Rehabilitation after the operation of the tunnel syndrome. Syndrome of the Carpal Channel - Methods of Treatment of Pathology Syndrome of the Carpal Channel Complication

Chatter syndrome (CTS) is a state caused by high pressure on the middle nerve at the wrist level.

The compression of the median nerve at the wrist level leads to numbness, tingling and pain in hand, palm, fingers. In the wrist there is a space called a tunnel, which is about the same wide as the thumb.

When a pressure is created in this tunnel, it squeezes the nerve passing through (median nerve) tunnel, leads to a violation of the normal functioning of the hand and fingers due to pain and numbness. Through this tunnel also passes several tendons and blood vessels.

The median nerve is the most important component of the tunnel. It gives a feeling of big, index and middle finger. Any condition that damaging the tendon of the forearm flexors when passing through the cranky tunnel leads to their inflammation.

This causes compression or irritation of this nerve, which leads to a blindfold syndrome.

Drugs, such as non-steroidal anti-inflammatory drugs (NSAID), are used to combat pain. Tunnel syndrome can be avoided by performing simple exercises.

Chatting syndrome is the main cumulative wrist injury associated with work, usually caused by deformation on hand. When the wrist is bend, at a right angle, the creep tunnel becomes already. Most of the activities, from playing guitar before printing, lunch, pushing the swing, requires the bend of the wrist.

A repeated bend or holding the wrist, bent over long periods of time, compresses the middle nerve, leads to a tunnel syndrome. T.

the same, as the attack on the garden hose slows down the flow of water through it, the compression of the median nerve fibers with swollen tendons and a thickened bundle slows down the transmission of nerve signals through a brush tunnel. The intensity, frequency, duration of work and their connection with the custod canal syndrome are unknown.

Risk at risk includes people working on a computer, carpenters, installers, meat packers, musicians, mechanics, since their actions are associated with repeating bending and wrist expansion. Actions such as gardening, needlework, golf, canoeing, can also lead to symptoms.

Six key risk factors at the workplace for the development of tunnel syndrome include:

1. Reiteration;
2. High strength;
3. Uncomfortable articular pose;
4. Direct pressure;
5. Vibration;
6. Long limited pose.

Women suffer 3 times more often than men. Hormonal changes related to, also make women more prone to this disorder. General conditions under which this state is manifested include:

• Pregnancy;
• Rheumatoid arthritis;
• Injuries;
• Endocrine disorders, such as diabetes, hypothyroidism;
• Outdoor fracture;
• In some cases, the presence of a tumor. It can also cause the compression of the median nerve.
• Some other reasons that lead to inflammation of tendons - hypothyroidism, pregnancy, diabetes.

Repeating actions that cause inflammation of tendons

• Increased hands, wrists;
• Driving;
• Letter;
• Painting;
• Sewing;
• An increase in the use of musical instruments;
• Work related to production on assembly lines;
• Use of tools that vibrate or are manual;
• Sports: Tennis or Squash.

Diseases causing the appearance of abnormal substances in the wrist tunnel

• Alcoholism;
• Outdoor arthritis, bone fractures;
• Leukemia;
• Diabetes;
• Obesity;
• Multiple myeloma;
• Acromegaly;
• Renal failure;
• Menopause;
• Amyloidosis;
• Pregnancy;
• Infections, injuries;
• Hypothyroidism;
• Sarcoidosis.

Signs

First, the symptoms occur more often at night. Many people have a habit of sleeping with a wrist bend, which can cause pain.

As the symptoms deteriorates, tingling can be felt during the daytime, along with the pain moving from his wrist to the fingers. Pain is usually felt on the palm side of the hand. Another symptom is the weakness of the hands, which over time worsens.

Fingers are felt swollen, even if it is not. If it is not treated, in some fingers there will be a loss of sensitivity and constant weakness of the thumb. There is a problem with a sensation difference between hot and cold temperatures.

Symptoms

• Numbness or tingling in hand, fingers, especially index and medium.
• Pain in the wrist, palm, forearm.
• Numbness or pain that worsen at night.
• Unbearable pain, testing in the middle of the night, can wake you up.
• Increase pain when using hands or wrist.
• The impossibility of holding items.
• Loss of feelings of heat and cold.
• The weakness of the thumb.

