Carpal tunnel syndrome - causes, symptoms, diagnosis and treatment methods. Carpal or carpal tunnel syndrome: main causes, treatment options, useful reminder for patients

Treatment at home which is early stages can give good results. However, when severe discomfort and a significant decrease in quality of life cannot be avoided without visiting a specialist doctor.

When is treatment necessary?

1. One of the first symptoms of the disease is a noticeable tingling and numbness in the fingers (thumb, middle and index). At first, this manifestation can occur with different frequency, sometimes appearing and then disappearing.
2. There is discomfort in the area of ​​the hand and forearm during movement.
3. Sudden pain in this area can wake a person in the middle of the night. Hands become weak to such an extent that sometimes they cannot hold objects familiar in everyday life. This is due to compression of the median nerve, as a result of which muscle function is disrupted. thumb.

The described symptoms are dangerous because if you do not consult a doctor in a timely manner, a person runs the risk of incurable damage to the nerves or muscles of the hands.

A compressed median nerve is the cause of the appearance and development of carpal tunnel syndrome. The median nerve is responsible for tactile sensation in the palm and fingers, as well as muscle function thumbs hands The median nerve is responsible for all fingers of the hand except the little finger.

It is often a complication of diseases such as:

• diabetes;
• rheumatoid arthritis;
• obesity.

Sometimes the pathology occurs during pregnancy due to fluid retention in the body, but after the birth of the child, the symptoms usually disappear on their own. Those at risk are those who work on equipment with vibrating parts, or those who work on a conveyor belt, when the same hand movement is repeated many times in a row.

According to statistics, women over 50 years of age are most susceptible to the disease. Making the situation worse bad habits human, due to which the blood supply to tissues deteriorates. Reception row medicines sometimes leads to swelling of the nerve trunk.

The development of symptoms of carpal tunnel syndrome is facilitated by long hours of work at the computer, especially the constant use of a computer mouse or joystick, and long periods of typing.

Treatment methods at home

Before you treat carpal tunnel syndrome wrists at home, you should definitely consult a specialist.

It is necessary to treat the disease immediately after the first symptoms appear, this will prevent further development illness.

The ideal conditions for the treatment of this pathology are to ensure rest of the diseased hand and immobilize it. To do this, you should put a not very tight splint on your hand at night, which will provide fixation. wrist joint.

At the first signs of illness, you should pay attention to working conditions, change your position to a safer one, and regularly do special ones. When working at a computer, you should take a short break every 15 minutes to rest.

If the pathology continues to progress, you should consult a doctor to prescribe anti-inflammatory drugs or physical therapy.

You can do simple exercises throughout the day to relieve symptoms of the disease. For example:

• squeezing a ball or using an expander;
• rotation of the hand clenched into a fist in different directions;
• squeezing and unclenching the hand with force.

Massaging the limb in an upward direction helps, which can be done independently. First, massage the back, and then inner side hands. Promotes well-being acceptance contrast shower, alcohol compresses.

ethnoscience

Treatment with folk remedies helps reduce painful sensations, and also relieve numbness of the limbs.

1. One of the recipes is a sea buckthorn hand bath. To do this, sea buckthorn berries are thoroughly kneaded and filled with water to form a thick paste. After this, the resulting mixture is heated to approximately 37 °C. Hands should be kept in the bath for half an hour, then dried with paper napkins. After the procedure, the limbs are wrapped in warm cloth. It is best to take a bath every day for about a month; after 2 weeks, the course is repeated if desired.
2. A good result is achieved from compresses, which must be done at night. To prepare a compress, mix 1 tbsp. l. salt, 50 ml ammonia, 10 ml camphor alcohol and 1 liter of water.
3. Lingonberry decoction will complement and enhance the effect of treatment. It will require 2-3 tsp. lingonberry leaves, which need to be filled with a glass of water. The broth is prepared on the stove for about 15 minutes, then infused for some time. Ready medicinal drink should be strained and drunk 1 tbsp. l. several times a day.

To prevent the disease, regular breaks from work are necessary, during which it is best to do hand exercises. You should avoid too sharp and amplitude flexion and extension of the arms, ensure a convenient location of the tools necessary for work, and monitor correct posture throughout the day.

