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.

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.

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 tensions (inflammation) of muscle tendons, reducing thumb, and a short thumb sprier. 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 right away that the shrewd channel syndrome folk remedies At home, do not cure.

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 persistent expressed symptoms shown surgery.

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 two 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 physiotherapy 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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G56.0 Chatter Channel Syndrome

Epidemiology

As we have already spoken, the blindfold syndrome is considered sufficiently common pathology. Most of the patients are women, and the share of the incidence of men is approximately 10%.

The disease may begin regardless of age features. However, the bulk of cases falls on a period of extinction of hormonal activity, that is, after 45 years. Among the total number of patients can be found patients up to 30 years. But, as a rule, they are 15 times less than those who are older.

Causes of the Syndrome of the Carpal Channel

The Syndrome of the Carpal Channel begins to develop when provoking circumstances appear, in which its diameter or swelling is reduced - something resulting in squeezing the nerve. For direct reasons can be attributed to:

• injury to the cranky joint, followed by swelling or hematoma;
• impaired integrity of the dice of the wrist;
• inflammatory process in the rays-up joint;
• neoplasms speakers in the carpal canal;
• inflammatory process in the tendons of muscle bends;
• other causes of swelling of soft tissues of the upper limbs (diabetes mellitus, hypothyroidism, etc.).

The most common cause is considered to be the tendosiveitis of the bending muscles of the wrist, which may be a consequence of the physical overwork of the brush.

Risk factors

Analyzing the above reasons for the syndrome, the corresponding risk factors can be distinguished:

• vascular diseases;
• diseases of the tendon and a ligament;
• temple vagina cysts;
• calcifications;
• arthritis and pseudoarthrosis;
• infectious diseases.

Pathogenesis

Symptoms of the Syndrome of the Carpal Channel

The first signs of the lock channel syndrome are manifested in the form of the loss of the sensitivity of the fingers on the hand, more often in the morning. Closer to the middle of the day, sensitivity is restored.

Somewhat later, numbness spreads to all fingers, with the exception of the maiden. In addition, soreness appears, "goosebumps" and the feeling of heat on the tips of the fingers.

Pain is observed throughout the finger, and not only in the joint area.

Sometimes listed symptoms exciting the entire brush, or even reach the elbow bend.

An unpleasant feeling can be delivered to considerable discomfort, especially at night. As a result, insomnia may develop.

If during the attack to make a light gymnastics of the upper extremities, then the state is temporarily improved as a result of the restoration of impaired blood circulation.

With the progression of the Syndrome of the Carpal Channel, more and more new symptoms appear. Patients note weakness in the brush and some violation of coordination, can drop items, losing the opportunity to keep them with their fingers.

Each third patient with tunnel syndrome has a change in the shade of skin: as a rule, the skin on the affected brush has a pale appearance.

In severe cases, with severe nerve ships, numbness can capture the entire hand to the elbow, and even before the shoulder joint or neck. This condition often leads to diagnostic errors, since doctors take it for signs of cervical osteochondrosis.

Forms

Several stages of the development of tunnel syndrome are distinguished:

1. Holy stage, when the only sign of the relief of the median nerve is pain.
2. The stage of numbness, which is characterized by the appearance of pain and numbness in the fingers.
3. Stage of motor disorders, when movements in the brushes become limited and unconisited.
4. The stage of increasing weakness, which develops against the background of soreness, disorders of sensitivity and limited movements.
5. The hypotrophy stage, which is often irreversible changes in the tissues.

In addition, they also identified different kinds Pathology of the Chat Canal:

• ray nerve neuropathy;
• capital and cubital channels syndrome.

This classification is adopted for a more accurate description of the disease when making a diagnosis, which makes it as detailed as possible.

Complications and consequences

The Syndrome of the Carpal Channel cannot be attributed to pathologies that are dangerous to the patient's life. But the sluggish painful process can gradually lead to a significant limitation of the mobility of the affected limb. Therefore, competent treatment is considered not only desirable, but also necessary for further full-fledged activity. Only after successful qualified therapy, the forecast of the syndrome can be called favorable.

Diagnostics of the Syndrome of the Carpal Channel

Collection of patient complaints, inspection and tackling problem areas. The doctor discovers the reduced sensitivity of the first 3-4 fingers from the palm side. With a started process, muscle weakness and atrophic motion changes are detected responsible for the thumb response.

Special testing:

• tinnel test - simultaneously with the climbing in the zone of the projection of the middle nerve, a feeling of tingling in the fingers appears;
• test Falen - if you beat the brushes in the wrist area and raise your arms up, then for one minute in the fingers you can feel numbness;
• a vest test - if you put on a pneumomagenet on the forearm area and pump it, then the patient will feel pain and signs of numbness in the fingers.

Tool diagnostics:

• the electronomyography method is used to visualize the partial blockade of the pulse by means of the middle nerve in the location;
• the radiographic method - helps to eliminate the diseases of the bone system;
• ultrasonic diagnostic method (ultrasonography) - may indicate the thickening of Lig. Retinaculum and deterioration of nerve mobility;
• magnetic-resonant tomography method - allows you to detect the compaction of the median nerve, which indicates its compression.

Differential diagnosis

Differential diagnosis It is carried out with compression neuropathy of other nerve endings, with osteochondrosis of the cervical (root syndrome C6-C7), with a transient brain circulation disorder, etc.

Treatment of the Syndrome of the Carpal Channel

Patients with the uncomplicated flow of the Syndrome of the Carpal Channel may be appointed by drug therapy, which consists in the use of anti-inflammatory medicines simultaneously with fixation (immobilization) of the affected brush.

If such treatment turned out to be unsolved, only an operation can be the only choice. Its essence is a dissection of a transverse cassette, participating in the formation of the Carpal Channel. With complicated situations, they resort to excision of modified scar tissues near the nerve, as well as to partial excision of tendon vagina.

• Medicines that are used to treat the lock channel syndrome:

To restore peripheral blood circulation, vascular means, such as Trental, xanthinol, nicotinic acid, in a complex in anti-inflammatory and diuretic drugs, removing edema (diakarb, triampur) can be assigned. When losing the sensitivity of the palms, drugs based on carbamazepine, for example, tegretol, in the amount of 200 mg to 3 times a day are used.

Early stages of the disease can be successfully immorted by introducing novocaine into the Carpal Channel.

• Physiotherapeutic treatment helps speed up the relief of the state, eliminate soreness, numbness. Often, the use of such procedures:
  • UHF - the impact on the affected zone of ultra-high frequencies, which contributes to the increase in blood circulation;
  • SMT - Amplipalserapy method.

• Treatment of the Syndrome of the Carpal Channel at home is possible only at an early stage of the disease. At the same time, it is necessary to take anti-inflammatory drugs, and also be sure to fix the brush for the night with a special bandage - Langelet, which prevents the bending of the ray-taking joint. In addition, doctors advise to reduce the motor activity of the limb, especially as for enhanced grabbing movements, wounding and tilt brush in the wrist.

If the listed actions did not bring the result, or the problem appeared again, then do not hesitate to go to the doctor.

People's Treatment of the Carpal Channel Syndrome

Before proceeding to folk treatment Syndrome, it is necessary to carefully weigh all the "for" and "against". If the treatment does not expect expected effective actionThe disease can be launched, and then to cure it becomes more difficult.

• First recipe. Pour boiling water (preferably in thermos) 1 tbsp. l. laurel sheet powder and 3 tbsp. l. Fenugrek. After 2 h infusion, filter and take 100 ml 3-4 times a day.
• Second recipe. Pour 0.5 l. Capacity with a drier of the Zverboard with warm sunflower oil, put in a cool place for three to four weeks. After that, we drag the oil through the gauze, mix the ginger powder (1 tbsp. Spoon). We had an ointment that should be used to massage the limb and wrist.
• Third recipe. Welrite in a thermos equal to the number of turns, rooting of the burdock, bumps of hops, birch leaves, elderberry and verbena colors. Insist 2-3 hours and take 100-150 ml 4 times a day.
• Fourth recipe. Intelligence white clay Warm drinking water to a casual density. We will apply on the fabric or gauze, folded in several layers, and apply to the affected area. Hold the compress until the clay dries.

Also well helps compress based on goat milk. A piece of x / b fabrics or gauze wet in the fresh goat milk and put 2-3 minutes on the affected area. We repeat the procedure several times a day before the resistant facilitation of the state.

Operational treatment of the Syndrome of the Carpal Channel

Operational treatment is one of the most effective for tunnel syndrome. It is not used until there is hope for a medication solution. The operation is prescribed only in the following cases:

• with permanent recurrences of the disease;
• when running, or so-called "long-standing" disease;
• in atrophic changes in the muscles;
• with a significant blockade of the impulse (according to the results of electromomyography).

The operation is a dissection of a custody and, in some cases, the excision of the scar tissue (neuroliza).

Surgical intervention can be carried out open or endoscopic. And the one and the other option pursues one goal - elimination of the compression of the median nerve.

Endoscopic operation is considered more gentle, since such a method involves minimal damage to the outer tissues. Accordingly, the scar after the operation will be virtually impaired.

Pros of open operational intervention is absolute access to the inspection of the operation zone. The doctor may carefully consider the problem and eliminate it.

As a rule, the operation is considered standard, without any difficulties, and lasts 30-50 minutes. Hospitalization will not need: the patient is carried out local anesthesia, and after the intervention, there are plaster (approximately 2 weeks). The patient operated on on the same day can go home, where he will independently receive treatment prescribed by the doctor.

Rehabilitation after surgery

The efficiency of the operation largely depends on the qualification of the surgeon, on the limitation of the pathological process. But it is also important and postoperative care for the damaged limb. Therefore, after surgery, it is necessary to follow these rules:

• carefully fulfill all the instructions of the doctor;
• attend a doctor for inspection regularly.

Immediately after the operation, the limb impose a gypsum bandage, or use a special bandage, which allows the fingers to move, but at the same time reliably fixes the custody joint. After about 12-14 days, the patient comes to remove the seams.

Night and morning pains in the limbs should disappear within a few days after the operation. A small numbness temporarily remains: for complete innervation restoration, it may be necessary to take a little longer.

After removal of the seams, the patient can already perform uncomplicated hand movements, but significant physical exertion will be prohibited even for even three months.

There is a small scar on the spot: as a rule, he is minority and does not cause uncomfortable to man.

Gymnastics in the Syndrome of the Carpal Channel

In the Syndrome of the Carpal Channel shows the exercise of the exercise. The purpose of such gymnastics is to restore the function and mobility of the joint, strengthen the atrophied muscles.

Often, therapeutic gymnastics are combined with electrical stimulation, when the patient is carried out synchronous irritation of the muscles, which is performed simultaneously with their reduction.

1. The hand is put on the surface of the table. Make intense bending and extensible movements by all fingers, and each individual finger.
2. The hand rests on the surface of the table. Fix the proximally located phalange with a healthy hand, after which they make intense bending and extension of interphalangeal joints.
3. Elbows rest on the surface of the table, the brushes are installed together, placing them up. Riding and breed fingers, helping a healthy hand.
4. Retain with finger pads to different points on the same palm.
5. Capture with fingers solid-caliber objects, from small to large.
6. Using fingers, rotate a small ball on the table, in one and the other way.

Exercises spend slowly, with repetitions from 5 to 8 times.

In addition, practicing similar exercises in the warm pool. At the same time in the water there should be the whole limb to the shoulder.

The second recovery stage consists of the following classes:

• completing click on your fingers in various weights and texture of objects (soft pad, tree, ball, etc.);
• pulling the rubber band with fingers;
• throwing and catching a small ball;
• reference of the balls of different sizes.

An additional effect has a bandaging of the brush overnight, as well as the overall relief of the employment process, until the limit function is fully restored.

Prevention

The prevention of the cranky syndrome is moderate physical exertion that would contribute to the relaxation of the brush. It is also important to fix and introduce some motor skills in the habit:

• keep a posture;
• avoid sharp movements;
• learn to relax.

For the prevention of the road syndrome, it should be carefully planned and equip the workplace. It should be equipped in such a way that it was possible to periodically relax the brush and a custody joint.

The seat must be comfortable, with an anatomical back and handrails located so that the hand rests on lock SustaBut not on the rayscass.

It's important to know!

In neurological practice, there are sometimes patients with a syndrome of a hanging brush, in which tendon reflexes are caused (they are not reduced), and their possible increase Looks doubtful. The absence of evidential sensitive disorders makes it difficult to interpret such clinical picture. A hanging brush is a symptom like a hanging foot.

The Syndrome of the Carpal Channel is a symptom complex, which manifests itself after the compression of the median nerve in the thicker of the cuptum canal. The functioning of the brush is limited during the carpal syndrome. They are more likely to suffer people whose work is associated with a constant load on the brush. Treatment of this pathology can be divided into conservative and surgical methods.

Anatomical features of the structure of the channel

The carpal canal is the space going from the forearm on the brush. It is formed wrist bones and a cross-ligament. If you look at the size of the space, it turns out a hole - the channel, through it: the middle nerve and the tendons of muscle flexor. The latter are located under the nerve, and it is under the transverse ligament of the wrist. The middle nerve gives the ability to feel the large, indicable, average and half of the nameless finger.

The muscles of the thumb brush controls the branch of the median nerve. These muscles make it possible to touch the pillow of the thumb with each tip of the hand phalange.

The tendons of the flexors, in turn, allow the hand to compress the palm.

Description of pathology

Tunnel syndrome A crew canal is characterized by squeezing and inside the median nerve in view of the narrowing of the channel in which it runs. The middle nerve is responsible for bringing the thumb, flexion and extension of the phalange of the index and middle fingers. Plus, he gives these fingers sensitivity, including a strip of thumb, half of the 4 fingers and the entire palm surface. In the composition of the nerve there are vegetative trunks.

The main reasons and risk factors

The Syndrome of the Carpal Channel (according to the ICD 10 - Captive Channel Syndrome) occurs due to changes in the diameter of the channel, leading to the squeezing of the nerve. This can happen for various reasons:

The frequent cause becomes inflammation that occurs in the synovial vagina of the wrist muscles, and which is the result of excessive loads on the brush.

What other factors can cause risk?

• Infectious diseases;
• lymphangit;
• vascular pathology;
• chronic diseases of the ligament complex and tendons;
• pseudoarthrosis and arthritis;
• calcificent brushes;
• cysts in vagina tendons.

Also endocrine I. autoimmune diseases They may cause a carpal syndrome through systematic exposure.

Symptoms

Symptoms of the Syndrome of the Carpal Channel are manifested after time. More often, the changes affect the "working" hand that is preparing or written. Occasionally, the nerve is squeezed in both hands (this can give pregnancy or any endocrine violation).

Presthesia

The first and paying attention is a sign - this is numbness and tingling in the fingers. These feelings clearly show themselves in the morning and the dinner completely disappear. But the further the development of the process is being developed, the duration of paresthesium increases. The patient is experiencing a number of inconvenience when the brush must be kept in one position - speaking by phone, holding a mouse of a computer. When trying to keep the subject in the hand, numbness and tingling only enhanced, and the person is forced to change the "working" hand or its position.

Pain

In the event of numbness, it can also show itself pain, it is tingling or burning. It arises at night of the day, forcing the patient to wake up to throw a hand with a bed or shake. Actions are committed in order to strengthen blood flow to fingers, after which the pain pokes.

Painful symptoms are detected not only in the affected joint, it is spilled. The whole finger or brush is enveloped by pain. If not starting treatment, pain becomes constant - and night, and during the day. Any movements bring discomfort, require effort. In the launched case of sensations cover not only fingers, but also the palm, reaching the elbow.

Loss of power

With increasing clinical symptoms, weakness appears in the brush, wrist. The hand seems to not listen, movement becomes inaccurate. The patient is difficult to keep a handle, a needle. There is a feeling that the subject slips out of his hand.

The patient gets hard to divert a thumb from the palm to capture any object.

Reduced sensitivity

This symptom is characteristic only with median nerve ischemia. In this case, the sensitivity in the hand becomes inadequate: when changing the temperature, pain and burning appear. With a long-term course of the disease, the patient may not feel lungs with a needle of needles.

Amyotrophy

In the later stages of the syndrome, changes in the muscles may appear. We can visually notice a decrease in the volume of the brush, and if you start the treatment, it is at all at all to the deformation (like a monkey's paws, when the thumb is locked little in motions).

Changing skin color

With the ischemia of the nerve, its nutrition is disturbed, and as a result, the skin becomes more pale hue due to insufficient blood flow.

Who to contact

You need to contact a specialist in Moscow, based on the symptoms. In addition to the consultation, complete wrist diagnosis will also be required. The cost of visiting plus diagnostics can be found online or with personal handling. The problem of wrist will be engaged in either a neurologist, or an orthopedic surgeon.

Diagnostics

The diagnosis of the carpal syndrome begins with the complaints of the patient and the collection of anamnesis. After the patient is a survey of a neurologist and orthopedic. If detected additional readingsRadiography, CT, MRI, electromyography can be used. And laboratory diagnostics will help determine the degree inflammatory processwhich may be the cause of the disease.

Differential diagnosis

In the syndrome of the Carpal Channel of Hands, you should always be degraded from the arthritis of the carpo-metacpyl joint 1 of the finger, diabetic polyneuropathy, cervical radiculitis.

• For arthritis, changes in the bones visible on the x-ray will be characteristic.
• The difference in the cranky syndrome from the cervical radiculopathy is that with the first - the pain is limited only to the distal part of the hand and is not connected with the neck.
• For diabetic polyneuropathy, a symmetric damage of the nerves is characterized, which is not available with a carpal syndrome. But diabetes can complicate the flow of the cranky syndrome.

Treatment

Treatment of the Syndrome of the Carpal Channel includes various therapy methods used by all: physiotherapy, the use of drugs and ointments with NSAIDs, wearing orthosis, surgical intervention for the separation of the brush transverse ligament.

Medicia treatment

The simplest and most used drugs can help - Naz, Nurofen, Ketanov (NSAID). They help to reduce pain symptoms. It is possible to introduce steroid hormones into the carpal canal, to reduce the inflammatory process. This gives some relief, but the symptoms are most often returned. The use of group vitamins B did not give reliable data on efficiency.

Special exercises

Exercises refer to funds that do not have evidence in their effectiveness. It is necessary to comply with the following recommendations:

At home you can use the same techniques, take a contrasting shower.

People's Treatment of the Carpal Channel Syndrome

Folk remedies can strengthen treatment dictated by the doctor. But their use is always worth coordination with the attending specialist.

A seafront or cabbage sheet, rubbing the mixture of black pepper and oil, the use of herbal teas with a diuretic effect, perfectly will remove the edema.

Surgical treatment of carpal syndrome

Often the Syndrome of the Carpal Channel and the operation go beside. The surgical treatment method suggests both open and endoscopic intervention.

With endoscopic effect, a cut is made, 2 cm long, with a probe and knife. It is introduced between the median nerve and the transverse bundle, which is subsequently dissected, and the channel volume increases.

With a strong change in the channel, the introduction of an endoscopic probe may not be possible, then they resort to an open operation. At the same time, a cut from the cushion of a larger finger to the little finger, and the transverse bundle forming the roof of the carpal canal dishes. This dissection can be performed on outpatient conditions.

Rehabilitation after surgery

After the operation, the brush will be edema, movement will be saved, but not in full. It is necessary to observe the rehabilitation recommended by the doctor to reduce the consequences and achieve a qualitative restoration of the brush function.

Pains may be present for several months, as nerves need to be fully recovered, and it takes time. It will be possible to engage in light activity and driving a car in a few days.

Complications and consequences

Splitting the transverse bundle surgically - it full cure. But with any operational intervention, there may be their complications.

They can be:

• infection;
• nerve damage;
• abundant blood loss;
• pain syndrome as an outcome of the operation;
• the impossibility of splitting the bundle during the operation.

These consequences are found in a small percentage of cases.

Forecast

After the treatment of a sharp channel syndrome, the symptoms are surrounded by almost 3 days, the recovery is complete. But the period of rehabilitation takes some time. The longer the current of the Syndrome of the Carpal Channel was observed, the more time to restore. This may require from 1 month to 1 year.

Prevention

To protect your hands from this pathology, you need to work with mandatory breaks, not to give an excessive load on the muscles of the brush or fingers. If some symptoms arose immediately need to change the scope of activity.

And the most important thing is that you need to strengthen your back and neck muscles, correctly have hands behind the office desk. After the working week it is worth a massage, and certainly adhere to a healthy lifestyle.

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Tunnel wrist syndrome - pathology that needs to be urgently eliminated. The disease causes discomfort, discomfort and swelling. There are many methods for conservative therapy, which will help to cope with the ailment. In severe cases, operational intervention is applied.

Why does the disease occur?

The causes of the tunnel custod canal syndrome are associated with nerve compression. Most often this happens as a result of swelling and stretching, which arise against the background of previously obtained injuries. People working on a computer often appear micro-tests. This is due to the repetition of monotonous manipulations. This category includes people working on construction, because permanent chronic wrist effects lead to microcracks.

The reasons for the development of the disease include pathologies and certain states of the body, as a result of which failure in the process of metabolism and the development of swelling (diabetes, pregnancy, arthritis, gout, bone grown) are arising. To other prerequisites of the disease include:

• the formation of nerve tumors, which passes through the channel;
• violation of blood supply due to smoking;
• overweight.

Pathology can affect 1 or 2 hands, it depends on the level of static load on the muscles.

Recently, young people who work at the computer are facing a poor. Even constant minor squeezing on the arm can lead to nerve damage.

Clinical manifestations of pathology and its diagnosis

Kytec syndrome is characterized by numbness of fingers (this happens at night). There are other symptoms of the disease. These include the unpleasant sensations in the affected area, tingling and the emergence of "goosebumps" on the body. Another sign of illness is weakness in hand.

Against the background of this, the muscles are defeated, which leads to rapid fatigue, atrophy and other motor disorders. Sometimes pain syndrome goes to the other parts of the upper extremities (shoulders, forearm and neck).

What doctor to contact to confirm the diagnosis? It will be able to make a surgeon or traumatologist by conducting special tests. The tinel method is most often used. For this, the doctor will start tapping on a specific area on the wrist, and if the patient feel pain in his fingers, this is a sign of pathology. The Durcana method is also applied. The wrist is compressed and in the area of \u200b\u200bthe phalange feel discomfort. Diagnosis of the disease is carried out by the opposition breakdown, shocking the fingers and electricity.

Sometimes pathology requires a differential study to check whether it is associated with arthritis, diabetic polyneuropathy or cervical radiculopathy. Only after confirmation of the diagnosis is allowed to begin the treatment of the wrist tunnel syndrome.

Conservative methods of treatment and physiotherapy

Carpal tunneling syndrome should begin to be treated with cold compresses and reduce the load on the hand. The affected wrist will need to fix tires or other special devices.

Early diagnosis of the disease allows treatment without surgery. For therapy assigned:

1. Preparations of the NVPS group. Nimesulide, ibuprofen, nymosis or analgin are used most often. Funds contribute to the removal of puffiness and deliverance from pain syndrome.
2. Corticosteroids. Treatment hormonal drugs aims to eliminate pressure on the affected nerve. Most often, medications are prescribed in the form of injections, because injections need to be done in the middle of the channel. Such therapy is considered more efficient.

Some patients are attributed to vitamin B6, since it has an anti-inflammatory effect, relieves swelling and painful feelings. Medicia treatment It must be appointed by an experienced specialist, its main task is the blockade and elimination of unpleasant symptoms.

Conduct disease therapy with physiological methods. Most often recommended:

• transcranial electricity;
• administration of drug electrophoresis with anesthetics and analgesics;
• cryotherapy at the local level;
• fluctuorization.

Physiotherapy is carried out with the help of high-frequency exposure to magnetic waves, vibrotherapy and special massage. To improve the regenerative processes of nervous tissue, laser and ultrasound radiation, wrapping of mud and compresses of ozokerite, are recommended. To lead neuromuscular transmission to normal, use neuroelectrostimulation.

At home, a special hand gymnastics can be used to eliminate the custod canal syndrome. It helps the compression of the rubber ball for 5-10 minutes. It is necessary to bend and blending the brushes of the upper limbs 10 times. Fingers can be compressed in a fist and rotate them clockwise and against it. The duration of manipulations is 1-2 minutes. With the help of an integrated approach to therapy, it will be possible to cope with the disease without detrimental effects.

Surgical intervention

In severe cases may be needed operational treatment The tunnel syndrome of the ray-tank joint. Before conducting the procedure, the patient must consult with a specialist, then pass general analysis Blood, take the study of the conductivity of the nerve. Mandatory condition is the conduct of an electromogram and MRI.

In about 7 days, the patient needs to abandon the use of certain drugs. These drugs include aspirin and other medicines with anti-inflammatory effects, and more warfin and clopidogrel. In the evening, on the eve of the designated surgical manipulations, it is better to eat light food, and you can not drink anything before the procedure.

The operation is carried out under general or local anesthesia. A physician should be prescribed a type of medication depending on the analyzes and personal preferences of the patient. Surgery can be performed by 2 methods:

1. Open technique. To do this, in the lower palm and wrist make a small incision. Bundles will be open, so the doctor will be able to free the middle nerve. At the end of the wound is sewn stitches. The exposure site is fixed with a bandage.
2. Endoscopic method. Two small cuts are made on the brush. A small chamber and surgical device are introduced through them. The doctor performs the necessary manipulations, removes the tools, imposes stitches, and then the dressings.

On average, the duration of the operation is 15-60 minutes. After surgery, there will be rehabilitation. The first days will have to spend in the hospital under the supervision of doctors. The wrist will be fixed in a raised position to reduce the swelling and tumor. When after surgery, the patient will be allowed to go home, he will have to adhere to certain recommendations:

• use ice for applications every day for 20 minutes;
• periodically change the dressing;
• do not strain your hand and do not lift heavy load before the permission of the doctor;
• you are a healing institution to remove seams (after 7-10 days).

If, after surgical manipulations, a person will feel chills, fever, he will have redness, swelling or pain will increase, then urgently consult a doctor.

After the operation, it is very important to adhere to the recommendations of specialists, so that there is no complications.

Application of local means of traditional medicine

Tunnel wrist syndrome can be treated with the help of folk methods.

