carpal tunnel syndrome

Carpal tunnel syndrome can greatly affect performance and cause significant discomfort and pain. Together with our experts, we discussed the causes of the development of carpal tunnel syndrome, talked about modern methods of diagnosis and treatment, and at the same time learned about preventive measures and whether this condition can be cured with the help of folk remedies.

What is carpal tunnel syndrome

Carpal tunnel syndrome or carpal syndrome is a whole complex of symptoms that are observed when the median nerve is compressed at the level of the wrist. The median nerve passes through an anatomical “tunnel” of bones and tendons. If this tunnel narrows, the median nerve cannot function properly – to provide sensitivity and fine motor skills of the thumb, index, middle and partially ring fingers.

Carpal tunnel syndrome is diagnosed in approximately 1% of the world’s population, and in the list of occupational diseases, this condition ranks 6th¹. Most often, people aged 30–60 years get sick, and women are 6–8 times more likely than men.

Causes of carpal tunnel syndrome

Very often, the cause of carpal tunnel syndrome cannot be established with XNUMX% accuracy. In this case, we speak of an idiopathic form of the disease. If we talk about risk factors, then the following pathologies and conditions can provoke the development of carpal tunnel syndrome:

• acute injuries – bruises, dislocations and fractures¹;
• chronic injuries – exposure to vibration, prolonged muscle tension that flexes and unbends the hand¹;
• diseases and conditions in which edema of the upper extremities is observed – renal failure, pregnancy¹;
• diseases that are accompanied by changes in the muscles, joints and tendons – gout, rheumatoid arthritis, scleroderma¹;
• metabolic disorders – diabetes mellitus, hypothyroidism, obesity¹.

We cannot discount the fact that half of the people with carpal syndrome are active computer users.². While working at a PC, the hand is in a static curved position and experiences an increased load when interacting with a computer mouse and keyboard². Therefore, carpal syndrome can become an occupational disease of programmers, layout designers, graphic designers, journalists and editors. Representatives of other professions are also at risk, for example, musicians, seamstresses, locksmiths, drillers, asphalt pavers, because their activities are also associated with a high load on their hands.

Symptoms of carpal tunnel syndrome

Hand numbness is the most common symptom of carpal tunnel syndrome. The numbness usually gets worse if the arm is held in the same position for a long time, such as while working or sleeping. It is not the whole hand that loses sensitivity, but the first three or four fingers². Often people with carpal syndrome complain of pulling, aching or sharp pains in the area of ​​the hand and wrist². Another common symptom of carpal tunnel syndrome is a burning sensation and goosebumps running down the skin.². If the disease progresses, fine motor skills are impaired: for example, it becomes difficult to fasten buttons or hold a needle in your hands.

Treatment of carpal tunnel syndrome

Treatment for carpal tunnel syndrome is most effective in the early stages. Sometimes the problem can be dealt with without drugs and orthopedic devices, only with the help of gymnastics and changing the mode of operation. Significant damage to the median nerve requires other measures, up to and including surgery.

Diagnostics

Carpal tunnel syndrome is diagnosed according to the clinical picture and using instrumental methods. First, the doctor listens to the patient’s complaints, checks the sensitivity and strength of the muscles. For a more accurate diagnosis, provocative tests are carried out, during which the symptoms become more pronounced.². The most commonly used tests are Tinel, Gillette and Phalen.².

The Tinel test is a light tapping with a hammer over the wrist area, in response to which there is a tingling or “shooting” in the fingers. The Phalen test can be used at home if you suspect carpal syndrome. To do this, you need to bend your hands as much as possible and raise your arms up. If after a minute your hands go numb or start to hurt, most likely your suspicions are justified.

In some cases, electroneuromyography is used for diagnosis. During the examination, the median nerve is stimulated with a weak discharge of electric current and thus determines the location and degree of damage to the nerve fibers.

With the help of ultrasound, CT and MRI, the condition of the median nerve and the surrounding muscles, bones and tendons can be detected. Most often, ultrasound is used for this purpose as the most affordable and economical way.

Modern treatments

At the initial stage of treatment, patients are advised to alternate periods of work with rest, change the position of the hand more often, use more ergonomic working tools, if possible. Good results are shown by such a method of therapy as orthotics. The patient is advised to put on a splint at night, which will keep the hand in a fixed position.

Drugs for the treatment of carpal tunnel syndrome are ineffective and therefore almost never used. The exception is corticosteroid hormones, which are injected into the wrist area.³.Such drugs have anti-inflammatory and analgesic effects³.

If conservative therapy fails, resort to surgical intervention. The techniques may be different, but they pursue the same goal – dissection of the palmar ligament and release of the compressed median nerve. The operation is done in a classical and endoscopic way.². Endoscopic surgery is considered less traumatic and leaves almost no marks.². After surgery, rehabilitation therapy is prescribed: massage, phonophoresis, paraffin therapy².

According to various data, surgical intervention gives good and excellent results in 25–90% of cases.². In patients, pain disappears and the functions of the median nerve are restored. Minor improvements after surgery are seen in 10–65% of people².

Prevention of carpal tunnel syndrome at home

Doctors give several recommendations for the prevention of carpal tunnel syndrome. First, you can not hold the brush in the same position for a long time. Therefore, while working with your hands or being at the computer for a long time, you need to pause and perform special exercises to relax your muscles. Secondly, you need to equip yourself with a comfortable workplace. For example, the ergonomically shaped mouse and keyboard greatly reduce hand strain.

Popular questions and answers

Our experts answer popular questions: hand surgeon Nikolay Karpinsky, general practitioner Olga Potapova and neurologist Larisa Neboga.

Sources of:

1. Carpal tunnel syndrome. Bogov AA, Masgutov RF, Hannanova IG, Galliamov AR, Mullin RI, Topyrkin VG Practical Medicine, No. 4 (80), 2014. https://cyberleninka.ru/article/n/sindrom-zapyastnogo-karpalnogo-kanala/viewer
2. Carpal tunnel syndrome: clinic, diagnosis and modern approaches to treatment. Yarikov A. V., Tutkin A. V., Boyarshinov A. A., Fraerman A. P., Perlmutter O. A. Medical Almanac, No. 3 (64), 2020. https://cyberleninka.ru/article/ n/karpalnyy-tunnelnyy-sindrom-klinika-diagnostika-i-sovremennye-podhody-k-lecheniyu-kratkiy-obzor/viewer
3. carpal tunnel syndrome. Vidal. Medical encyclopedia. Edition 2021. https://www.vidal.ru/encyclopedia/nevrologia/syndrome-zapyastnogo-kanala