Compression-ischemic lesion of the median nerve in the carpal (carpal) tunnel. Manifested by pain, decreased sensitivity and paresthesia in the area of ​​the palmar surface of the 1st–4th fingers, some weakness and awkwardness when moving the hand, especially when a gripping movement is required thumb. The diagnostic algorithm includes examination by a neurologist, electrophysiological testing, biochemical blood testing, radiography, ultrasound, CT or MRI of the wrist area. Treatment is mainly conservative - anti-inflammatory, decongestant, analgesic, physiotherapeutic. If it fails, surgical dissection of the carpal ligament is indicated. The prognosis is favorable provided that treatment measures are timely.

Chronic inflammatory process in the carpal tunnel area is possible with constant trauma associated with professional activity, which involves repeated flexion and extension of the hand, for example, in pianists, cellists, packers, carpenters. A number of authors suggest that long-term daily work Using a computer keyboard can also trigger carpal tunnel syndrome. However, statistical studies have not revealed significant differences between the incidence among keyboard workers and the average incidence of the population.

Compression of the median nerve primarily leads to disruption of its blood supply, i.e., to ischemia. At the beginning, only the sheath of the nerve trunk is affected, as the compression increases pathological changes affect the deeper layers of the nerve. The function of sensory fibers is disrupted first, then motor and autonomic fibers. Long-term ischemia leads to degenerative changes in nerve fibers, replacement of nervous tissue with connective tissue elements and, as a consequence, persistent loss of function of the median nerve.

Symptoms of Carpal Tunnel Syndrome

Carpal tunnel syndrome manifests itself with pain and paresthesia. Patients note numbness, tingling, “lumbago” in the palm of the hand and in the first 3-4 fingers of the hand. The pain often spreads upward to inner surface forearm, but can go down from the wrist to the fingers. Painful attacks at night are typical, forcing patients to wake up. The intensity of pain and severity of numbness decrease when rubbing the palms, lowering the hands down, shaking or waving them in a lowered state. Carpal tunnel syndrome can be bilateral, but the dominant hand is more often and more severely affected.

Over time, along with sensory disturbances, difficulties in hand movements are observed, especially those that require the exciting participation of the thumb. With the affected hand, patients find it difficult to hold a book, draw, hold on to the top handrail in transport, hold mobile phone near the ear, driving a car for a long time, etc. Inaccuracy and discoordination of hand movements occurs, which patients describe as if “everything is falling out of their hands.” Disorder autonomic function the median nerve is manifested by a feeling of “swelling of the hand”, its cooling or, conversely, a feeling of increasing temperature in it, hypersensitivity to cold, paleness or hyperemia of the skin of the hand.

Diagnosis of carpal tunnel syndrome

A neurological examination reveals an area of ​​hypoesthesia corresponding to the zone of innervation of the median nerve, a slight decrease in strength in the muscles innervated by the median nerve, vegetative changes in the skin of the hand (color and temperature of the skin, its marbling). Additional tests are carried out that reveal: Phalen's symptom - the occurrence of paresthesia or numbness in the hand during passive flexion and extension for a minute, Tinel's symptom - tingling in the hand that occurs when tapping in the area of ​​the carpal tunnel. Accurate data on the topic of the lesion can be obtained using electromyography and electroneurography.

In order to study the genesis of carpal syndrome, a blood test for RF, blood biochemistry, radiography of the wrist joint and hand, ultrasound of the wrist joint, CT scan of the wrist joint or MRI are performed, and if indicated, a puncture is performed. It is possible to consult an orthopedist or traumatologist, endocrinologist, or oncologist. It is necessary to differentiate carpal tunnel syndrome from radial nerve neuropathy, ulnar nerve neuropathy, polyneuropathy upper limbs, vertebrogenic syndromes caused by cervical spondyloarthrosis and osteochondrosis.

Treatment of carpal tunnel syndrome

The basis therapeutic tactics is the elimination of the causes of narrowing of the carpal tunnel. This includes reduction of dislocations, immobilization of the hand, correction of endocrine and metabolic disorders, relief of inflammation and reduction of tissue swelling. Conservative therapy carried out by a neurologist, if necessary, together with other specialists. The issue of surgical treatment is discussed with a neurosurgeon.

Conservative methods Therapy is reduced to immobilization of the affected hand with a splint for a period of about 2 weeks, anti-inflammatory, analgesic, and decongestant pharmacotherapy. NSAIDs are used (ibuprofen, indomethacin, diclofenac, naproxen, etc.), in severe cases resort to the prescription of glucocorticosteroids (hydrocortisone, prednisolone); in case of severe pain syndrome, therapeutic blockades of the wrist area are carried out with the introduction local anesthetics(lidocaine). Decongestant therapy is carried out using diuretics, mainly furosemide. Positive effect provides vitamin therapy with gr. B, mud therapy, electrophoresis, ultraphonophoresis, compresses with dimethyl sulfoxide. Vascular therapy with pentoxifylline can reduce median nerve ischemia. nicotinic acid. After achieving clinical improvement, physical therapy, hand massage, and myofascial massage of the hand are recommended to restore nerve function and strength in the hand muscles.

If conservative measures are ineffective, carpal syndrome requires surgical treatment. The operation involves cutting the transverse carpal ligament. It is performed on an outpatient basis using endoscopic techniques. With significant structural changes In the area of ​​the carpal tunnel, due to the impossibility of using endoscopic techniques, the operation is performed in an open manner. The result of the intervention is an increase in the volume of the carpal tunnel and relief of compression of the median nerve. 2 weeks after surgery, the patient can already perform movements with his hand that do not require significant load. However, it takes several months for the hand to fully recover.

Prognosis and prevention of carpal tunnel syndrome

With timely complex treatment Carpal tunnel syndrome generally has a favorable prognosis. However, about 10% of compression cases do not respond to even the most optimal conservative treatment and require surgery. The best postoperative prognosis is for cases not accompanied by total loss sensitivity and atrophy of the hand muscles. In most cases, one month after surgery, hand function is restored by approximately 70%. However, awkwardness and weakness can be observed even after several months. In some cases, relapse of carpal tunnel syndrome occurs.

Prevention consists of normalizing working conditions: adequate equipment of the workplace, ergonomic organization of the work process, changing types of activities, and taking breaks. TO preventive measures also include warning and timely treatment injuries and diseases of the wrist area.

Repeated sprains and fractures, unusual wrist anatomy, arthritis, and certain other conditions can reduce the space in the carpal tunnel, thereby increasing the risk of CTS. From accompanying symptoms It can often be treated at home, but sometimes medical attention is required for complete recovery.

Steps

Part 1

Treatment of CTS at home

Try not to pinch the median nerve. The carpal tunnel is a narrow tunnel made up of small bones in the wrist, connected by ligaments. This channel protects the nerves blood vessels and tendons. The main nerve responsible for the movements of the palm and its sensitivity is called the median nerve. Therefore, you should avoid activities that lead to pinching and irritation of the median nerve, such as frequent bending of the wrist, lifting heavy objects, sleeping with bent wrists, and punching hard surfaces.

• Make sure that wrist watch and the bracelets sat quite loosely on the wrist - if they are too tight on the wrist, this can lead to irritation of the median nerve.
• In most cases of CTS, it is difficult to identify a single cause. Typically, CTS is caused by a combination various factors, such as frequent wrist strain combined with arthritis or diabetes.
• The anatomy of the wrist can also contribute - in some people the bones of the carpal tunnel at or do not have the correct shape.

1. Stretch your wrists regularly. Daily wrist stretching can help reduce the symptoms of CTS or get rid of them altogether. In particular, wrist stretches help expand the space available for the median nerve within the carpal tunnel because it stretches the ligaments surrounding the tunnel. The best way To stretch both wrists at the same time is to assume a “praying pose.” Place your palms together about 6 inches from your chest and lift your elbows until you feel a stretch in both wrists. Hold this position for 30 seconds, then lower your elbows again. Repeat the exercise 3-5 times a day.

   Shake your palms. Feeling numb or aching pain in one or both palms (or wrists), shake them thoroughly for 10-15 seconds, as if shaking off water from them. By doing this, you will achieve quick, albeit temporary, improvement. This shaking will stimulate circulation and improve blood flow to the median nerve, causing symptoms to temporarily disappear. You can do this type of exercise, which helps combat the symptoms of CTS, many times a day, just taking a few seconds off from your work.

   • Symptoms of CTS most often appear (and first appear) in the thumb, index and middle fingers, as well as part of the ring finger. This is why people with CTS seem clumsy and often drop things.
   • Only the little finger is not affected by CTS symptoms because it is not connected to the median nerve.

2. Wear a special wrist support bandage. This semi-rigid brace or splint will help you avoid the symptoms of CTS throughout the day by keeping your wrist in a natural position and preventing it from bending too much. A wrist splint or brace should also be worn during activities that may aggravate symptoms of CTS, such as computer work, carrying heavy bags, driving, or bowling. Wearing a support bandage while you sleep can help prevent nighttime symptoms, especially if you have a habit of tucking your hands under your body while you sleep.

   • You may need a support bandage for several weeks (day and night) to noticeably reduce the symptoms of CTS. However, in some cases, the support bandage has a negative effect.
   • Wearing wrist splints is also helpful if you have CTS and are pregnant, since your palms (and feet) are more likely to swell during pregnancy.
   • Wrist supports and splints can be purchased at a pharmacy or medical supply store.

3. Consider changing the position in which you sleep. Some postures can significantly worsen the symptoms of CTS, which reduces sleep duration and quality. The worst posture is one in which your fists are tightly clenched and/or your palms (with curved wrists) are tucked under your body; The posture in which the arms are above the head is also unfavorable. Instead, try sleeping on your back or side with your arms close to your body, wrists straight, and palms open. This position will ensure normal blood circulation in the wrists and blood supply to the median nerve.

   • As noted above, using support slings while sleeping can help prevent hand and wrist misalignment, but it will take some getting used to.
   • Avoid sleeping on your stomach with your arms under the pillow, as this will cause your wrists to become pinched. People sleeping in this position often experience numbness and tingling in their palms upon awakening.
   • Most wrist supports are made of nylon and have Velcro fastening, which can irritate your skin. In this case, place a sock or piece of thin cloth under the bandage to reduce skin irritation.

4. Take a closer look at your workplace. In addition to poor sleep posture, symptoms of CTS can be caused or exacerbated by poor workplace design. If your computer keyboard, mouse, desk, or chair is positioned poorly and without consideration for your height and body type, it can cause tension in your wrists, shoulders, and mid-back. Make sure the keyboard is positioned in such a way that you don't have to bend your wrists all the time when typing. Buy an ergonomic keyboard and mouse designed to reduce stress on your hands and wrists. Your employer may cover the costs.

   Take over-the-counter medications. Symptoms of CTS are often associated with inflammation and swelling in the wrist, which further irritates the median nerve and adjacent blood vessels. Therefore, reduce the symptoms of CTS by at least in the short term, nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil) or naproxen (Aleve) often help. You can also take painkillers such as paracetamol (Tylenol, Panadol) to relieve pain caused by CTS, but they do not reduce inflammation and swelling.

   Part 2

   Medical care for CTS

   1. Make an appointment with your doctor. If you experience the symptoms listed above in your wrist/hand for several weeks or more, you should see a doctor. The doctor will examine you and probably prescribe X-ray examination and a blood test to rule out possible diseases and injuries whose symptoms resemble CTS, such as rheumatoid arthritis, osteoarthritis, diabetes, a stress fracture in the wrist, or blood vessel problems.

      Visit a physical therapist or massage therapist.

      Try corticosteroid injections. To relieve pain, inflammation, and other symptoms of CTS, your doctor may recommend injections of a corticosteroid drug (such as cortisone) into your wrist or heel of your hand. Corticosteroids are powerful and fast-acting drug, which can relieve swelling in the wrist and relieve pressure on the median nerve. They can also be taken orally, but this is considered much less effective than injections and also causes more severe side effects.

      • Other steroid medications such as prednisolone, dexamethasone, and triamcinolone are also used in the treatment of CTS.
      • Corticosteroid injections can lead to complications such as local infection, profuse bleeding, weakening of tendons, muscle atrophy and nerve damage. Therefore, they are usually done no more than twice a year.
      • If steroid injections do not significantly improve the condition, surgery should be considered.

   2. Carpal tunnel surgery should be considered as a last resort. If other treatments have failed to relieve the symptoms of CTS, your doctor may recommend surgery. The operation is resorted to extreme cases, as there is a risk of making the situation even worse, although for many patients, surgery helps completely relieve the symptoms of CTS. The purpose of this surgery is to relieve pressure on the median nerve by cutting the main ligament that is pressing on it. In case of CTS, the operation is performed in two various methods: endoscopic and open.

      • At endoscopic surgery uses a thin, telescope-like device with a camera on the end (called an endoscope) that is inserted into the carpal tunnel through an incision in the wrist or palm. Using an endoscope, the surgeon sees the canal and can cut the ligament pressing on the nerve.
      • Typically, endoscopic surgery results in less pain and less side effects, and also promotes faster healing.
      • Unlike endoscopic surgery, open surgery involves making a larger incision in the palm and wrist to reach the problematic ligament and release the median nerve.
      • The risks of surgery include nerve damage, infection, and scar tissue formation. All this can lead to a worsening of the situation with the SZK.

   3. Please remain patient during the post-operative recovery period. During this period, you will be advised to frequently hold your operated arm above heart level and move your fingers, which will help reduce swelling and prevent stiffness. Mild pain, inflammation, and stiffness may be present in the hand and wrist for up to six months after surgery, and full recovery may take a whole year. You will be asked to wear a wrist support for the first 2-4 weeks after surgery, although you will be advised to develop your palm.

The carpal tunnel is located on the palmar side of the hand at the junction of the forearm and the hand and is formed by the carpal bones on one side and the transverse carpal ligament on the other.

The tendons of the finger flexor muscles and the median nerve pass through the carpal tunnel.

When the contents of the carpal tunnel are compressed, the median nerve, which is least resistant to damage compared to tendons, is the first to suffer. Therefore, neurological symptoms come to the fore.

Carpal tunnel syndrome- one of the types of tunnel neuropathies (nerve diseases), in which damage occurs peripheral nerves as a result prolonged compression and their constant traumatization in the musculoskeletal canals by chronically inflamed surrounding tissues.

Carpal tunnel syndrome is also known as carpal tunnel syndrome or carpal tunnel syndrome.

Causes of the disease

There are various reasons that can cause the development of carpal tunnel syndrome:

• Tissue swelling as a result of injury to the forearm and hand (fractures, dislocations, bruises);
• Tissue swelling in pregnant women, especially during pregnancy later pregnancy, and in women taking oral contraceptives;
• Chronic inflammation and swelling of the carpal tunnel structures due to constant occupational trauma (the same type of repetitive flexion-extension movements with constant tension of the hands, work associated with constant vibration);
• Tissue swelling as a consequence of a number of diseases internal organs (renal failure), endocrine diseases(decreased function thyroid gland, early period menopause, condition after removal of ovaries, diabetes);
• Narrowing of the synovial sheaths (sheaths) of tendons and thickening of their walls as a result of acute or chronic inflammation at systemic diseases connective tissue (rheumatism), metabolic disorders (), tuberculosis;
• Discrepancy between the size of the canal and the size of its contents as a result of genetically inherited characteristics (square wrist, thick transverse ligament, narrower canal in women, etc.), or pathological growth bones of the hand and wrist (acromegaly);
• Tumor of the median nerve;
• There is an observation that the diagnosis of carpal tunnel syndrome is more often made in the cold season, which proves the role of cold and hypothermia in the development of this disease.

Symptoms

At the beginning of the disease, tingling, burning sensations and pain appear in the thumb, index, middle, and less often ring fingers. The pain is most often dull, aching, can spread to the hand and forearm, and is felt in the deep tissues of the arm. There is often numbness in the skin of the hand and fingers in the morning immediately after waking up, which is accompanied by a decrease or loss of pain sensitivity.

First, sensitivity is lost on the palmar surface of the index and middle fingers; over time, numbness affects both the palmar surfaces of the thumb and ring finger. The feeling of numbness usually goes away within a few hours of waking up.

Pain, numbness and tingling usually go away if you lower your hand down and move your fingers lightly. But after some time the symptoms appear again.

As the disease progresses, movement disorders: it becomes difficult for the patient to hold small objects in his fingers, inaccuracy of movements appears, objects may periodically fall out of the hands against the will of the person, the strength of gripping objects with the hand with the participation of the thumb decreases.

Often there are symptoms of impaired microcirculation of the diseased hand in the form of pale skin or the appearance of a bluish tint due to vasospasm, coldness of the skin of the fingers to the touch, impaired sweating (increased or, conversely, decreased sweating). As a result of constant vascular spasm, the nutrition of the skin and nails is disrupted with a significant deterioration in their appearance.

Diagnostics

Diagnostic tests and electromyography are used to confirm the diagnosis of carpal tunnel syndrome.

Diagnostic tests

1. Flexion and extension test. The arm is held in the position of maximum flexion or extension for 1 minute. With carpal tunnel syndrome, tingling sensations appear in the skin of the thumb, index and middle fingers during this time.
2. Tinnel test. Lightly tapping the carpal tunnel area causes tingling and pain in the fingers. The Tinnel test is positive, as a rule, in severe cases of the disease.

Electromyography studies the ability of muscles to contract under the influence of electrical impulses. Allows you to confirm the diagnosis of carpal tunnel syndrome or suspect another cause of median nerve disease other than compression in the carpal tunnel.

Treatment of carpal tunnel syndrome

The stage of the disease and the prevailing symptoms determine how to treat carpal tunnel syndrome, which techniques are preferable for a particular patient, and whether surgery can be avoided.

Conservative (without surgery) treatment:

1. Restriction of movements in the sore hand for a long period of time, up to the application of a splint on the wrist or a plaster splint;
2. Medications:
   • non-steroidal anti-inflammatory drugs to reduce pain;
   • dehydrating action (removing water from the body), namely diuretics to relieve swelling;
   • injection of glucocorticoids into the carpal tunnel area to locally reduce tissue swelling and relieve inflammation;
   • drugs that improve blood circulation through the vessels to restore blood supply to the tissues of the diseased hand and restore the function of the median nerve.
3. Physiotherapeutic treatment: constant magnetic field, acupuncture to improve metabolic processes in damaged tissues.

Surgical treatment is used if conservative treatment is ineffective and consists of cutting the transverse carpal ligament. The operation is performed under local anesthesia. Crossing the transverse carpal ligament allows you to relieve pressure on the finger flexor tendons and median nerve and restore normal blood supply to the tissues of the hand.

After the operation, the affected arm is immobilized with a plaster splint for 10-12 days. IN postoperative period the patient is prescribed physiotherapy, massage, thermal procedures, B vitamins. The function of the hand and the patient’s ability to work are completely restored 4-5 weeks after the operation.

1. Vitamin B12. Useful for increasing the body's defenses, reducing paresthesia and chilliness.
2. Vitamin B6. Restores nerve fibers, reducing swelling in the joint area and pain symptoms.
3. Vitamin WITH. It has an anti-inflammatory and strengthening effect, enhances the effectiveness of B vitamins.
4. Vitamin D3.
5. Vitamin E.

The most popular complexes:

• “Dihydroquercetin Plus” – contains a valuable natural antioxidant – dihydroquercetin , obtained from the bark of the Siberian larch. As part of the drug, the effect of dihydroquercetin is enhanced by vitamin C and vitamin E, the combined action of which helps restore blood microcirculation in the affected area of ​​the hand and wrist.

• “Osteo-vit” – contains vitamin D3 And drone brood . D3, when acting together with B6, participates in mineral metabolism body.

3. Local treatment– injection of drugs into the joint

Direct injection of medication into the carpal tunnel– most effective method treatment of carpal syndrome. To do this, a mixture of painkillers Lidocaine and Novocaine with the addition of corticosteroids is injected into the carpal tunnel with a special long needle. Most often, after introducing the medicine into the cavity, the pain will disappear.

In some cases, it may intensify, but after a day or two it will go away completely. The course of treatment is up to three weeks and consists of two injections.

If pain syndrome does not go away at all, the procedure is repeated at two-week intervals.

4. Non-drug treatment

Besides medicinal method effects, doctors use other techniques to achieve good results. The most common impact options include: acupuncture, manual therapy and yoga.

5. Treatment of the disease that led to the syndrome

For treatment to be truly effective, care must first be taken to rid the patient of the diseases that caused carpal syndrome (if any). Otherwise, the applied methods will not give any results, and a relapse may occur. Each type of pathology will require individual treatment:

• Treatment of rheumatoid diseases associated with damage to the hand joint;
• Hypothyroidism requires hormone replacement therapy;
• During menopause it is prescribed hormone therapy, but provided that the woman is not yet 60 years old and her last menstruation was no later than 10 years ago;
• At diabetes mellitus treatment is applied that is aimed at preventing surges in the patient’s sugar;
• Chronic renal failure involves helping the patient to improve the process of removing fluid from the body or end products of protein metabolism;
• At high blood pressure HPF inhibitors are used.

6. Physiotherapy

IMPORTANT: This technique cannot be used for people with contraindications (oncology, heart failure, pregnancy and other problems).