1. Credit with swelling will be able to use compresses from cabbage leaves or plantain.
2. A good method is the use of cucumber infusion. 3 salted cucumbers are required to grind and add red pepper pod to weight. Components must be pouring 500 ml of vodka, put a means in a dark room for 7 days. After the specified time, the drug should be strain and used to rub the affected areas.
3. To speed up the restoration of the inflamed wrist, you can use the tool made from 1 tbsp. l. Salts, 50 g 10% ammonia alcohol, 10 g of camphor oil and 1 l of water. The drug must be used for rubbing fingers.
4. Conduct with pain syndrome will be able to use a fuel agent. Berries need to be rented and mixed with water. Mass warm to a temperature of 37 ° C, omit into it hands and keep it for half an hour. Before such a procedure, a relaxing massage should be made. Upon completion of manipulations, it is necessary to wipe the limbs and insulate the mittens. The duration of therapy is 30 days.
5. Chatter syndrome is often treated with pumpkin compress. From the fetus you need to cook porridge, put it on the sore hand, turn top to the food film and wind the scarf. Perform such applications should be 1 time per day. The duration of therapy is 5-6 days.
6. It is possible to rub the inflamed areas with a means of black ground pepper, for the preparation of which 100 g of powder is poured 1 liter of vegetable oil. Mass must be put on a slow fire for 30-40 minutes. Prepared drug is required to lubricate the affected area up to 4 times a day.

Oral folk remedies

The treatment of tunnel wrist syndrome can be carried out with the help of drugs for internal reception. Bloom Lamberry has good recommendations. Plant leaves (2-3 hours l.) Pour 250 ml of water and put on the slab for 15-20 minutes. The medicine is required to strain and take 1 tbsp. l. up to 4 times a day. There are some more effective ragners for pathology therapy:

1. 2 h. L. Parsley roots pour 500 ml of boiling water and leave for 12 hours. Use medicine during the day.
2. 2-3 tbsp. l. Birch leaves brew 1 cup boiling water and put on the middle fire for 3 hours. Take the drug it is necessary to 60 ml to metrase.
3. 1 tbsp. l. Taspberry leaves pour 250 ml of hot water and leave for 4 hours. Consume medication for 2 hours l. up to 5 times a day.

If you see for a timely manner medical helpYou can effectively eliminate tunnel syndrome. During the therapy, you need to adhere to all medical recommendations.

Birth of a baby is a happy event for many women. But the period of pregnancy often darken various ailments. For example, during pregnancy, a woman may suffer from articular pain. However, why do the joints hurt during pregnancy?

If we speak simple words, the joint is the "meeting place" of two bones. Bone fastening feature on one ligaments. For the movement of bones, the tendon and muscles correspond. It is pain in these parts of the body is considered by a man as a joint.

Sore joints during pregnancy: why so?

Pain in the joints during pregnancy arise due to physiological changes in the body of a woman:

• Hormon relaxing. Excessive development of this hormone provokes a weakening of the ligament.
• Insufficient amount of vitamin D3 and calcium. Such problems make themselves known only for the second trimester of pregnancy. It is during this period that the active growth of the fetus begins. The future kid begins to demand more and more nutrients.
• Excessive load on bone-muscular system. The growing belly of the future mother greatly increases the load on the bone-muscular system.

It is worth noting that pathological conditions may become the cause of pain in the joints. In connection with these pregnant women, we recommend not engaged in self-medication, but to seek advice with an experienced specialist. Independent attempts to get rid of unpleasant sensations during pregnancy can harm you and your child.

Hand pains

As a rule, pain in the joints of the fingers in pregnant women arise, if the future mother is even before the toddler conception suffered from articular diseases. During the pregnancy, they go to the staging of exacerbations, as the immunity of women is laughing. My patients enjoy a proven means, thanks to which you can get rid of pain in 2 weeks without much effort.

If you hurt the joints of the hands during pregnancy, you should not tolerate. But the future mother also should not take drugs at their discretion. Most of the drugs that are prescribed for the treatment of articular diseases are categorically contraindicated by pregnant women. The future mother should apply for advice to the experienced doctor. According to the results of the inspection, the specialist must appoint such medication toolsthat will not harm the fetus.

To cope with this problem, it is not enough to use products containing calcium (cottage cheese, milk, kefir). The future mother needs to undergo a biochemical blood test. Relying on its results, the doctor will prescribe a calcium-containing biological additive during pregnancy.

The third reason why the fingers of the hands may hurt, is an excess of the relaxin hormone. This hormone is necessary for a pregnant woman in order to soften the articulations. If this hormone would be absent in the body, the bones of Thai simply broke under the pressure of the growing uterus. However, the excess of the Relxin hormone delivers the future mother also a lot of unpleasant sensations. A woman begins to feel that she hurts the joints of the fingers of the hands during pregnancy in the second or third trimester.

Unfortunately, to get rid of these sensations during pregnancy with medicines will not be released. Single way out - wait for childbirth. Hormonal background of a woman after the birth of a child gradually recover, which means discomfort in the hands, too, will gradually disappear.

Approximately 40% of women hurt the joints of the fingers of the hands during pregnancy. This problem provokes a custod canal syndrome. As a rule, this syndrome in pregnant women is observed during the second and third trimester. It was during this period that the future mother intensively gaining weight, swelling also appear in it. Under the influence of such changes in the body of the tube with nerves, connecting fingers with brushes, squeezed and breaks the functions of the nerves. As a result, the hands begin to root.

Chatter syndrome is accompanied by other symptoms, namely:

• itching, tingling in the fingers, burning
• the weakness of the fingers when a pregnant woman is trying to compress them;
• numbness of hands or individual fingers;
• "Estimating" pain.

Hands hurt: musculoskeys

It happens that the cause of pain in the joints during pregnancy is a musculoskeletal disease. For example, a future mother can suffer from arthritis with a finger. This disease causes not only the syndrome in which the brushes hurt, but still accompanied by their redness, increasing and swelling. Arthritis of fingers can also cause an increase in body temperature. Treatment during pregnancy includes use medicinal preparations and creams. Surgical intervention is rarely applied.

The articular discomfort during pregnancy can also provoke fractures, stretching or large physical exertion.
Osteoporosis and osteochondrosis are two more reasons why the future mothers have brush hands during pregnancy. These diseases cause numbness or pain in their hands, which indicates negative changes in the spine.

Main pain: Preventive measures

In some cases, it is impossible to get rid of pain sensations with medicines. However, a pregnant woman can adhere to some recommendations that will help to significantly alleviate pain in the upper limbs:

• during night sleep, put your hands under the head;
• for a day, periodically try to bend and blend your hands in your fingers, brushes and elbows. Performing such simple exercises, you immediately notice that it has become less to root;
• if the joints of the hands began to hurt, when the future mother lies, she needs to be intensely die. Numbness and pain in the upper limbs must pass;
• moderate physical exertion;
• less time should be carried out at the computer;
• it is necessary to take complex vitamin preparations, as well as balanced to eat;
• monotonous work should be avoided;
• when a woman is sitting, she must ensure that the arms and legs do not breathe. Try to put your hands on the railing of the chair or sofa, and under the feet put pouf.

- This is a pinching of a tricky nerve, as a result of which pain occurs, loss of control over the movements of the fingers, as well as a decrease in sensitivity.

What will happen to the brush if you ignore the appearance of the disease?

The middle nerve controls all the muscles, it helps to move the fingers and feel any impact of the environment. When ignoring pain syndrome due to pinching, the loss of brush flexibility is possible, the fabric will start pale, strong sweating will appear. Everything can end regular numbencies and muscle atrophy, Therefore, you should not run the disease.

Causes of occurrence

The reasons for the occurrence of this disease are the most different: anatomical related to labor activity, with a state of health or even the floor.

Who is in the risk group?

There are several risk factors that increase the likelihood of the appearance of the Capal Channel syndrome:

1. The resulting fractures of the wrists, especially which missed the wrong. The compression of the nervous channel increases, the nerve itself is squeezed.
2. Congenital defects in the development of a custody canal.
3. Genetic predisposition: the wrist of the square shape, the thick transverse bunch.
4. Little Channel Channel And any damage to women.
5. Diseases negatively affecting the human nervous system (diabetes mellitus, sclerosis, etc.).
6. Inflammatory processes in brush tendons.
7. Edema's formation (both external and internal) during the tooling or reception of contraceptives.
8. Big body weight.
9. Diseases of the kidneys or thyroid gland.
10. Work with high weights or traumatic activity, durable work at the computer.

Carpal tunnel syndrome is most often characteristic of women older than 50, which are engaged in difficulty requiring constant frequently repetitive movements of the brushes (secretary, a collector at the factory conveyor, a hairdresser, musician).

Diagnosis of tunnel neuropathy

There are several simple tests that will help determine the presence of a carpal syndrome yourself:

1. Tinel test - Neat tapping in the area of \u200b\u200bthe patient. At the same time, pain should increase, and the finiteness of the nonsense may have tingling sensations.
2. Hand raising up - This test implies the following: pull up your head straight hands, you need to stand in this position for about a minute. If the carpal tunnel syndrome is, then fine tingles will begin in the hand, it will start a nonsense, pain will appear.
3. Test for flexion - Brush until the stop bends in the ray-taking joint for 60 seconds. After performing the test when the brush is extension, there is pain and numbness.
4. Test using a bottle - Indicative and thumbs cannot raise and keep the bottle for the neck.

If none of the texts showed numbness of 1-3 fingers, perhaps you.

Attention! The results obtained during tests do not guarantee an accurate diagnosis. For the diagnosis and treatment of treatment, it is necessary to consult a doctor.

Medical diagnosis

In addition to tests that can be conducted independently, the doctor prescribes the following types of research:

• ENG (electroeomyomputer);
• conductivity studies of nerves;
• thermalview;
• ultrasound procedure;
• x-rays of the rayscassay joint to eliminate other ailments.

The doctor can also hold another test, which is to use the measurement instrument arterial pressure. On hand just above the place where the nerve is presumably clamped, the cuff is put on, it is inflated to normal level blood pressure and is held within 60 seconds. At the same time, paresthesias are marked where the nerve is supplied with food.

Symptoms

Patients who are diagnosed with the "Carpal Tunnel" syndrome, are constantly complaining about the numbness of the brush and unpleasant tingling on average, indexed and unnamed fingers, the items begin to ride out of the hands, the hand quickly gets tired.

At an early stage, the entire picture of the symptoms is temporary, after some time lapse the pain and unpleasant sensations pass, but then appear again when driving a car, raise your hands up, talking on the phone or reading a book. Muscular power of brush is lost, in some cases there is a complete rosal of movements.

The above sensations of patients are always accompanied by burning pain in palm or the first 3 fingers. At the same time, pain sensations spread almost before the forearm.

At night, the symptoms also do not leave patients alone. Due to the fact that at night the position of the brush is not controlled, the nerve is clamped, the pain and stiffness occurs. A person can even wake up. Easy toasting with brush or rubbing palms soften pain.

Double-sided channel syndrome is distributed, but the disease of one hand is most common: it is left-handed for the left hand, for the right one's right. With double-sided syndrome, one hand may have lesions harder than the second, it is also due to the convenience frequent use for labor activity One of the limbs.

Patients also complain about the manifestation of vegetative symptoms. Palm and wrist swell, a feeling of compresses appears.

It is noted either low, or an increased temperature of the brush, since due to the compresses of the nervous channel, the vessels cease to work in full.

Maybe even strengthen sweating. The brush begins to sensitively react to sharp temperature differences: the color of the fabrics changes.

Over time, all symptoms of the disease can exacerbate and purchase a permanent nature. Muscular weakness and numbness will interfere with labor activity, and constant pain will not allow small work, up to the fastening of the shirt and the tie of the shoelaces.

What complications arise?

If you do not pay attention to the symptoms of tunnel syndrome and do not carry out treatment, the nerve will start atrophyThe brushes will start irreversible processes that can lead to a complete loss of the motor function. In most cases, the forecast for the carpal hand syndrome is positive, the disease can be cured conservatively or with the help of surgical intervention.

But if the disease remission over long time alternates with its appearance, the disease can go to chronic form Finally, pain symptoms will increase, and on their background there will be other nervous disorders.

Treatment

The use of conservative methods

Lack of serious omissions ( early stage Diseases) and progression of carpal syndrome of hands are indications for the use of conservative treatment methods. What do they turn on to themselves?

1. Holding the ray-taking joint alone: Recommended for a while sleeping on a brush a special retainer, which will not allow night to squeeze the carpal canal. The tire can be used in the afternoon during honeycomb work.
2. Use of drugs: The doctor may assign an intact analgesics ( Npvp) To relieve pain syndrome.
3. Recommendations for changing the place of work To avoid overload and pinching a custody nerve.
4. Injections steroids: The drug is introduced directly into the nervous channel, gives relief of the symptoms of the disease. In the absence of positive dynamics during the six months of the injection period, operational intervention is assigned.

Read more about treatment methods.

Alternative methods, such as the patient, use alternative methods, for example yogu. Some postures help improve stretching, strengthen the joints and make the muscles stronger. You can also try manual therapy and high-frequency ultrasound treatment.

If you need to get rid of the pain in the joint itself, read the article about. And help restore a damaged brush.

Operation

If conservative treatments do not provide an appropriate effect, then operational interventions are appointed. There are two ways: open and minimally invasive. The first implies the dissection of the skin over the carpal bundle and the decompression of the median nerve, the second is carried out through a mini-section using video equipment and special tools.

All surgical operations for the treatment of carpal syndrome are carried out in outpatient conditions using local anesthesia.

After the operation, the appearance of pain, feelings of stiffness and swelling are possible. But on the first day after the intervention, you can start moving your fingers.

To reduce postoperative symptoms, rehabilitation therapy is assigned to restore the wicked functional. For several months, all postoperative sensations pass, during this period it is recommended to refuse driving a car, severe labor activity or simply flexing limbs. It is necessary to give nervous fibers to recover. Only after the permission of the attending physician can be returned to the usual way of life.

IMPORTANT! Relief may not come immediately after the operation, so you should be patient for gradual recovery: it can take time from month to a complete year.

Good news - after surgery, reviews are mostly positive. Naturally, the effect and degree of channel decompression is different, but mostly patients note only improvement.

Actual studies in the field of treatment of the brush

Tunnel syndrome is considered the most common disease among all ails associated with the upper limbs.

Operations for the treatment of carpal ligaments are the most common among all operations on the wrist.

Annually in America operate 463,000 people. The studies claimed that it is the Syndrome of the Carpal Channel that the most common cause of excommunication from labor activity is required for at least a month for rehabilitation.

For some professions, researchers clearly allocated the causes of the disease: for cashiers it is constant reading of barcodes, for people working at a computer, this is the wrong arrangement of the brush during printing or using the mouse. Even at the beginning of the century, the incidence of tunnel syndrome among men and women was the same, now women suffer from this ailment twice as often.

There are various adaptations for the treatment of syndrome, for example (information about it in the middle of the article).

Prevention

In order to prevent the appearance of tunnel syndrome, it is necessary to treat particular care to the prevention of the prevention of the nervous channel. What is recommended to prevent the disease?

Exercises for hands

Three complex of physical exercises can be used as prophylactic measures of the Syndrome of the Carpal Channel.

Complex number 1:

1. It is necessary to be confused and heat the palms from the inside and outside.
2. Take your right hand and with the help of the thumb of the same hand start turn down All other fingers and make four clicks on them. The same actions must be repeated for the left brush.
3. To bring the brush with the inner sides together, connect the fingers with each other, start pressed by the fingers of one hand to the fingers of the other, after the end of the exercise, shake the brushes for relaxation.
4. Several times as much as possible squeeze fists shake hands.
5. To squeeze the fists several times, while when you swallowing sharply throwing out your fingers out. After the end of the exercise shake hands.

Complex number 2:

1. You need to raise up 10 times and drop down your hands again, then shake the brushes.
2. Slowly squeeze the fists and detain them in a tense position for 10 seconds, repeat several times, then relax hands with shaking.
3. Stretch straight hands in front of them and start quickly to move with all your fingers.
4. Run 10-15 rotation with brushes in both directions.

Complex number 3:

1. To the finger to brighten 10 times in both directions, after performing the exercise, shake the brushes.
2. Connect the palm together and pressed with your fingers on each other.

How to organize your workspace?

To prevent tunnel syndrome or after passing treatment, it is recommended competently equip your workplace. What should be done first?

1. Set the table of proper height, it should not be too high so that the brushes do not have in the bent position during operation and did not resist. The hand should lie smoothly on the table or armrest.
2. Find out the right office equipment: a computer mouse is convenient to be located in the palm of your hand, for those who have moved surgery there are special models of mice in the form of joysticks, be sure to choose a good mouse pad with a special elevation for the brush, the keyboard is recommended to buy with a slope.
3. When typing texts, the monitor screen should be straight before the eyes at a distance of 30 centimeters, so you can choose a special stand for it.
4. Foot should be smoothly standing on the floor, not being in suspended state or on socks. Back straight. To fulfill these recommendations, you need to purchase a chair from which you can change the height.

At the same time, it is important every hour to take breaks to work and perform at least one set of exercises presented above.

Naturally, to prevent any disease it is necessary to lead healthy image Life: Abandon alcohol and nicotine, start playing sports, carefully treat your health and try to use harmful food less.

At the same time, it is necessary to monitor the position of the hands: they should be placed right with respect to the forearm, the brush should not be suspended or constantly in the bent state. Recommended observe the correct posture: A straight angle should be formed between the hips and the lower back.

Clinical Research in the Prevention

Currently, research is being prepared or already underwent research concerning the prevention and treatment of the Carpal Channel syndrome. In one of them, a comparative analysis is carried out between surgical intervention and the improvement of the clinical picture in conservative methods of treatment, a magnetic resonance tomograph is used for research, patients are selected with an average or easy-to-afford of the carpal nerve.

The second prospective study is considering the benefit of the wearing of a special bracelet, which should prevent the nerve pinch when working with vibration equipment. All research is currently being held in America at the University of California.

Recently, various pathologies of the musculoskeletal system are increasingly found in young people. One of these problems that violates the work of the hand of hand is the Syndrome of the Carpal Channel Brush. Pathology is still known as a tunnel or shuttle syndrome. It is characterized by squeezing the middle nerve of the hand in the wrist area. This may occur with various violations associated with narrowing a custody of the Channel. But most often it happens with constant elevated loads on the brush. Therefore, pathology is found mainly from manual workers, and more often a woman is exposed to it.

general characteristics

The innervation of all peripheral departments of the musculoskeletal system occurs through the nerve fibers, departing from spinal cord. They pass through special channels, designed to protect them from squeezing. But in some places such channels have a small size and are called tunnels.

Especially narrow tunnel is located in the wrist. Here in a small gap between the three bones of the hand and the transverse ligament of the wrist pass through several tendons, many blood vessels and the middle nerve, which ensures the innervation of the palm and three fingers of the brush. Therefore, its normal work depends on the state of the custody. The features of its anatomical structure lead to the fact that often the nerve is squeezed between the tendons and the transverse ligament of the wrist.

With the narrowing of this channel, there is a tunnel, or a carpal, syndrome. This is the name of the condition at which inflammation or squeezing the middle nerve occurs. His ischemia arises, that is, blood supply disorders. At the same time slows down the speed of nerve impulses And the normal innervation of the brush is disturbed. There are various motor disorders and neurological symptoms. If you cannot immediately remove the pressure on the nerve, the scar cloth is formed inside it, it is thickened. Over time, the chances of recovery decrease, as its atrophy may develop.

The reasons

Squeezing the median nerve may occur for various reasons. Although most often this happens under the influence of external factors. Sleeve the middle nerve can be squeezed as due to the narrowing of the cutting canal and due to the increase in the size of the tissue inside it. Often it happens due to injury. Strong bruise, fracture, tensile ligaments or dislocation always cause edema appearance. The condition is especially aggravated if the bone displacement occurs during injury.

A common cause of the appearance of a carpal syndrome is also constant load on the wrist. They may be such:

• monotonous movements, as when printing on a computer keyboard;
• incorrect hand position when working, for example, with a computer mouse;
• power app, frequent weight lifting;
• work at low temperatures;
• activities associated with vibration.

Quite often, the Syndrome of the Carpal Channel is found in those who work for a long time at the computer

Therefore, susceptible to the narrowing of the carpal canal most often office workers, musicians, tailors, collectors of technology, builders. And about half of the cases, this pathology is found among active users of the computer.

In addition, the narrowing of the channel may occur due to inflammation and sealing of the synovial shell. The reason for this is often the tendinites of tendons, arthritis, especially rheumatoid or gouty, rheumatism. Harmful habits can also provoke the narrowing of the channel, frequent consumption of caffeine, obesity, a disturbance of peripheral blood circulation. Some medicines, such as hormonal contraceptives, also sometimes cause swelling.

Some internal diseases may also lead to the development of the Carpal Channel syndrome. These are mainly those that cause the accumulation of fluid in the tissues. Edems often occur during pregnancy, disorders of the kidney or heart. Sugar diabetes, hypoteriosis, peripheral neuropathy and other pathologies can also be the cause of the shuffling syndrome. This sometimes happens in women in the menopacteric period due to the hormonal restructuring of the body.

Symptoms

One of the first signs of the Syndrome of the Carpal Channel is paresthesia in the brush, especially very sensitive in the morning. The patient feels numbness, tingling in the tips of the fingers, burning, cooling. This symptom is gradually enhanced, the patient can no longer hold the brush on the weight, the sensitivity of the skin is disturbed. Then there appears burning pain. It can only occur at the point of innervation of the nerve in the brush or spread across the arm to the shoulder. It is usually affected by one working hand, but with pathologies associated with a fluid delay, the narrowing of the channel may occur on both sides.

Gradually weaken the muscles of the brush, the thumbs are especially suffering. Therefore, the brush movements are broken. It is difficult for the patient to hold various items in your hand, even lungs. Therefore, difficulties arise when performing the most common actions. The patient begins to fall out of the hands, it can not fasten the buttons, keep a spoon. Gradually, muscle atrophy enhances, the deformation of the brush occurs. Vegetative violations may also arise. At the same time there is a cooling brush, pale skin, it grundes and thickens on the palm. Perhaps violation of sweating, changing the color of the nails.

A feature of the Syndrome of the Carpal Channel, in contrast to other similar pathologies, is that the little finger is not amazed.

When diagnosing a diagnosis, the doctor necessarily draws attention to these characteristic symptoms. Indeed, it is important to differentiate pathology with the hernia of the cervical spine or anomalia of Arnold Kiari, in which pain and numbness may also occur in the brush.

The main method of treatment is to ensure the right position of the brush, preventing the nerve compression

Treatment

To cure the lock channel syndrome, it is necessary to start therapy as early as possible. Otherwise, the rebirth of the nerve and its atrophy will make it impossible to restore the innervation of the brush. When the first symptoms of pathology appear, first of all, the factors that are the cause of the narrowing of the channel must be eliminated. When trauma, you need to remove edema as quickly as possible or put in the place of the bone. It is also necessary to immediately begin the treatment of diseases that led to edeq or inflammation

If the cause of pathology has become elevated loads, the main method of treatment will be avoiding them. It is necessary to stop using vibrating tools, avoid repetitive movements, working with inclined or bent wrist. Amend lifestyle is required for 1-2 weeks. Effectively limits unnecessary movements special bandage. It prevents the brush bending and saves the cutting channel smooth. Due to this, the nerve compression is removed, and painfully feel. Sometimes it may be necessary for the individual manufacturer of the bandage. At the initial stage of pathology, if it is not connected with other serious violations, only with the help of a competently selected orthosis one can get rid of this syndrome.

If such symptoms appear, it is necessary to consult with a specialist in labor hygiene. He advises in what position to keep his hand when working, how best to use tools to avoid such problems in the future. Usually, when complying with all recommendations, the doctor's recovery occurs after 4-6 weeks. But then some time you need to wear a bandage for the night to avoid flexing the brush and squeezing the nerve.

In more serious cases, drugs are used for pain. Most often it is the NSPD - Moviece, Nimesulide, Ketanov. A good effect gives a combination of such agents with paracetamol. Improve blood circulation and remove numbness helps the use of high doses of vitamin B6. These may be neurobion or Milgamma preparations. Vasodilators, such as Trental or Nicotine Acid, Diuretics - Furosemide, Miorlaxants - Middokalm are also used.

Sometimes it is possible to remove a strong pain in this pathology only by injection of hydrocortisone

In case of strong pains that are not removed by conventional drugs, an injection of cortisone is prescribed. This means introduced directly to the channel quickly removes pain and swelling. And for a doctor, such an injection can be an additional diagnostic method. If the pain after the injection does not pass, then their reason has become not a migratory syndrome, but the other pathology. For injection can also be used by a combination of diprospan with lidocaine. But it can not be considered effective treatmentSince only removes external symptoms. And for the full removal of the nerve compression, it is necessary to eliminate its causes.

Besides internal application Medicinal preparations for the treatment of the Syndrome of the Carpal Channel apply such methods:

• at initial stages, ice applying is recommended for 2-3 minutes several times a day;
• local treatment with compresses with domexide, lidocaine or hydrocortisone;
• physiotherapeutic treatment with shock-wave therapy, ultrafonophoresis, acupuncture;
• massage;
• physiotherapy;
• in the most difficult cases, the liberation of the impaired nerve is shown using surgical intervention.

In the most difficult cases, it is possible to remove the nerve compression only with the help of the operation.

Operation

If conservative therapy did not help remove the pressure in the cranky channel, surgical treatment can be recommended. In the course of the operation, the transverse bunch of wrist is most often cut, which increases the size of the channel and frees the nerve. Such treatment is carried out outpatiently through a small incision on the palm with the use of local anesthesia.

After the operation, rehabilitation takes several months. Typically, the symptoms of the locked channel disappear immediately with the removal of pressure on the nerve, but it is necessary to restore the ligament and wait for the lion healing. First, the hand is held on a tireless bandage, it is better to keep it higher in the first days. To prevent pains and edema, ice and NSAVP can be used in tablets. After removal of seams for rehabilitation, physiotherapeutic procedures are applied.

To accelerate healing, ice wraps, magnetotherapy, ultrasound are used. Massage is useful, performing special exercises. Moves should be carried out from the first day after the operation. And to start more serious classes is better with modeling of special soft plasticine. Then you can perform with your fingers and brush, gradually increasing their intensity.

The Syndrome of the Carpal Channel is not dangerous for the life of the patient. But he seriously disrupts the performance, causes discomfort. Therefore, it is desirable to immediately begin to eliminate the squeezing of the nerve so that complications do not develop.