The carpal tunnel syndrome is a pathology at which there is a squeezing of the middle nerve in the wrist area. It can be said that the tunneling syndrome is the illness of the century, which is currently distributed, especially among the Aytichnikov, for a long time working at the computer. The ailments refers to neurological diseases and is included in the group of tunnel neuropathies.

The syndrome is manifested by very unpleasant symptoms: the lasting numbness of the fingers and sharp pain in the wrist. Long-term pastime for a computer, constant monotonous loads on the brush with a robot with a mouse lead to narrowing an anatomical channel, which infringes and squeezes the peripheral nerve in the cranky channel.

What is a tunnel syndrome

Tunnel syndromes are not an independent disease, but a complex of clinical symptoms caused by the infringement and compression of the nerve in narrow spaces, so-called anatomical tunnels. The walls of such tunnels are natural channels that are normal free to pass peripheral vessels and nerves. With different pathologies, their narrowing occurs, which leads to squeezing of vessels and nerves passing through it.

Pathology at all times met women significantly more often than men. This is due to the fact that women are more likely to perform monotonous monotone work, which has a load on the muscles of the brush. Among men, the disease is striking programmers working at the computer. Squeezing the cranky nerve can be caused by a sealing of tendons that are close to the middle nerve, as well as the damage to the nerve itself: its thickening and edema.

Tunnel wrist syndrome develops as a result of monotonous movements, which involved the same wrist muscles. The first symptoms are manifested when using a computer mouse when the brush is in a constant wrong position. It bears a large pressure on the wrist and can be complicated by elbow tunnel syndrome. It is a computer mouse that is a guilt of the dissemination of the illness around the world. And since computers are located in every home and young people are in many hours sit on the network, the disease takes the character of a pandemic.

Causes of the development of syndrome

We have already written about the causes of the pathological process. Any pathological processes that reduce the size of the anatomical channels and contributing to the seal of tissues within it can cause the development of tunnel syndrome. There are many additional factors that can provoke the development of the syndrome. These include:

1. Injuries of wrist (stretching, fractures, bruises);
2. Pregnancy. During this period, the female organism is subject to many phenomena, for example, edema. When a significant amount of fluid accumulates in the body, problems with nerve fibers arise, since the swelling has increased pressure on the wrist, which leads to the infringement of the nerve.
3. Metabolism disorders (diabetes mellitus).
4. Rheumatoid arthritis.
5. Hormonal failures. In the period of hormonal restructuring, predominantly in women, there are problems with joints that are often accompanied by tunnel neuropathy.

The above-mentioned problems can cause unpleasant symptoms when performing the following actions:

• monotonous actions with hands;
• with an inconvenient position of hands;
• during a conversation on a mobile phone;
• when performing physical exercises when the wrist is stopped;
• with prolonged vibration (keyboard operation);
• with long use of the mouse (brush is in a limful condition).

In addition, harmful habits can complicate the situation: smoking, alcohol, obesity.

Symptoms

Primary symptoms that are manifested at an early stage of illness are characterized by tingling in the fingers, strong, but short-term pain in the site of the passage of the median nerve. As the illness progress, the symptoms are complicated and multiplied. The most brightly symptoms make themselves to know at night, which prevents human full-fledged rest. At the same time, a person cannot fall asleep until the morning because of the extremely unpleasant numbness of the brush and severe pain, he develops insomnia and chronic fatigue.

The syndrome has its own characteristic features. For example, not the whole brush, but only three of her fingers: large, index, middle and half of the nameless finger, the little finger is never affected by this pathology. In very launched cases, the functionality of the brush is disturbed, it is impossible to squeeze into a fist, painful sensations arise when trying to combine the thumb and a little finger, a person is not able to take an object in hand, and then hold it. In other words, the shallow motor was disturbed and the hands cease to obey, which can lead to muscle atrophy and disability.

A person becomes helpless and vulnerable, he cannot drive a car, talk on the phone, to work at a computer, perform household actions, serve itself independently.

All symptoms at the initial stage of the disease have a reversible character and are safely eliminated. In advanced cases, surgical treatment may be required, at which the channel expansion and the removal of excess tendons.

Chronology of symptoms:

1. During monotonous and monotonous movements (for example, by a computer, or with knitting knitting), there is a strong stupid pain in the field of nerve passage, which gives to a large, index and middle finger. To eliminate pain, it is enough to interrupt and shake several times with your arms, as well as make a half-hour break. The problem arises due to poor nerve patency and circulatory disorders. At this stage, all the symptoms are reversible.
2. They had a problem to ignore for a long time, then after a certain time, tingling and burning in the brush no longer passes on their own, but pursuing a person even at all-working time for several hours, turning into constant stupid pain. The cause of permanent pain is the sealing of the tendon located around the nerve. It is starting to put pressure on the nerve and there are pains on the inside of the brush that are in fingers.
3. The body is trying to compensate for adverse factors, so there is a cluster of lymphatic fluid between cartilage, which takes the fragments of the affected fabric and cells with a flow of lymph. In the natural state, this process is perfectly eliminating problems, and the liquid is solved independently. With constant loads, the inflammatory process is not capable of regressing and its self-healing is impossible. Therefore, long-term swelling and luminas are irreversible without additional treatment. Edema and numbness are significant at night, and if they are accompanied by severe pain, the disease reached the culmination stage. And soon the only way out will be surgical intervention.

Diagnostics

The diagnosis is carried out by an experienced neurologist or neurosurgeon, since the doctor of another specialization will not be able to distinguish a short-term night numbness of the brush from the pathological process. The main diagnostic method is to determine the nervous conductivity rate of pulses. For this purpose, electromyography (EMG) or electronomiography (ENG) is carried out. The latter allows you to differentiate the tunneling syndrome from the hernia of the spine and osteochondrosis.

How to conduct electromyography? The patient who sits in a comfortable chair is applied to the brush electrodes, having previously treated them with an antiseptic agent. Electrodes are connected to a special electronics apparatus. Electrical pulses are passed through electrodes, and nervous conductivity is fixed. The result is displayed on a computer monitor, and simultaneously recorded on a paper carrier in the form of waves. The result of electromyography is very similar to an electrocardiogram and is made on the basis of the same principles. The specialist studies and evaluates the result for the submission of verdict.

Diagnose the disease can also be based on some tests.

Dough Fallen.. To perform the test, it is necessary to bend and blends the brush 90 degrees (see Figure). The feeling of numbness or tingling occurs immediately for 20 seconds. A healthy person can also have numbness and pain, but not earlier than 1 minute.

Tinell test. When tapping a neurological hammer, tingling and irradiation of three fingers pain is felt. Sometimes tapping causes acute pain.

Test Durcana. Mechanical squeezing of the wrist in the field of nerve causes numbness of a large, index, medium and sometimes half of the nameless finger.

Also conduct an opposition sample, which lies in the impossibility of connecting the thumb and the little finger. This phenomenon develops as a result of the weakness of the Tenar (elevation at the base of the thumb).

Treatment of tunnel syndrome

Treatment of the disease is carried out in three directions:

• medication treatment;
• physiotherapy;
• gymnastic exercises;
• surgery.

Medicia treatment

At an early stage of the disease, it is possible to improve the patient's condition with medicines, such treatment is carried out outpatient. Prescribed drugs of the NSAID Group (nonsteroidal anti-inflammatory drugs), which quickly remove inflammation, pain and edema:

• diclofenac;
• ibuprofen;
• nimesulide;
• analgin.

To reduce the pressure in the area of \u200b\u200bthe compressed nerve, hormonal drugs of corticosteroids are used in the form of injections directly into the cranky channel. Injections are very effectively coping with pain, edema and inflammation.

Vitamin B has a good healing effect, since Vitamin himself has an anti-inflammatory effect.

It should be noted that symptomatic treatment with the help of drugs does not lead to complete healing, but only facilitates the patient's condition. Therefore, along with medicines, it is recommended to wear orthosis. The wearing of orthosis allows you to remove night symptoms, which is particularly exhausting the patient.

Physiotherapy

As physiotherapeutic treatment is used:

1. Paraffin baths. A patient brush is lowered in a bath with molten paraffin. Then the procedure is repeated another 3-4 times, while the so-called paraffin glove is formed on the hand. Then a special glove on the hand with paraffin is put on or wrapped in a warm towel. Sustaines and tendons under the influence of hot paraffin are warming up, which removes the inflammatory process, swelling and pain.
2. Ultraviolet therapy. In this case, the treatment of tendon and joints are heated by short-wave electromagnetic waves in the range of several giga-hertz.
3. Ultrasound treatment. The effects of high frequency sound waves leads to an increase in temperature on the processed area, which improves the conductivity of the channel, removes swelling and pain. The two-week course of ultrasound treatment is capable of significantly reduce the manifestation with the symptom.
4. Manual therapy. In the treatment of this method, the improvements in the brush circulation were noticed.

Gymnastic exercises

Exercises can be performed independently at home, so their advantage is obvious.

Exercise number 1. Lower your hand in the bath with hot water, squeeze it into the fist and rotate in the water. Hot water should be a suitable temperature to warm the hand. The duration of the procedure is not more than 15 minutes. After graduating from putting on the hand in the winter glove or wrap your hand in a warm fabric or scarf.

Exercise number 2. Night warming compress that is done on the basis of dilute alcohol or vodka. Do not take clean medical alcohol, it can burn the skin on his hand.

Exercise number 3. Massage. It is necessary to massage the entire hand, and not just a brush, starting with the outside of the palm, rising up on the outdoor side of the forearm. Massage should conduct a professional massage therapist.

Exercise number 4 hydromassage. You can do yourself twice a day. In the morning use cool and warm water, and in the evening warm. Massage should affect the collar part, blades, shoulders, forearm, hand brushes.

Surgery

Conducted in difficult launched cases when all other methods are ineffective. The purpose of operational intervention is the excision of a liga, which puts pressure on the middle nerve.

Conduct two types of operations:

• endoscopic;
• classical intervention in the open way.

The endoscopic procedure involves the use of an endoscope, which is introduced into a cranky channel through a point cut. This is a minimally invasive operation that leaves a small point on the patient's skin. The recovery period after such a procedure is short and almost painless.

Classical intervention in the open way implies a larger incision on the inside of the palm. After this type of intervention, the scar remains larger and the recovery period is longer.

Radial tunnel syndrome

It is an increase in pressure on the radial nerve, which is located in the muscles and bones of the elbow, as well as forearm. The causes of this ailment can be:

• injury;
• lipoma (benign tumors);
• inflammation of surrounding tissues;
• osteochondrosis;
• spinal hernia.

Symptoms of illness are sharp pains that have a burning character on the back of the brush and at the top of the forearm appearing when trying to straighten your fingers and wrist. Unlike the carpal syndrome, the radial tunnel syndrome does not cause numbness or tingling, since the radial nerve is responsible for the contraction of the muscles.

Chatting Channel Syndrome or Carpal Channel Syndrome or Tunnel Neuropathy of the Mediterranean at the level of the cranky (carpal) channel is the compression of the median nerve at the level of the wrist (in a cranky channel) by a cross-cuff ligament. This is the most common neuropathy as a result of compression on hand. Observed in middle-aged patients, more often in women. At half past cases, it happens on both sides, but is more expressed on the dominant hand.

Code on the ICD 10 of the Captive Channel Syndrome G56.0.

Causes of cpalar syndrome (carpal) channel.

Picture Source: (C) CAN STOCK Photo / Alila

The "classic" cpalar casal syndrome has a chronic current.

The following causes of the cranky (carpal) channel syndrome are:

• Injury, often associated with work: repeated movements of the brush or wrist; repeated brush compression, holding tools; uncomfortable positions of the brush and wrist, especially strong flexion of the wrist; Direct pressure on the wrist; Work with vibrating tools.
• General reasons: obesity; may temporarily appear during pregnancy; Mukopolisaccharideosis V; tuberculous thaosinovitis; diabetes; hypothyroidism; acromegaly; amyloidosis; carcinomatosis; rheumatic polymalgia; Rumered arthritis; gout.

The "acute" cpalar syndrome (carpal) channel is extremely rare. His symptoms appear quickly and pronounced.

The reasons:

• Middle artery thrombosis.
• Hemorrhage or hematoma of a transverse cassett.

Symptoms of tunnel syndrome of a custody (carpal) channel.

Click on the picture to enlarge Middle nerve innervation zone

1. Disruption of sensitivity in the form of painful numbness in the brush. The pain can give up hand, sometimes up to the shoulder. The localization of numbness is usually along the palm surface of the 1st, 2nd, 3rd fingers of the brush and the radiy side of the palm.
2. Weakness brush, especially when compressing in a fist. There may be atrophy of the Tenar (the muscles of the rise of the thumb on the palm surface of the brush).
3. The awkwardness of the brush and the difficulty with accurate movements.
4. Hyperesthesia (increased sensitivity) in the 1st, 2nd and 3rd fingers, the most pronounced in the tips of the fingers.
5. Test Palan: Brush compression in a fist for 30-60 seconds leads to the appearance of pain or tingling.
6. Tinel's symptom: tapping over the cutting channel causes pain and tingling in the innervation zone of the middle nerve on the brush.

Diagnostics of the tunnel syndrome of a custody (carpal) channel.

First of all, it is necessary to conduct differential diagnosis with cervical radiculopathy against the background of the hernia of the intervertebral disk. To do this, you need to perform the MRI of the cervical spine. It is also necessary to eliminate the thaosinovitis (inflammation) of muscle tendons, a pulling thumb, and a short thumb spinner. A very important role in the diagnosis has an e-ophospiriography of a median nerve, which will help to distinguish the defeat of the cervical roots and tendons of the brush from the custod canal syndrome. But electronomyography in 31% of cases may be normal. Be sure to do ultrasound of the cuptum channel. On ultrasound, the structure of the median nerve and the transverse custody can be thickened.

Treatment of tunnel syndrome of a custody (carpal) channel.

How to treat a custod canal syndrome? I will say that it is not cured by folk remedies at home with a custod canal.

Treatment of tunnel claroped channel syndrome may be conservative and surgical. It is resorted to conservative therapy if the symptoms began recently and have no pronounced nature.

Conservative therapy includes peace, the reception of NSAIDs (non-steroidal anti-inflammatory drugs), vascular drugs, cholinesterase inhibitors (drugs that improve neuromuscular conductivity), vitamins of group B, the use of a tire with a neutral position, the injection of sverdes (usually hydrocortisone) into a custody canal.

With the ineffectiveness of conservative therapy, frequent recurrence and presence of expressed symptoms shows surgical treatment.

Click on the picture to enlarge Enclosure to access the middle nerve

The operation of the cranky channel syndrome is called the neuroliza of the middle nerve in the cranky (cartoon) channel.

In the case of bilateral damage to the median nerve, usually first operate with a more pronounced pain. However, with severe nerve defeat, when weakness and numbness already appeared, it is more expedient to start with a more "healthy" side to ensure maximum nerve restoration of at least one hand. Sometimes they produce surgical intervention at the same time from both sides.

The technique of operation is to perform a cut on the palm surface of the brush along the imaginary line on the interval between the 3rd and 4th fingers, adhering to the elbow edge of the intercredar fold so as not to hurt the palm skin branch. The incision begins at distal casal fold. The length of the cut depends on the thickness of the brush, it can continue until the large finger. Next, a complete dissection of the transverse cassette ligament and the imposition of seams on the wound is performed.

After the operation, analgesics are prescribed, sometimes cholinesterase inhibitors (preparations that improve neuromuscular conductivity), vascular preparations that improve microcirculation and vitamins V.

Restriction of physical exertion on hand for 2-3 weeks. Next is appointed therapeutic physical culture and physiotherapy.

The seams are removed about 10 days.

Literature:

1. Neurosurgery / Mark S. Grinberg; Per. from English - M.: Medpress-Inform, 2010. - 1008 C.: Il.
2. Practical neurosurgery: Guide for doctors / ed. B.V. Hydar. - SPb.: Hippocrat, 2002. - 648 p.
3. Topic diagnostics of diseases of the nervous system / A.V.Triumphs. - 15th ed. - M.: Medpress-Inform, 2007. - 264 p.: Ill.
4. Al-Zamil M.Kh. Carpal syndrome. Clinical neurology. - 2008. - №1. - p.41-45
5. Govlyko F.S. Surgery of damage to peripheral nerves. - SPB.: Phoenix, 2010. - 384 p.
6. Equipment M. M., Zhalivopeov 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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The Syndrome of the Carpal Channel is a symptom complex, which appears due to squeezing the fibers of the median nerve inside the cranky channel. The carpal syndrome is manifested by characteristic symptoms and is accompanied by a violation of the functioning of the brush. This syndrome is more likely to suffer from work with a permanent load on the brush. It is possible to treat pathology with conservative methods, but in some cases surgical treatment requires.

Anatomical features of the structure of the channel

Chatted canal is limited to bones of the brush from below and side from both sides, the transverse locking (clarified) bunch passes from above. Muscle tendons and middle nerve are located in the tunnel. This nerve has sensitive and motor conductive paths in its composition. Sensitive nerve fibers innervate the first 3 fingers and 1/2 unnamed, and motorways are directed to the muscles of the thumb. The squeezing of the median nerve occurs when a decrease in the size of the tunnel or an increase in the intravenous tissues due to pathological processes. The characteristic symptoms of the disease appear.

Causes of syndrome

The Syndrome of the Carpal Channel arises as a result of the following reasons:

1. Professional factors. Pathology arises in persons who perform a permanent job with their hands: pianists, artists, computerists.
2. Age changes. The disease occurs more often in women aged 50-55 years.
3. Outlet in the area of \u200b\u200bthe carpal canal as a result of the forearm injury.
4. Hormonal restructuring during pregnancy. In this case, there is a delay in the liquid in the shells of muscle tendons of the brush.
5. Hereditary predisposition.
6. Endocrine diseases. These include sugar diabetes, thyroid disease, obesity, hypothyroidism.
7. Rheumatoid arthritis, arthrosis and other arthritis.
8. Infectious diseases leading to the defeat of wrist tissues.
9. Tumors and cystic education.
10. Wrist injuries and brushes: bruises, dislocations, fractures.
11. Systemic communication tissue diseases.
12. Tuberculosis.

Symptoms of the disease

The Syndrome of the Carpal Channel appears after a while after the impact of the damaging factor. Symptoms of illness can appear at any time by bringing a sick feeling of discomfort and expressed pain syndrome. The following symptoms are characteristic of damage to the carpal canal:

The symptoms of the destruction of the carpal canal are more often disturbed by the patient at night and in the morning after awakening. During the day, they decrease, and their appearance is characteristic when performing the simplest action: holding the book in hand, talking on the phone. Reduce manifestations helps shaking hand or change the position of the brush. If the disease is progressing, the symptoms become permanent. This leads to a deterioration in the quality of life of the patient. There are difficulties in the commission of small actions: the tie of laces on shoes, buttons stubbing, holding a mug. It becomes impossible to touch with a thumb of other fingers of the amazed brush.

Diagnosis of tunnel syndrome

The Syndrome of the Carpal Channel does not cause difficulties in diagnosis. The diagnosis is made on the basis of the following data:

1. Poll survey. Sign up patient complaints, disease history. On their basis, it can be assumed the reason for the development of alert.
2. Inspection of the striking limb, conducting functional samples and detecting sensitivity. In this case, you can reveal the following:
   • the symptom of tinel - when tinking in the area of \u200b\u200bthe carpal canal, the patient feels the tingling of fingertips.
   • pHALEN test - 60 second flexion in the wrist causes numbness and weakness of the brush.
   • palpation of the palm surface causes pain.
   • in case of inspection, the swelling of the affected area is determined.
3. X-ray brushes and ray-tunny joint.
4. Electromyography. With it, it is determined by the conduct of nerve pulses on the fibers of the median nerve.
5. Ultrasound of rash joint.
6. Magnetic resonance tomography.

Conservative treatment of carpal syndrome

The conservative treatment of the Syndrome of the Carpal Channel is carried out in the early stages of the disease and includes the following ways:

Fixation of amazed wrist

It is carried out using a special bandage. Lucumber joint is fixed in the physiological position, which prevents the infringement of the nerve. Bandage must be worn in the afternoon, especially during the routine hand, as well as at night.

Medicia treatment

1. Non-steroidal anti-inflammatory drugs are used in tablets for receiving inside or in the form of ointments for local applications. You can use nooofen, ibuprofen in the age dosage.
2. With pronounced inflammation and pain syndrome, an injection of hormones is prescribed to a custody canal.
3. Vitamins of group B contribute to the reduction of pathological processes in the deckal channel.

Physiotherapeutic treatment

Puts electrophoresis on the affected area, phonophoresis, treatment with a laser. These methods reduce inflammatory processes, eliminate the enemy, pain relief, contribute to the regeneration of damaged tissues inside the cuptum channel.

Special exercises

Performed when anemiating of acute manifestations of the disease. Exercises must be diverse and performed on average 10 times. Here are some simple exercises:

• shaking hands, without sharp movements;
• compression and squeezing of fists;
• raising and lowering hands;
• finger tips perform circular movements;
• pressing the fingers of one hand to the fingers of another hand.

With this gymnastics, blood circulation in the tissues of the carpal canal is improved, muscle tissue brushes are strengthened.

Surgical treatment of carpal syndrome

This treatment method is appointed in the event of the ineffectiveness of conservative methods for 6 months. If the lock channel syndrome is strongly expressed, accompanied by severe pain and restriction of the functions of the brush, then the operation can be carried out immediately. Especially in cases where tumors or cystic education are the cause of the ailment. The following operations are performed:

Operational intervention can be carried out in outpatient conditions under local anesthesia. After surgery, the tissue was maintained for some time and restricting movements in the brush. The patient shows the rehabilitation period. Physiotherapeutic treatment, therapeutic gymnastics is carried out. The full restoration of the functions of the brush occurs within 6-12 months, depending on the degree of violations.

Carpal syndrome is a state that requires an immediate assistance.

With the appearance of characteristic symptoms, it is not necessary to engage in self-medication, you must immediately consult a doctor. Early diagnosis and treatment of disease will avoid the progression of the process and operational intervention. If the occurrence of the syndrome is associated with professional activities, it is possible to change the work. This will help reduce the manifestations of the disease and stop further progression.

Chatting syndrome (SZK) is caused by the root of the nerve and irritation in the wrist, which leads to pain, numbness, tingling and / or weakness in the wrist and palm. Repeated stretching and fractures, an unusual anatomy of wrist, arthritis and some other diseases can reduce the space in a cranky channel, thereby increasing the risk of SGC. From associated symptoms, you can often get rid of home, but sometimes medical care is required for complete cure.

Steps

Part 1

Treatment of SPC at home

Try not to clamp the middle nerve. The cutting channel is a narrow tunnel consisting of small bones of the wrist interconnected by ligaments. This channel protects the nerves, blood vessels and tendons. The main nerve responsible for the movement of the palm and its sensitivity is called the median. Therefore, actions should be avoided leading to the clamp and irritation of the middle nerve, such as frequent bending of the hands in the wrist, lifting weights, sleep with curved wrists, blows fist for solid surfaces.

• Watch that the wrist watch and bracelets sat on the wrist freely freely - if they are too tightly covered the wrist, it can cause an irritation of the median nerve.
• In most cases, the SPC is difficult to identify the only reason. As a rule, the SPC is caused by a combination of various factors, such as frequent stress in the wrist in combination with arthritis or diabetes.
• Anatomy of the wrist is capable of contributing to their contribution - in some people the bones of the shuttle canal w.same or have not exactly the right form.

1. Stretch your wrists regularly. Daily stretching of the wrists will help reduce the symptoms of the SGC or get rid of them at all. In particular, stretching the wrists helps to expand the space intended for the middle nerve inside the cpalar channel, since it is stretched with bundles surrounding this channel. The best way to simultaneously stretch both wrists is to accept the "praying pose." Fold your palm together at a distance of about 15 cm from your chest and lift the elbows until you feel the tension in both wrists. Street in such a posture of 30 seconds, then lower the elbows. Repeat the exercise 3-5 times a day.

   Shake your palms. Feeling numbness or other pain in one or both palms (or wrists), shake well for 10-15 seconds, as if shaking the water from them. Thus, you will achieve a quick, although temporary improvement. Such a shaking will spur blood circulation and improve blood flow to the median nerve, as a result of which the symptoms will temporarily disappear. You can make such a charging that helps to fight the symptoms of the SGK, many times a day, just a few seconds, breaking away from your work.

   • Symptoms of the SPC are most often manifested (and first occur) in large, indicated and middle fingers, as well as in the part of the nameless finger. That is why people suffering from SZK seem clumsy and often drop items.
   • Symptoms of the SPC are not subject to only a little finger, since it is not associated with the middle nerve.

2. Wear a special supporting wrist bandage. Such a semi-rigid bandage or tire will help to avoid the symptoms of the SPC throughout the day, supporting the wrist in a natural position and not allowing it to be curled too much. Supporting bus or bandage should also be worn on the wrist when working capable of aggravating SZK symptoms, such as a computer work, wearing heavy bags, driving a car or a bowling game. Owing supporting bandage for sleep time, you will prevent the manifestation of night symptoms, especially if you have a habit of slipping your palms in a dream.

   • Supporting bandage may need to be needed for several weeks (day and night) in order to significantly reduce the symptoms of the SPC. However, in some cases, the supporting bandage has a negative impact.
   • Supporting the supporting tires on the wrists is useful and in the event that you have a SPC and you are pregnant, because the palms (and feet) swell more often during pregnancy.
   • Supporting dressings and tires for wrists can be purchased at a pharmacy or medical supplies store.

3. Think about changing the pose in which you sleep. Some postures are able to significantly aggravate the symptoms of the SVP, which reduces sleep duration and its quality. The worst pose is the one in which your fists are firmly compressed and / or palms (with curved wrists) are pressed under the body; Adverse and the posture at which the hands are above head. Instead, try to sleep on the back or on the side with your hands, located close to the body, straightening the wrist and open the palm. Such a pose will provide normal blood circulation in the wrists and the blood supply to the median nerve.

   • As noted above, the use of supporting dressings during sleep helps to prevent the wrong position of the palms and wrists, but it will take some time to get used to it.
   • Do not sleep on the stomach, putting hands under the pillow, because in this case the wrists will be compressed. Sleeping people in such a position awakening are often experiencing numbness and tingling in the palms.
   • Most supporting wrist dressings are made of nylon and fastened on velcro, which can irritate your skin. In this case, put a sock under the dressing or a piece of thin tissue to reduce skin irritation.

4. Look at your workplace. In addition to unsuccessful posture in a dream, the SMC symptoms can be caused or reinforced by poor workplace layout. If the computer keyboard, mouse, the table or chair are unfortunately and without taking into account your growth and physique, it can cause stress in wrists, shoulders and middle of the back. Make sure the keyboard is located in such a way that when printing you have not accounted for all the time to flex your hands in the wrists. Get the ergonomic keyboard and mouse, arranged in such a way as to reduce the stress in the palms and wrists. Your employer may compensate for costs.

   Take medicines released without prescription. Symptoms of SPC are often associated with inflammation and swelling in the wrist, which additionally annoys the middle nerve and the blood vessels adjacent to it. Therefore, to reduce the symptoms of the SGC, at least in the short term, non-steroidal anti-inflammatory drugs are often helped, such as ibuprofen (Motin, Advil) or Naproxen (Al.). To remove the pain caused pain, painkillers such as paracetamol (Tylenol, Panadol) can also be taken, but they do not reduce inflammation and swelling.

   Part 2

   Medical Help at SGC

   1. Sign up for a reception to the doctor. If you experience the symptoms listed above in the wrist / palm and more, doctors should be visited. The doctor will examine you and is likely to prescribe a radiographic study and blood test to eliminate possible diseases and damage, the symptoms of which are reminiscent of SPCs, such as rheumatoid arthritis, osteoarthritis, diabetes, fatigue fracture in wrist or problems with blood vessels.

      Visit the physiotherapist or massage therapist.

      Try the injection of corticosteroids. In order to relieve pain, inflammation and other SPC symptoms, the doctor can recommend you injecting a corticosteroidal drug (such as cortisone) in the wrist or the base of the palm. Corticosteroids are a powerful and high-speed drug capable of removing swelling in the wrist and facilitate the pressure on the middle nerve. They can also be taken orally, but it is considered much less effective than injections, and moreover, more pronounced side effects cause.

      • In the treatment of SPCs, other steroid preparations are also used, such as prednisone, dexamethasone and triamcinolone.
      • Injections of corticosteroids can lead to such complications as local infection, abundant bleeding, weakening of tendons, muscle atrophy and nerve damage. Therefore, they usually make them no more than two times a year.
      • If the steroid injections did not lead to a significant improvement in the state, the possibility of the operation should be given.

   2. The cutting channel operation should be considered as an extreme measure. If other methods of treatment did not give results and did not help get rid of SPC symptoms, the doctor may recommend surgery. Operations are resorted to operations in extreme cases, since there is a risk of even more worsening the position, although many patients have operations to completely get rid of the SMC symptoms. The purpose of such an operation is to reduce the pressure on the middle nerve by the head of the main ligament on it.