Carpal tunnel syndrome - causes, symptoms, diagnosis and treatment methods. What we treat carpal tunnel syndrome Drug treatment of the disease

Definition of carpal tunnel syndrome

Orthopedic doctors talk about carpal tunnel syndrome when there is damage to the median nerve (Nervus Medianus) at the wrist. With tissue edema, pressure on the median nerve (Nervus Medianus) increases, which, as a result, causes it to be pinched.

Carpal tunnel syndrome is one of the most common diseases diagnosed by orthopedists. Approximately every tenth inhabitant of Germany faces this disease during his life.

The carpal tunnel is located on the inside of the wrist, at the base of the hand and is surrounded by a ligament connective tissue- Ligament of the wrist. Through the carpal canal pass the tendons and the median nerve (Nervus Medianus), which controls certain muscles of the hand and fingers, and is also responsible for sensitivity in the thumb, index, middle and part of the ring fingers.

Damage to the median nerve is accompanied by the following symptoms:

• decreased sensitivity of the hands
• a feeling of tingling and numbness in the hands, especially in the area of ​​the thumb and middle fingers
• pain with grasping movements
• pain in fingers radiating to hand

Symptoms appear, as a rule, at night, in the morning and are aggravated by additional stress on the hands.

Orthopedists diagnose carpal tunnel syndrome primarily in people over the age of 40. In women, the disease occurs three times more often than in men. In a particularly severe case, numbness can become permanent and lead to atrophy of the muscles of the palmar cavity (at the base thumb).

Synonyms: carpal tunnel syndrome(CTS), carpal tunnel syndrome (CTS), median nerve compression syndrome, nerve compression syndrome.
The term in English lang: carpal tunnel syndrome

Description

Carpal tunnel syndrome occurs primarily in people aged 40-70 years. In children, orthopedists diagnose this disease extremely rarely. Patients wake up in the morning because their arm is numb or tingling. If you shake your hand, then, as a rule, complaints disappear. Later on to sensory disorders motor disturbances are added, for example, a decrease in strength in the thumb.

Carpal tunnel syndrome often develops not on one, but immediately on both hands. At first, complaints appear only periodically. However, prolonged pressure on the median nerve (Nervus Medianus) inevitably leads to its damage. If carpal tunnel syndrome is not monitored by an orthopedic doctor, the muscles at the base of the thumb will atrophy. Damage to the median nerve and severe muscle atrophy cannot be restored. Therefore, it is important to seek the help of an orthopedic doctor in a timely manner.

Causes of Carpal Tunnel Syndrome

Quite often it is impossible to identify any specific cause of this disease. In this case, orthopedic doctors speak of idiopathic carpal tunnel syndrome, which mainly occurs in women during menopause due to excessive accumulation of fluid and tissue edema in the carpal tunnel. Also, pregnancy can trigger the development of carpal tunnel syndrome.

In addition to the above, orthopedists call the following reasons onset of the disease:

• hypofunction thyroid gland(hypothyroidism)
• deformities and displacements in the wrist area after previous injuries
• rheumatic diseases
• scar tissue that puts pressure on a nerve
• chronic inflammation of the tendon sheaths (tenosynovitis)
• swelling and inflammatory tissue swelling
• diabetes
• dialysis therapy for kidney failure

It is still not clear whether carpal tunnel syndrome is inherited. However, often orthopedic doctors diagnose the disease in several maternal family members.

People in certain professions whose wrist is subjected to excessive stress for a long period of time are at a significantly increased risk of developing carpal tunnel syndrome.

What can you do about carpal tunnel syndrome?

Orthopedic doctors advise avoiding stress and refusing to perform heavy physical work. Shaking and cooling the hand can provide short-term relief from pain. A good effect is exerted by applying an ice pack wrapped in a towel to the wrist area.

Splinting the wrist at night and during the day helps keep the wrist extended, thereby preventing pressure on the median nerve. For those who work a lot at the computer screen, it is highly recommended to use an ergonomic keyboard.

Help from experts

Depending on the symptomatology, in addition to consulting your doctor, a detailed diagnosis by various specialists may follow. These include:

• orthopedist
• neurologist

What awaits you at the appointment with an orthopedic doctor?

Before the orthopedic doctor starts the examinations, he will start with a conversation (anamnesis) about your current complaints. In addition, he will also ask you about past complaints, as well as the availability possible diseases.
The following questions may await you:

• How long ago did the symptoms start?
• Could you describe the symptoms more precisely and localize them?
• Have you noticed any changes in the process of symptomatology?
• Do you experience additional symptoms such as shortness of breath, chest pain, dizziness?
• Have you already experienced this and have similar symptoms in the family?
• Do you currently have any diseases or hereditary predisposition to the disease and are you under treatment for this?
• Are you currently taking medications?
• Do you suffer from allergies?
• Do you often experience stress at home?

What medications do you take regularly?

Orthopedic doctor needs a review medicines that you regularly take. Please prepare a chart of the medications you are taking before your first appointment with the podiatrist. An example of such a table can be found at the link:.

Examinations (diagnosis) performed by an orthopedist

Based on the characteristics of the symptoms identified during the anamnesis and your current state, the orthopedic doctor may resort to the following examinations:

• measurement of the speed of propagation of excitation along the fibers of the median nerve (Nervus Medianus) of the wrist
• lab tests
• x-ray examination
• Ultrasound (ultrasound examination of the nerve)
• electrophysiological study (EPS)

Treatment (therapy)

With light and moderate An orthopedist may prescribe a nighttime splint to relieve pain and stabilize the wrist. In the event that some other disease is the cause of the development of carpal tunnel syndrome, for example, hypofunction of the thyroid gland (hypothyroidism), the efforts of doctors will be directed primarily to the treatment of the primary disease.

To reduce pain, the podiatrist prescribes pain medications such as paracetamol, diclofenac, or ibuprofen. In addition, injections of glucocorticoids (cortisone) may be prescribed. However, in most cases, after some time, complaints reappear.

If the patient already has a violation of sensitivity (numbness) or paralysis, an operation is necessary. In this case, the ligament of the wrist is excised, reducing the load on the median nerve. Most often, the orthopedist performs the operation under local anesthesia and, as a rule, it leads to good results. After the operation, it is necessary to ensure complete immobilization of the wrist for the next two weeks. However, doctors advise patients to immediately begin active finger movements to avoid stiffness.

Preventive

Since the causes of carpal tunnel syndrome in most cases are not clear, the disease cannot be prevented. It is important to seek the help of an orthopedic doctor in a timely manner, which will avoid subsequent damage.

Forecast

Surgical intervention will help eliminate the patient's complaints about long time. After two to three weeks, the functions of the fingers and hand are restored almost to their full extent. However, surgery is not always necessary.

Carpal tunnel syndrome or carpal tunnel syndrome or median nerve tunnel neuropathy at the level of the carpal (carpal) tunnel is compression of the median nerve at the level of the wrist (in the carpal tunnel) by the transverse carpal ligament. This is the most common neuropathy resulting from pressure on the hand. It is observed in middle-aged patients, more often in women. In half of the cases it happens on both sides, but is more pronounced on the dominant hand.

ICD code 10 for carpal tunnel syndrome G56.0.

Causes of carpal tunnel syndrome.

The "classic" carpal tunnel syndrome has a chronic course.

There are the following causes of carpal tunnel syndrome:

• Injury often associated with work: repetitive movements of the hand or wrist; re-squeezing the brush, holding tools; uncomfortable positions of the hand and wrist, especially strong flexion of the wrist; direct pressure on the wrist; work with vibrating tools.
• Common Causes: obesity; may appear temporarily during pregnancy; mucopolysaccharidosis V; tuberculous tenosynovitis; diabetes; hypothyroidism; acromegaly; amyloidosis; carcinomatosis; rheumatic polymyalgia; rheumatoid arthritis; gout.

"Acute" carpal tunnel syndrome is extremely rare. Its symptoms appear quickly and are pronounced.

Causes:

• Thrombosis of the median artery.
• Hemorrhage or hematoma of the transverse carpal ligament.

Symptoms of carpal tunnel syndrome.

1. Violation of sensitivity in the form of painful numbness in the hand. The pain may radiate up the arm, sometimes down to the shoulder. Localization of numbness is usually along the palmar surface of the 1st, 2nd, 3rd fingers of the hand and the radial side of the palm.
2. Weakness of the hand, especially when making a fist. There may be atrophy of thenar (muscles of the elevation of the thumb on the palmar surface of the hand).
3. Clumsiness of the hand and difficulty with precise movements.
4. Hyperesthesia ( hypersensitivity) in the 1st, 2nd and 3rd fingers, most pronounced in the fingertips.
5. Phalen test: clenching the hand into a fist for 30-60 seconds leads to pain or tingling.
6. Tinel's symptom: tapping over the carpal tunnel causes pain and tingling in the zone of innervation of the median nerve on the hand.

Diagnosis of carpal tunnel syndrome.

First of all, it is necessary to differential diagnosis with cervical radiculopathy on the background of a hernia intervertebral disc. This requires an MRI. cervical spine. It is also necessary to exclude tenosynovitis (inflammation) of the tendons of the muscle that removes the thumb and the short extensor of the thumb. Electroneuromyography of the median nerve plays a very important role in diagnosis, which will help distinguish damage to the cervical roots and tendons of the hand from carpal tunnel syndrome. But electroneuromyography in 31% of cases can be normal. Be sure to do an ultrasound of the carpal tunnel. Ultrasound shows the structure of the median nerve and the transverse carpal ligament, which may be thickened.

Treatment of carpal tunnel syndrome.

How to treat carpal tunnel syndrome? I will say right away that carpal tunnel syndrome folk remedies cannot be cured at home.

Treatment for carpal tunnel syndrome can be conservative or surgical. Conservative therapy is resorted to if the symptoms began recently and are not pronounced.

Conservative therapy includes rest, NSAIDs (non-steroidal anti-inflammatory drugs), vascular drugs, cholinesterase inhibitors (drugs that improve neuromuscular conduction), B vitamins, use of a neutral splint, injection of steroids (usually hydrocortisone) into the carpal tunnel.

With the ineffectiveness of conservative therapy, frequent recurrence and the presence of persistent severe symptoms, surgical treatment is indicated.

Click on the picture to enlarge Incision to access the median nerve

Surgery for carpal tunnel syndrome is called neurolysis of the median nerve in the carpal (carpal) tunnel.

In the case of a bilateral median nerve lesion, the side with more severe pain is usually operated on first. However, in case of severe nerve damage, when weakness and numbness have already appeared, it is more expedient to start from a more “healthy” side in order to ensure maximum nerve recovery on at least one side. Sometimes surgery is performed simultaneously on both sides.

The surgical technique consists in making an incision on the palmar surface of the hand along an imaginary line extending from the gap between the 3rd and 4th fingers, adhering to the ulnar edge of the intertenar fold, so as not to touch the palmar skin branch. The incision begins at the distal carpal crease. The length of the incision depends on the thickness of the hand, it can continue up to the gap of the thumb. Next, a complete dissection of the transverse carpal ligament and suturing of the wound is performed.

After the operation, analgesics are prescribed, sometimes cholinesterase inhibitors (drugs that improve neuromuscular conduction), vascular drugs that improve microcirculation and B vitamins.

Limitation physical activity on hand within 2-3 weeks. Next, physiotherapy exercises and physiotherapy are prescribed.

The stitches are removed on the 10th day.

Literature:

1. Neurosurgery / Mark S. Greenberg; per. from English. - M.: MEDpress-inform, 2010. - 1008 p.: ill.
2. Practical Neurosurgery: A Guide for Physicians / Ed. B.V. Gaidar. - St. Petersburg: Hippocrates, 2002. - 648 p.
3. Topical diagnosis of diseases nervous system/ A.V. Triumfov. - 15th ed. - M.: MEDpress-inform, 2007. - 264 p.: illustration.
4. Al-Zamil M.H. carpal syndrome. Clinical neurology. - 2008. - No. 1. - p.41-45
5. Govenko F.S. Surgery of peripheral nerve injuries. - St. Petersburg: Phoenix, 2010. - 384 p.
6. Odinak M. M., Zhivolupov S. A. Diseases and injuries of the peripheral nervous system (generalization of clinical and experimental experience). Guide for doctors. - St. Petersburg: SpecLit, 2009. - 367 p.
7. Russell S.M. Diagnosis of damage to peripheral nerves. Per. from English. - M.: BINOM, 2009. - 251 p.

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Carpal tunnel syndrome is a common condition that causes pain, numbness, and weakness in the hands and wrist. The disease occurs when the median nerve is compressed in the carpal tunnel. This nerve supplies the thumb, index and middle fingers, as well as half of the ring finger. The little finger ("little finger") is usually not affected. The median nerve also provides strength to some muscles at the base of the thumb.

What is a carpal canal?

The carpal tunnel is a narrow tunnel in the wrist. The bottom and sides of the tunnel are formed by a semicircle of carpal bones. The transverse ligament forms upper part tunnel.

The median nerve and tendons pass through this narrow space. (Tendons are "rope" structures that connect the muscles of the forearm to the bones of the hand.) Tendons allow the fingers to bend and straighten. Conditions that cause narrowing of the carpal tunnel or swelling and inflammation of the tendons that go away

through this tunnel, cause carpal tunnel syndrome by compressing the median nerve.

Causes of the disease

The causes of the carpal tunnel syndrome are all conditions in which the tunnel narrows and the nerve is compressed in it. Among them are:

• injuries in the wrist area (fractures and dislocations of bones).
• cysts or tumors in the wrist area that cause compression of the median nerve.
• frequent repetitive movements of the same type in the area of ​​the wrist joint (flexion-extension as well as the impact of vibration on the hand). People of certain professions are subject to this: painters, violinists, cashiers,
  milkmaids, equipment assemblers, artists, dentists, tattoo artists.
  An additional effect is exerted by hypothermia of the brush.
• prolonged incorrect position of the hand in the position of excessive flexion or extension, most often the result of an incorrect position of the hand and computer mouse in office workers - with excessive extension, the median nerve is squashed in the canal.
• risk factors are diseases and conditions of the body in which there is a tendency to tissue edema, as a result of which the carpal canal narrows - these are pregnancy, thyroid diseases, diabetes mellitus, obesity, amyloidosis, taking hormonal contraceptives, rheumatism, kidney failure and etc

Symptoms.

Among the main complaints of patients with carpal tunnel syndrome are tingling, numbness, burning, crawling, pain or shooting in the fingers (all including the thumb, but excluding the little finger). Sometimes the pain radiates to the forearm or shoulder.

As a rule, symptoms appear at night or in the morning after waking up. The pain is so pronounced that it can wake the patient. Symptoms decrease after a few minutes after shaking the hand, this forces the person to lower the hand down from the bed, shake the hand. May appear

weakness in the hands, which is manifested by the awkwardness of the hand and the difficulty of holding objects.

In severe cases, there is a disappearance of sensitivity, muscle atrophy, dry skin of the fingers, weakness of the muscles of the thumb. Habitual gestures such as grasping objects, sewing, buttoning shirts become difficult to perform.

Diagnostics

In most cases, a physical examination of the patient, conducting special tests, can diagnose carpal tunnel syndrome.

Phalene's maneuver

This maneuver can be performed as follows:

• Place the backs of your hands on top of each other with your fingers pointing down
• Drop both elbows down.
• Hold this position for 20 seconds.

If you feel pain and the sensation in your arm increases, the test is positive, which could mean narrowing of the carpal tunnel.
Second carpal tunnel syndrome Tinnel test. The test is performed as follows:

• The wrist joint is in the middle position, that is, the arm lies straight
• Now press with two fingers on the carpal tunnel.
• Keep pressing for 20 seconds. If you feel a tingle in your hand, the test is considered positive.

However, studies such as electroneuromyogram, radiography of the wrist joint, CT scan and blood tests. They confirm the diagnosis and, to a greater extent, serve to assess the severity of nerve damage and determine the tactics of therapy.

How is carpal tunnel syndrome treated?

Non-surgical treatment

Treatment begins with wearing an orthosis on the wrist joint at night to give it a neutral position and, accordingly, to reduce nerve compression. Also, non-steroidal anti-inflammatory drugs, such as ibuprofen, nimesil, ketonal, etc., are prescribed to alleviate the pain syndrome. Diuretics are indicated to reduce tissue swelling. In order to improve microcirculation, angioprotectors are used - pentoxifylline or nicotinic acid. To improve the nutrition of the nerve - vitamins of the B-milgamma group, combilipen, etc.

Topical application of NSAIDs is shown, as well as compresses on the wrist joint (with dimexide, artrafik). In some cases, medical and drug blockades with glucocorticoids are used, which allow you to remove local swelling and compression of the nerve, in addition to alleviating

symptoms, they are a diagnostic measure to confirm the diagnosis. As physiotherapy, ultraphonophoresis with hydrocortisone, laser therapy, magnetotherapy, manual therapy, shock wave therapy are indicated. As an auxiliary method, acupuncture can be used.

carpal tunnel and median nerve

The carpal tunnel is a tunnel that is formed by the carpal bones on one side and the transverse carpal ligament on the other. The tendons of the flexor muscles of the hand and the median nerve pass through this tunnel.

The median nerve is the thickest nerve in the area upper limb. Passing in the area of ​​the carpal canal to the hand, it gives branches to the thumb, index, middle and half of the ring finger. In addition, it innervates the muscles of the thumb. The median nerve, passing through the carpal canal, is located above the tendons of the muscles. The tendons of the flexor muscles are covered with a special sheath - synovial sheaths. In these sheaths, the tendons glide during movement.

Carpal syndrome (carpal tunnel syndrome) is one of the most common diseases of the wrist area. It consists in compression of the median nerve in the area of ​​the carpal tunnel. In a broad sense, the syndrome of the carpal tunnel occurs under the condition of a decrease in its size or an increase in the volume of tissues inside it.

Carpal tunnel syndrome occurs under any condition that leads to a decrease in its size or an increase in the tissues inside it, which leads to compression of the median nerve.

Causes of carpal tunnel syndrome include:

Injury to the wrist area, which leads to swelling of the tissues in it, the occurrence of hematomas.

A fracture of the bones in the wrist area is most often a fracture of the radius.

Arthritis of the wrist joint.

Tumors in the carpal canal.

Inflammation in the area of ​​the synovial sheaths of the tendons of the flexor muscles.

Pregnancy, while there is a tendency to swelling of soft tissues.

Diabetes mellitus, which is manifested by pathology of peripheral nerves - neuropathy.

Decreased thyroid function.

With compression of the median nerve, there is a violation of the blood supply to its outer shell and even a complete cessation of blood circulation in it. There is ischemia. In the beginning, only the superficial parts of the nerve are affected. But with prolonged ischemia, the lesion also affects the deep layers of the nervous tissue. As a result, scar tissue forms in the nerve. This causes pain and numbness in the fingers.

Manifestations of carpal syndrome

The manifestations of carpal tunnel syndrome are usually bright. This is accompanied by intermittent or constant numbness in the fingers (and palms), tingling and pain, which are noticeably worse at night. Patients repeatedly wake up at night due to pain, are forced to move and knead their stiff and “stiff” fingers, and put their hands down.

In the morning, there is an increase in these symptoms. During the day, patients experience gradual relief, but even after short overloads, deterioration occurs again. Over time, the discomfort gets worse. Sometimes the pain can radiate up to the shoulder. Numbness first captures one or two fingers, then spreads to all the others, sometimes including the little finger. When raising the arm up, the pain intensifies, which is associated with a deterioration in blood flow.

On examination, you can notice some cyanosis and pasty swelling. When feeling in the palm area, pain is determined.

Diagnosis of carpal syndrome

Diagnosis of carpal tunnel syndrome is mainly based on diagnostic tests. They consist in the artificial induction of ischemia of the median nerve and further evaluation of the manifestations. A certain role in the diagnosis of this pathology can be played by radiography, in the case when this syndrome is a consequence of a fracture of the bones of the forearm. In addition, magnetic resonance imaging is performed.

Treatment of carpal syndrome can be either conservative or surgical.

Conservative therapy

The most popular method of conservative treatment of carpal tunnel syndrome is the use of anti-inflammatory drugs. In mild cases, they are taken in the form of tablets. In severe cases of manifestation of this disease, the so-called steroidal anti-inflammatory drugs (hydrocortisone, kenalog, etc.) are used. Steroid medications are given by injection into the carpal tunnel itself. Usually, two injections are given with an interval of about 2 to 3 weeks. In rare cases, a third injection may be required.

Surgery

In the absence of the effect of conservative treatment, surgical treatment is indicated. The operation for carpal tunnel syndrome consists in decompression, that is, reducing pressure in the area of ​​the carpal tunnel, and, accordingly, reducing compression of the median nerve.

Usually, general anesthesia is used for this operation, but under certain conditions, conduction anesthesia can also be used. Several methods have been proposed for performing an incision during this operation. An incision is made on the inner surface of the wrist, about 3-4 cm long. The flexor retinaculum ligament, which is one of the walls of the canal, is necessarily dissected. Next, the contents of the canal are examined, abnormal muscles, tumors, hypertrophied synovial membranes, unusual bone protrusions, fibrous cords constricting the nerve, etc.) are detected and eliminated.

Endoscopic surgery

There is also endoscopic method surgical treatment this syndrome. It requires a minimal skin incision. A special cannula is used, which is inserted into the carpal canal. The doctor examines the canal and makes sure that there is no location nearby blood vessels. then a special scalpel in the form of a hook is inserted through the cannula. With its help, the ligament of the carpal tunnel is dissected and compression of the median nerve is eliminated.

Operational risks and possible complications

As with any surgical intervention, surgical treatment complications of carpal tunnel syndrome may occur.

• Complications associated with anesthesia (for example, allergies and more serious complications).
• Infectious complications - are manifested by pain in the area of ​​​​the surgical wound, redness and swelling. To prevent this complication, postoperative period antibiotics are prescribed.
• Technical errors in the operation - ranging from incomplete dissection of the carpal ligament of the canal to damage to blood vessels and nerves.

• Carpal syndrome - treatment

I have a friend who, for a year and a half of monotonous work with microcircuits at the factory, has earned herself carpal tunnel syndrome, the treatment of which is difficult for her. I want to help with this article.

With carpal tunnel syndrome, treatment can be carried out as conservative methods, and surgical intervention. Consider how to deal with a pinched median nerve with folk remedies, pharmaceutical preparations, with the help of exercises and massage.

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Let's find out the nuances of working at a computer that will prevent or stop the development of carpal tunnel syndrome (English carpal tunnel). We will deal with the symptoms of the disease and find out in which cases resort to surgery. Let's get acquainted with the reviews of people who have overcome neuralgia.

What is carpal tunnel syndrome? This is the most common form of compression-ischemic neuropathy. It is caused by squeezing of the median nerve in the wrist by surrounding tissues.

Carpal tunnel syndrome: treatment with folk remedies

If carpal tunnel syndrome manifests itself, treatment for early stages you can do it yourself at home, using available and tested means. Their action is aimed at eliminating the inflammatory process, swelling, which as a result leads to a decrease in pressure on the median nerve.

Pathological process in ICD-10 ( international classification diseases) is designated by the code G56.0.

More often, women are affected by the disease due to the natural narrowness of the carpal tunnel. The disease is considered professional among needlewomen and butchers, computer scientists and musicians, draftsmen, assemblers. Statistics on carpal tunnel syndrome affects approximately 3-6% of adults.

What means to use to eliminate inflammation

Take off inflammatory process in the hand will help the infusion of wild rosemary (bog) on apple cider vinegar. You should take 1 part of the swamp and 3 parts of vinegar, stand for 7 days. Rub into the affected area three times/day.

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For the treatment of pain, numbness, folk remedies are used:

1. . Cover a teaspoon of chopped herbs (dry or fresh) with 0.5 cups of boiling water, hold on low heat for 10 minutes. Drink 1-2 teaspoons of the potion in the morning and before bed.
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2. : string, birch and burdock leaves, hop cones, elder flowers and verbena. Take all components in equal proportions, grind. Brew in a thermos 3 tbsp. spoons of the mixture 1 liter of boiling water. After 2-3 hours, the drug is ready. Take 150 ml four times / day.
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3. Linseed oil. For 15 days, drink 1 teaspoon of oil per day.
4. B vitamins. Include leafy greens, bananas, oatmeal, rice and buckwheat porridge, nuts, dried fruits, potatoes, sprouted wheat grains, sunflower seeds, sesame seeds, bran, chicken meat in your daily diet.
5. . Dilute the powder (freely sold in pharmacies) with water to a slurry. Transfer to a gauze pad, bandage to the affected area.
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6. pumpkin compress. Rub the pumpkin on a fine grater (raw or baked), apply on the wrist, wrap with cellophane (food wrap).
7. Sea buckthorn (rowanberry) decoction. Pound the berries, pour a small amount of water, heat. Steam the handles (to the elbows) for 10-15 minutes. After the session, dry them with a towel, put on woolen mittens.
8. . 100 g black pepper cover 1 l vegetable oil, soak in a water bath for 25-30 minutes. Rub warm oil on the affected area 2-3 times a day.
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Use a warm alcohol compress to treat neuralgia at home: combine alcohol with cool water (1: 2). Wrap the limb overnight. “How to treat malaise if the pain does not allow you to sleep?” — frequently asked question on the forums. Mix in 1 liter of water 10 ml of ammonia, 10 ml camphor alcohol and 1 tbsp. l. salt (preferably sea). Rub the solution into the affected joint 15-20 minutes before bedtime.

Means to eliminate edema

To relieve swelling and relieve joint pain ethnoscience suggests using an infusion of meadowsweet. A couple of st. spoons of grass brew in 400 ml of boiling water. Filter the infusion after 2 hours. Drink half a cup three times/day.

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Anti-edematous effect is exerted by:

• rosemary,
• bear ears,
• cowberry,
• lovage,
• horsetail,
• birch buds and leaves,
• rose hip.

From them you can prepare decoctions, infusions. Use both individually and in mixtures (always taking into account individual tolerance).

Symptoms of carpal pathology, similarity with other diseases

Since the median nerve innervates (provides communication with the central nervous system) most brush (from the side of the thumb), then numbness, pain, tingling appear in the thumb and two adjacent fingers, half of the ring finger, less often - trembling, itching. In the wrist area, there may be a feeling of stiffness, burning.

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The person may lose some of the strength in the hand. Difficulties arise with clenching the fist, capturing small objects. Simple operations become a problem: fastening buttons, opening a bottle of mineral water, lacing shoes, etc. Over time, an individual may notice that he distinguishes the temperature of objects worse, may not feel light touches. Basically, a pinched median nerve is manifested on the right limb in right-handers, on the left in left-handers.

We often tend to self-diagnose ourselves and fight the disease with “working” prescriptions from colleagues and acquaintances. Why shouldn't it be done? The disease is often similar to other pathologies, for example:

• diabetic polyneuropathy (peripheral nerve damage);
• arthritis (inflammation) of the thumb joint;
• cervical radiculopathy (infringement of the nerve roots);
• lateral epicondylitis (inflammatory process in the elbow zone);
• wrist periarthritis against the background of arthrosis, osteoarthritis (joint damage).

Here are some of the differences in diseases. So, diabetic polyneuropathy is basically a bilateral process in which other nerves (not just the median) are involved. With carpal and humeroscapular periarthrosis, there is a specific deformity of the joints, the inability to raise or place a hand behind the back, cephalgic syndrome.

Also, soreness of the wrists can be associated with damage to their ankylosing spondylitis (Bekhterev's disease), resulting subluxation (when injured), myelopathy (pathology of the spinal cord).

Prolonged squeezing of the median nerve often leads to the fact that numbness and pain affect not only the fingers, but also spread throughout the upper limb, covering the cervico-shoulder region. Even doctors can make a diagnostic mistake, considering the pathology " cervical osteochondrosis with radicular syndrome ”- the symptoms of the diseases are largely similar.

Special exercises for the wrist

Applying exercise therapy for neurological disease, you can forget about the painful condition forever. The exercises are simple and easy to do. The main thing is the regularity of execution.

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In chronic pain, you should lower your hands into a basin (bucket) with hot water, clench your fists and slowly rotate them left and right. Duration water treatment 10-15 minutes. After the session, dry your hands and do not immediately cool them - wrap them in a woolen scarf or put on mittens.

For many, a “rescue wand” is a massage for debilitating pain in the hands. It is not necessary to have special skills and knowledge to do it. You need to massage the entire limb: start from the outside of the palm and gradually rise to the outside of the forearm. Movements - slightly pressing, stroking, rubbing.

Watch a video with simple and useful exercises:

Advice : In the case when, after exercise therapy, the ailment temporarily subsides, and then again falls on you - make an appointment with a physiotherapist. He will understand your specific case, point out mistakes, and help you choose the right set of exercises for you.

How to treat the disease with pharmaceutical preparations

If neuropathy is accompanied by persistent symptoms and treatment with folk methods does not work, you should consult with doctors. If you suspect a compression of the median nerve, which doctor should I contact? An accurate diagnosis can be established by a neurologist.

Most doctors prescribe painkillers pharmaceuticals- Pentalgin, Ketonal. Severe inflammation is mainly relieved by injections of corticosteroid drugs directly into the joint area. With compression of the median nerve, from 3 to 5 blocks are made every other day. After blockades, a long-term effect occurs (patient reviews confirm this).

We suggest watching a video: the doctor talks about the manifestations of the disease, shows how the local summing up of the medicinal substance is carried out:

To improve blood flow when "turning off the hands" is administered nicotinic acid, Trental or Xanthinol. For complex therapy vitamins B6 and B12, C, garlic tablets can be used. Patients with severe paresthesia (sensitivity disorder) may be prescribed medicines carbamazepine series - Tegretol 2-3 r / day, 200 mg. Recommend diuretics, antidepressants, etc.

What to do if the brushes “fall off”, but you need to work

How often unbearable "tunnel" pain and unfinished work torment at the same time. What to do? Even in the presence of mild symptoms, it is important stop the activity that provoked the malaise. Switch to simple household chores that allow you to relieve tension in the channel:

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Use a brace or wrist splint. A bandage for trap syndrome will help keep the wrist at rest (without tilting and arching). Pharmacies (specialized stores) sell models of varying degrees of fixation, size, color. Since the carpal tunnel maintains maximum volume in this position, the nerve is provided with sufficient space.

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The latches are practical: they are easy to put on and take off, do not restrict the wearer's movements, and can be used to work. If wearing a retainer during the day is inconvenient for any reason, put it on at night. Please note that the retainer must contain a rigid or springy element, be made of durable and breathable fabric.

At home, the pain will decrease if:

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A trip to the pool will return the perfect state of health. The main condition for therapeutic swimming is that the water should be warm, covering the limb up to the shoulder. Also, experts advise to learn yoga. Classes contribute to the development of joints and muscle elasticity, contribute to psycho-emotional stability.

When resorting to surgery

If the decrease in load and conservative treatment do not help, then there are indications for surgery in this type of neuropathy - resection of the transverse ligament of the wrist.

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It is carried out both in an open way and with the help of an endoscope.

Numbness and pain disappear immediately after surgery or within a few months. In Moscow clinics price surgical intervention within 21,000 rubles, in Kyiv - 6,800 hryvnia (outpatient) - the cost at the time of writing.

Occasionally, there are cases when a wrist operation is performed, but patients continue to feel pain, discomfort (negative reviews can also be found on the forums).

The reason may lie in the fact that with prolonged compression of the nerve, its irreversible damage often occurs. In this case, the symptoms of the disease may persist after surgery. Arthritis (inflammation of the joints) or tendovaginitis (inflammation of the tendons) can also cause annoying pain after surgery.

Among various ways diagnostics, electroneuromyography (ENMG), ultrasound of the nerve, and MRI are especially popular.

Let's say a word about IT people

Doctors are sounding the alarm different stages pathology was recorded in every sixth person working on a computer. Treatment of neuropathy (especially if detected in the initial phase) is not required if you follow the recommendations:

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Try to type with both hands. It is noticed that the pain is aggravated by overloading the thumb. Often this happens when pressing the spacebar with the thumb of only one hand.

Note! You can determine the disease in the early stages, if you fold the backs of the hands, lower them down. In this case, the elbows should “look” in different directions, and the wrists should be bent at an angle of 90 degrees. If after 30-60 seconds there are drawing pains in the hands - you should contact a neurologist to clarify the diagnosis.

Petrov A.P. (neurologist, Moscow).

With carpal tunnel syndrome, I advise patients to use birch and fir rubbing: 1 tbsp. combine a spoonful of birch (fir) buds with 500 ml of vodka, leave for 7 days. Rub a sore hand before going to bed.

Anna (Moscow).

She warmed her hands with heated sea salt, after which she rubbed fir oil into them. I don't remember the problem.

Galina (Yaroslavl region).

There was a hitch with the right hand after I milked the goats for a week both for myself and for my partner. Fingers began to numb. I did a paraffin bath, applied Alpine herbs balm, rubbed the brush with an asterisk. Now everything is in order, but I try not to overstrain my hand.

Maria (Tver).

The painful area was treated with an ointment from the seeds of fenugreek (spice): the crushed seeds were diluted (I used a coffee grinder) with water to a creamy state.

Summary of the article:

Now you know - if carpal tunnel syndrome bothers you, treatment can be done independently with folk remedies. Decoctions and infusions, compresses, special exercises, massage of the diseased limb will help. Drug therapy can be used alone or in combination with folk treatment. We also examined the symptoms of the disease and figured out in which cases they resort to surgery. Learned how to use a computer the right way. We got acquainted with the reviews of people who successfully coped with the disease.

Always remember that the main thing is not to give up and look for a way out if there is a breakdown in the body. Good health to you!