Prescribed as physiotherapeutic treatment various procedures, For example, electrophoresis or local cryotherapy.

7. Ultraphonophoresis

The procedure is carried out in conjunction with medications and is a technique in which special ultrasonic vibrations influence the body. It leads to better penetration of drugs into cells, and also allows you to accelerate blood flow in the capillaries. With this treatment of the carpal tunnel, the vessels dilate, pain disappears and swelling subsides. As medicine Dimexide is used.

The procedure aims to reduce pain and inflammation in the treatment of carpal tunnel syndrome. One session takes up to 30 minutes, and treatment course is 8-12 sessions.

8. Shockwave therapy

This method treatment of carpal tunnel syndrome has established itself as a fairly effective and proven technique.

UVT has a complex effect on the entire body and promotes breaking up calcium deposits and uric acid , which narrow the channel when rheumatic diseases. The therapy has a positive effect on the blood supply to the affected area, allowing swelling to be relieved and the patient to be relieved of pain.

CAUTION: SWT cannot be prescribed to patients under the age of 18 to avoid problems associated with pathology of bone development.

Surgery

Surgery is recommended only when all other methods have failed. Surgery required in case when the form of carpal syndrome is advanced, and the patient experiences constant relapses or muscle atrophy.

The operation involves dissection of the carpal ligament, and in some cases, excision of scar tissue. Surgical intervention May be open or endoscopic. The second option is more gentle a technique after which the scar is practically absent.

With open surgery, the surgeon receives full access to the damaged area, which provides more opportunities to relieve pressure on the carpal tunnel.

This operation is not considered difficult, so the likelihood of complications is minimal.

As a result of numerous operations, experts came to the conclusion that it is worth giving preference to the endoscopic technique under local anesthesia. This approach requires less time for patient rehabilitation.

Diet

Proper nutrition for carpal tunnel syndrome is very important for the patient, because this will make up for the lack of vitamins, minerals and essential microelements. It is best to supplement the menu with products rich calcium And vitamin B. This will strengthen bone and nerve tissue. Fast food should be excluded from the menu, everything fatty, fried, spicy and overly salty.

Treatment at home

If you diagnose the problem in a timely manner and begin treatment at home, then it is quite possible to exclude the development of irreversible complications. In addition to the described techniques, doctors recommend that patients engage in special therapeutic exercises for arm training. Going to the pool gives excellent results. It is important that the water is warm and covers the entire limb up to the shoulder. Also, experts recommend To do yoga, or other types therapeutic techniques aimed at developing the joint.

Even if you have mild symptoms of carpal syndrome, it is important to stop doing the work that caused the disease.

This alone will give you much more than all the pills, believe me. If you work at home (for example, at the computer) and have problems with the carpal tunnel, take a break. Do something that relaxes the tension in the channel:

• Wash the dishes. Warm water perfectly relaxing.
• Do a wet cleaning of the floor. Be sure to use your hands and warm water.
• Wash the windows.

And be sure to do it regular physical exercise, which strengthen the joint and muscles of the wrist.

Folk remedies

Before turning to folk medicine, you should first visit an experienced doctor. Only he can advise on this or that folk recipe. Folk remedies may not give the desired result or even cause complications. If folk recipe can really help, it's worth trying. The most famous ones include:

1. Tincture from a string. The composition of string, burdock leaves, hop cones, birch leaves, verbena and elderberry flowers should be brewed in a thermos and left for 2-3 hours, and then taken 150 ml four times a day.
2. White clay. Dilute the white clay with water, transfer the pulp to gauze and apply to the affected area of ​​the wrist.
3. Make a compress from fresh goat milk.
4. Tincture of cucumber and wild rosemary. Grind 2-3 red peppers and 3 cucumbers in a blender, add half a liter of water and let it brew for about a week. Rub it on your wrist: the tincture will improve blood circulation and relieve the feeling of numbness in your fingers.
5. Pumpkin compress. Turn the pumpkin into a mushy state and apply it to your wrist, wrapping it in cellophane.
6. Sea ​​buckthorn. Grind the berries, add water and heat. Soak your hands in the broth, and then be sure to wipe them so that they do not cool down.
7. Pepper rub. pour 150 grams of pepper vegetable oil and simmer over low heat for half an hour. Once it cools down, rub it into your wrist.

Conclusion

Video with a set of exercises

Be sure to watch the video from useful exercises for treatment: