spot.
2. Then there is a waterproof layer of oil cloth or polyethylene.
3. Then you need a heater. All is fixed with a bandage.
4. Warm-up time of 2-3 hours.
5. If you get uncomfortable, remove the poultice, wash with water and lubricate the skin cream.

Anesthetic

you must:

• Saline - 6 ml;
• Dimexidum - 60 ml;
• Hydrocortisone - 2 ampoules;
• 10% lidocaine - 4 ml.

Sequencing:

1. All the ingredients are mixed. (Stored until the next use can be refrigerated).
2. Gauze or other cloth to moisten the mixture, wring out, put on the sore spot.
3. Then there is a waterproof layer of oil cloth or polyethylene.
4. Then you need a heater and all fix bandage.
5. Duration 60 min.
6. If you get uncomfortable, remove the poultice, wash with water and lubricate the skin cream.

Compresses relieve inflammation, swelling and reduce pain.

drug therapy

The earlier treatment starts, the more effective it will be. In some cases, it does not require the use of drugs, to do enough work stoppages at night to wear a bandage fixation and eliminate much of the load. In more severe cases, no medication can not do. Examples of medicaments prescribed by a doctor, described below.

Medications used in the treatment tunnel syndrome:

Why apply	The name and the form of medicines	The method and the dose of medicament receiving
Removal of edema	Furosimid 40 mg (tablet)	20 - 80 mg (1 \ 2 - Table 2.) Per day. Beginning with the lower dose and gradually increase to a maximum. Take to the disappearance of edema
Torasimid 5 mg (tablet)	2.5 - 10 mg (1 \ 2 - Table 2.) Per day. Beginning with the lower dose and gradually increase to a maximum. Take to the disappearance of edema
vasodilation	A nicotinic acid 10 mg / 1 ampoule (Solution for intravenous administration)	It is parenterally administered (i.v.) 10 mg (1 ampoule) 1 - 2 times a day. The course is 10-15 days
Trental 20 mg / 1 ml (Solution for intravenous administration)	Is administered intravenously by infusion 100-300 mg. Duration system 2 - 3 hours, 1 times a day. The course is 10 days
Removal of non-hormonal medicines inflammation	Movalis 15mg / 1.5ml (injection)	Intramuscular (intravenously administered impossible). From 7.5 to 15 mg 1 time per day. The dose depends on the severity of inflammation and pain intensity
Diklobern 50 mg (pills)	1 table. (50 mg) was 2 - 3 times a day. The dose depends on the severity of inflammation and pain intensity
Removing inflammation hormonal drugs	Prednisolone 5 mg (pills)	The initial dose of 20 - 30 mg per day. The maintenance dose is 5 - 10 mg per day
1% Hydrocortisone (Ointment for external use)	1 - 2 times a day. More than 5 days does not apply
Removal of chronic pain	Venlafaxine 37.5 mg (pills)	1 tablet 2 times a day, gradually increasing to 2 tablets 2 times a day
Withdrawal seizures	Pregabalin 300 mg (Capsules)	Start with 150 mg per day. After 3 - 7 days dose increased to 300 mg
Gabapentin 300 mg (Capsules)	1st day: 300 mg 1 time per day. Day 2: 300 mg 2 times a day. Day 3: 300 mg 3 times a day
Removing muscle tone	Mydocalm 150mg (pills)	The initial dose of 50 mg of 2 - 3 times a day. Gradually increasing to 150 mg of 2 - 3 times a day.
Sirdalud 2 mg (pills)	The starting dose of 2 mg three times a day. Gradually increasing to 4 mg per day

Administering medicaments in carpal tunnel

Tunnel carpal tunnel syndrome is treated by administering to said region medicaments, e.g. diprospana novocaine, lidocaine or Movalis. These drugs reduce swelling and inflammation.

The doctor makes a long needle puncture channel and angle enters the right drug in the right channel.

This procedure is called a blockade. After this treatment, the patient quickly goes on the amendment, but there may be more pain in the first day. Then the pain subsides. Repeat the blockade may be in 2 weeks.

Tunnel Syndrome Treatment folk remedies

Folk Remedies in conjunction with conventional medicine gives good results in treatment.

herbal teas

Many herbs have a diuretic effect and can relieve swelling. These herbs include: parsley, white birch leaves, cranberries. Bearberry has anti-inflammatory effect. Taking decoctions need 3 times a day. Exchange treatment is carried out. Month receiving alternates from a month vacation. Or every month to take a variety of herbs.

compresses

you must:

• Pumpkin (can replace camphor oil);
• gauze;
• insulation (wool, shawl, scarf);
• bandage.

Sequencing:

1. From pumpkins to make gruel.
2. Compress impose on the wrist.
3. Then the waterproof layer oilcloths or polyethylene.
4. After this layer is insulation.
5. Secure the wrap with a bandage and leave overnight.
6. Do the procedure daily until symptoms disappear.

trays

Baths restore blood circulation and soothe the affected channel.

you must:

• turpentine emulsion;
• Water heated to 37-39 degrees;
• insulation (scarf, gloves, shawl).

Sequencing:

1. Turpentine is added to the prepared container.
2. Brush dipped in the tub.
   
3. Duration of treatment 30 min.
4. Insulate hand. Wrapped in a shawl or a scarf (wool) suit gloves or mittens.

The following recipe, you need:

• sea ​​buckthorn;
• water;
• insulation.

Sequencing:

1. Buckthorn crumple and diluted with water.
2. Is heated to 37-39 degrees.
3. Brush dipped in the prepared tray.
4. Duration of treatment 30 min.
5. Insulate hand. Wrapped in a shawl or a scarf (wool) suit gloves or mittens.

infriction

The procedure has a warming effect, relieves pain and numbness in the limbs.

The first recipe

you must:

• water - 1 liter;
• Alcohol 10% - 50 g;
• camphor - 10 g

Sequencing:

1. These ingredients are mixed.
2. Prepared mixture to rub into the affected arm with light massage movements.
   
3. After the procedure, warm hand.

The second recipe

you must:

• Black pepper - 100 g;
• Vegetable oil - 1 liter.

Sequencing:

1. Pepper pour vegetable oil.
2. To warm over low heat.
3. Rub the warm mixture.
4. After the procedure, warm hand.

Physical therapy procedures

Tunnel carpal tunnel syndrome is treated fizioprotsedurami:

• for tissue recovery after the operation is used: ultrasonic, high-frequency currents, galvanization;
• electrical muscle relaxant;
• ultraviolet and infrared rays increases the protective function of the cells, increasing their resistance to infections;
• laser therapy, electromagnetic waves accelerate the movement of blood through the bloodstream;
• As a rule, massage combined with any procedure from the list;
• to deliver the drug directly into the center of inflammation, is used electrophoresis.

The above procedures have contraindications: high fever, severe pain, cancer.

Self-massage

An effective and simple procedure will help to maintain the health of the house and spend the prevention of carpal tunnel syndrome. Self-massage techniques can be learned by anyone. Massage reduces congestion, driving blood, lymph improves movement, removes muscle spasm.

Better to massage in the morning (an energetic 2 min.) And the evening (long 8 min.), As well as in case of discomfort in the region of the channel. Is contraindicated in temperature, skin lesions, skin pustular lesions. For the procedure used warming creams, oils or regular fat cream.

During the massage, the discomfort should not be:

1. Trituration. Movements like hand washing. Gently walk on the fingers, palms, wrists.
2. Kneading, a more active and with the push of each fingers, palms, back of the hand, wrist.
3. Compress and unclench his fist, repeat 5 times.
4. Rub hands vigorously together.
5. The thumb of the opposite hand to rub with pressure, starting with the little finger, ending with your thumb, then do the same with his hand, then go on the wrist.
6. Edge of the hand to tap from the fingertips to the wrist.
7. Repeat active grinding.
8. Patted his arm.
9. Rotating the brush in one direction, then in another.
10. Pinch your fingers, palm and wrist on the skin.
11. Complete self-massage stroking.
12. Massage the first one arm, then the other.

special gymnastics

Exercising helps relieve the stress and fatigue with it.

You should begin with a warm-up:

1. Compress and decompress hands, actively repeat 8-10 times.
2. Put your hands down and shake them.
3. Rotate each finger in a circle, one way or the other.
4. Make a circular motion wrists.

After warm-up to perform the basic set of exercises.

The number of repetitions of 4-6 times:

1. To join hands in the castle. To turn myself in his hands and straighten the arms to full extension at the elbow.
2. Take each finger far back as possible.
3. Connect your fingers into the lock, take the elbows to the side and with the power to try to disconnect.
4. To connect palms at chest level (as in prayer). Give up in this position down to her waist and lifted up above his head.
5. Turn the hands, palms facing you. Bend each finger in turn, collecting the fingers into a fist. Now, in the opposite direction to straighten each finger in turn.

Charging helps to prevent the recurrence of the syndrome. you can not do exercises in inflammatory processes. Gymnastics should cause a pleasant sensation, discomfort at not perform.

Surgery

If, after all of the treatment the patient complains of pain, the doctor-neurologist gives direction to the operation. The surgical method is aimed at expansion of the channel and reducing the pressure on the median nerve.

The operation is performed in two ways:

• endoscopic method. It makes two small incisions, 0.5 cm. One introduced an endoscope equipped with a camera in the other tool for surgery. Tunnel expand due to the cut in the ligaments.
• Clear the way. In the palm of an incision of approximately 5 cm. The surgeon gains access to the tunnel, and makes an incision in the bundle, expanding it, thus reducing the pressure on the nerve.

Both methods are carried out under local anesthesia. The wound was closed several stitches bandage. Stitches are removed after a week. A tire wear need another 6 months.

If the situation demands, endoscopic operation proceeds in the open.

The first method is less traumatic, shorter recovery period. In compliance with all recommendations of the doctor the possible complications are minimized.

Rehabilitation

After surgery, the patient is given the following recommendations:

• Appointed by the narcotic drugs for 14 days. They relieve pain, but addictive and abused by these means is not necessary.
• To reduce swelling using a heating pad with ice. It is applied for 10-15 min.
• Appointed anti-inflammatory, such as ibuprofen, Nuprinom.
  
• It is necessary to maintain the protection regime for the hand. This concept includes a ban on lifting, any actions associated with the voltage in your hand.
• Diet in the postoperative period are contraindicated. Meals should be full, containing sufficient protein, needed for tissue repair.
• The bandage should be clean and dry.
• Showing physiotherapy.
• After the permission of the doctor begin to massage and gymnastics.

3 months after surgery on carpal canal, patients recover much of the hand features a full recovery and relief of symptoms occurs after six months.

The most important part of the treatment tunnel syndrome - is prevention. In order to avoid tension in the carpal canal at work at the keyboard, you should take a break, stretching his hand, conducting or performing self-massage exercises. When the first symptoms to consult specialists. The earlier treatment starts, the better chance to recover your hands thoroughly.

Registration of the article: Lozinski Oleg

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