Carpal tunnel syndrome

Carpal tunnel syndrome

Description of carpal tunnel syndrome

Before we get to the essence of the disease, we should explain what is actually the term carpal tunnel hiding.

Called carpal tunnel refers to a narrow slit in the wrist area,which is surrounded on three sides by wrist bones and on the fourth side to press her hard wrist ligament.

This tunnel leads into the palm of nine flexor tendons of the fingers and thumb and medial nerve (n. Medianus), who just might become a source of pain. Median nerves innervate the hand and provides both sensitivity and moves fine and gross motor skills.

Carpal tunnel syndrome is one of the most útlakových syndromes. This creates a permanent compressing themedian nerve, which occurs most often overload, trauma, swelling of one of the tendons, bone spurs, dislocations, or exudative, causing pain.

Carpal Tunnel Syndrome suffer in the Czech Republic about 35 000 inhabitants, and its incidence is still increasing. According to research, it is one of the most common occupational diseases.

The main originators of origin are chronic overloading or prolonged exposure wrist wrist pressure. The highest incidence is measured by employment, such as working on the computer, playing the piano, journalist and others. If you do not work on a computer ergonomically correct, there is constant pressure on the wrist, thereby thickening of the ligament covering the carpal tunnel, and it starts to oppress nerve.

It may also be due to diseases such as phlebitis or ligaments. It also occurs frequently inpregnancy, because for this period is characterized by water retention and edema formation.Overall, the incidence of up to 4 times more frequent in women than in men, and almost always occurs on the dominant hand. During life, is diagnosed in about 4% of the population.


Risk factors for carpal tunnel syndrome

The risk of this disease tend to be repetitive motions of the hand and fingers, which occur when writing to the stands, playing a musical instrument, work on the belt, etc.

Overloading may cause inflammation of tendons and ligaments, at which the swelling of the structures in the carpal tunnel and subsequent oppressed nerve.

The emergence of problems or significant deterioration increases closely related to hormonal changes. So accompanies especially the use of hormonal contraception, menstrual cycle, pregnancy or menopause. The most common occurrence is for overweight women in the age range 30-60 years.

Carpal tunnel syndrome can also be one of the complications of systemic diseases e.g. Raynadovy disease, rheumatoid arthritis or diabetes mellitus.
It is proven that this disease may also have a genetic predisposition in the family, which may or may not materialize.


Preventing Carpal Tunnel Syndrome

Given that the disease is most affected administrative staff, sitting hours at the computer, it was invented many ergonomic devices that can help you to avoid this disease.

They are used special pads wrist to ensure you keep your wrist aligned with the forearm. In addition, you work should take regular breaks to stretch his arm, wrist, shoulder joints and cervical spine. It is also appropriate massaging and stretching fingers.

For blue-collar and other demanding professions should use all required gear and practices to prevent disease.

Never treat carpal tunnel syndrome for a long time do not delay, because it could lead to permanent changes in the function and structure of the hand and wrist.


Signs and symptoms of carpal tunnel syndrome

Carpal tunnel syndrome is most often manifested initially tingling, tingling, or burning your fingers on the affected extremity (usually the thumb, forefinger and middle finger).

Then you may lose skin sensitivity and weakening of these fingers, which is accompanied by arelatively large pain. Hand operates awkwardly and forearm muscles lose muscle strength and gradually weaken.

Discomfort is usually manifested in a calm, often the patient wakes from sleep. Pain in the wrist may radiate to the shoulder joint and head.

It also occurs swelling and stiffness in the wrist. Patients may feel swollen fingers, although the swelling is not visible. The intensity of the difficulties often varies, but usually the symptoms gradually worsen.


Diagnosis of Carpal Tunnel Syndrome

What is important is history, on the basis of which the physician determines the subjective feelings of patients and recommend apparently examination hand instrument using electromyography (EMG).Using this examination to measure the conductivity of nerves, and based neurologist prove or disprove the diagnosis of carpal tunnel and determine the severity of disability.


Treatment of carpal tunnel syndrome

Disability median nerve oppression is initially reversible, but after prolonged untreated compression may occur irreversible changes, so it is advisable to start treatment as soon as possible, if necessary. try the aforementioned diseases preventable. Early treatment can cause several months to mitigate the disappearance of the symptoms, while chronic course takes years and even after that period of time may not be a cure.

Treatment of carpal tunnel syndrome can be both conservative and surgical.

Conservative treatment of carpal tunnel syndrome

First, patients are just trying to avoid activities which cause overloading the muscles wrist. While it is important to change lifestyle habits, avoiding monotonous movements and regular exercises to stretch the muscles wrist.

Often also indicates immobilization of the wrist by using splints, orthoses or detachable gypsum, especially at night. Will eliminate the majority of adverse influences on nerve and he has better conditions for regeneration.

Of course there are unpleasant pains prescribed different drugs, especially anti-inflammatory drugs with analgesic and relaxants muscle spasm.

Problems alleviate and cold compresses, which also accelerate the healing process itself.

It is recommended that the prolonged use of dietary supplements. The beneficial effects of a higher daily dose of vitamin B6 (50 mg 3 times a week) and bromelain (2 × 1000 mg daily during the acute phase, 50 mg two times daily in reducing symptoms). Vitamin B6 relieves inflammatory processes in nervous tissue, reduces susceptibility to pain and regulates blood flow. Bromelain enzyme is contained e.g. in pineapple and has anti-inflammatory effect, and also helps to suppress pain.

Conversely avoid you should excessive salting because salt helps retain water in the body, leading to edema.

Assistance may also bring physical therapy applied by trained physiotherapist. It helps to reduce pain, ultrasound, diathermy, galvanotherapy, electrical nerve stimulation, hydrotherapy and physical exercise.

Among alternative treatments that may help in the treatment of carpal tunnel syndrome include acupuncture, Alexander Technique or chiropractic.

Surgical treatment of carpal tunnel syndrome

This procedure is accessed after despite conservative treatment occurs to the full development of disease, since treatment does not sufficiently positive effect.

This is a light operation, in which the transverse cut through the ligament in the wrist, to release the structures stored in the carpal tunnel. Cut a length of about 2.5 cm. The actual procedure is performed on an outpatient basis, takes place under local anesthesia and takes about 30 minutes.

After a successful operation without developing complications can often go straight home patient.Relief comes in 1-2 days and normalization of the function of the whole hand is expected in a few weeks, respectively. months. The limb may be full burden after a period of about 3 months.

Properly executed surgery will solve the problem permanently, therefore it is not necessary to postpone, as it is the most effective treatment for this disease.

The postoperative course of treatment is based on the pursuit of the patient again. It is necessary to attend the GP, because of the control wound and bandaging wounds. Suitable pressure massage isscarring that occurs due to increased blood flow and wash away waste products, which makes more rapid healing of scars and the prevention of coalescence of soft tissue structures.

The wound is necessary first week to maintain a clean and dry to prevent ingress of infection.Between 7 to 10 days after surgery you should undergo removing stitches. Then most likely you will get a voucher for rehabilitative therapy where you learn all the necessary exercises and apply any of the above methods of physical therapy. It is important to practice the movements in all joints, stretch the shortened muscle structure and gradually begin to strengthen his hand at various manual activities. Still we do not forget to care about the scar. Gentle massage and combat scars lard, Indulona or other fatty cream not only speeds up the healing process, but also has a cosmetic effect.


How can I help myself

If you suspect carpal tunnel syndrome, avoid all activities that cause increased pain and worsening of symptoms. You limb cool and fixed in parallel position with the forearm. Fixation is particularly recommended during sleep, since it is nighttime pain patients are most uncomfortable. With a visit to the doctor but do not delay, because it could lead to irreversible changes.


Complications of carpal tunnel syndrome

In the event that the patient may impose treatment and the disease progresses, it can lead to irreversible damage to the nerve. This will result in a loss of sensitivity and movement disorders of the hand and thumb, which is not able to stand up against the other toes, thus losing all hand handling function.

Risks of surgical treatment only rarely. Appearing may be a little swelling, bruising or pain in the scar. These problems are only temporary.

More serious complications, wound infection, or damage to certain branches of the medial nerve.May occur and persistent swelling, redness and soreness.

Other names: canalis carpi syndrome, entrapment syndrome

Share your experience: