Can carpal tunnel go away without treatment. We wrote, we wrote or what to do when we are overtaken by a tunnel syndrome. Non-drug conservative therapy

tunnel syndrome- this is a whole group of diseases of peripheral nerve fibers that occur due to compression of these nerves in certain anatomical channels (tunnels) of the body, which can be formed by bone, muscle and tendon anatomical structures.

To date, several dozen tunnel syndromes have been described. Some of them are very common, for example, carpal tunnel syndrome, which affects about 1% of the general population, others can be seen quite rarely and are known only to narrow specialists.

Despite the clinical diversity of this group of pathologies of peripheral nervous system, the root causes of development are the same - pinching of the nerve fiber in its natural anatomical receptacle. This pathology in the English-speaking medical literature can also be found under the name of trap neuropathy, which very well reflects the mechanism of nerve damage.

Beyond squeezing nervous tissue, with the development of carpal tunnel syndrome, there is a violation of the blood supply to the nerve. From here comes another common name for this group of pathologies - compression-ischemic neuropathy.

Tinel's symptom is important in the diagnosis of tunnel syndromes: when tapping in the area of the affected nerve, tingling and pain occur.

Most often, tunnel syndromes of the hands occur, the nerve trunks of the lower extremities suffer much less often. As a rule, the debut of the disease occurs at the age of 30-45 years, women suffer more often than men. The course of the pathology is chronic with periods of exacerbations and remissions, accompanied by 3 clinical syndromes - pain, signs of impaired sensitivity and motor function limbs, which can be expressed to varying degrees.

The reasons

The main importance in the development of compression-ischemic neuropathies is given to chronic microtraumatization of the nerve, which is of a professional, household or sports nature. That is why the nerve structures that are in close proximity to the movable joints are most often infringed.

To date, the number one cause of carpal tunnel syndrome is working with a computer mouse and keyboard.

Increase the risk of developing this group of ailments, metabolic and endocrine disorders in the body. For example, the disease occurs more often in women during pregnancy, breastfeeding, during menopausal adjustment, in patients with hypothyroidism, with long-term use hormonal drugs, including oral contraceptives.

In some cases, severe weight loss can be the cause of the pinched nerve. At the same time, the amount of fatty tissue decreases, which protects the nerve and performs shock-absorbing functions for it.

Also in medicine, cases of family tunnel syndromes are described. At the same time, clearly narrow canals in which nerve fibers are located were initially recorded in relatives.

The risk of such disorders is increased in patients with systemic diseases connective tissue, arthritis, arthrosis, past injuries and joint operations diabetes, chronic alcoholism, multiple myeloma and other hematological diseases.

Below are those tunnel syndromes that occur most often.

carpal tunnel syndrome

Carpal tunnel syndrome accounts for approximately 50% of all compression-ischemic neuropathies and in last years its number is increasing sharply, which can be explained by the increase in the number of workers who regularly use the keyboard and computer mouse.

The carpal canal (carpal) itself is very narrow, its bottom and walls are the bones of the wrist, and the canal is covered from above by the transverse carpal ligament. Inside the case are the tendons of the flexor muscles of the fingers and the median nerve.

When carpal tunnel syndrome occurs, the median nerve is affected

The median nerve in its function is mixed, that is, it provides both sensitivity and motor activity. It takes part in the innervation of the palmar surface of 3-5 fingers of the hand, interdigital areas and the back side nail phalanges first 3 fingers. The motor part of the nerve provides normal function muscles that form the elevation of the first finger of the hand.

Symptoms of Carpal Tunnel Syndrome

In the case of the development of carpal tunnel syndrome, the patient develops compression-ischemic neuropathy of the median nerve. Pathology is characterized by a chronic long-term course. Among the first signs of neuropathy, one can note pain in the area of \u200b\u200bthe corresponding innervation, paresthesia (tingling, crawling sensation, numbness), which appear mainly at night and often cause a person to wake up. As the disease progresses, these symptoms disturb both day and night.

Area of innervation of the median nerve

At the next stage of the progression of the disease, the sensitivity of the skin gradually decreases and motor disorders appear - a decrease in muscle strength tenor muscles, hypotrophy and atrophy of muscle tissue, weakness in the arm, inability to perform habitual movements and even hold objects.

Pain in carpal tunnel syndrome is characterized by spreading not only to the hand, but also to the forearm, shoulder, and even to the neck. Painful sensations decrease when rubbing and shaking the hands (improves blood supply to the damaged nerve).

Simple tests to diagnose the syndrome carpal tunnel:

Tinel test - with percussion in the area of \u200b\u200bthe damaged nerve, the appearance or increase of pain and paresthesia in the zone of its innervation is observed.
Lift test upper limb - to do this, you need to raise and stretch straight arms above your head, hold the limbs in this position for 60 seconds. Due to the decrease in the intensity of blood flow in a patient who has carpal tunnel syndrome, pain and paresthesias occur.
Flexion test- for this you need to bend the hand in the wrist joint as much as possible and hold it in this position for a minute. Subsequently, when the arm is extended, pain and paresthesia occur in the zone of innervation of the median nerve.
Bottle test - becomes positive only when attached movement disorders. In this case, the patient cannot lift and hold the bottle by the neck with the thumb and forefinger.

In case of rough pathological changes changes significantly in the late stages of the disease appearance brushes. The skin becomes very pale, the tenor muscles atrophy, the hand begins to resemble a primate's paw.

Arrows indicate tenor muscle atrophy in a patient with carpal tunnel syndrome.

Treatment of carpal tunnel syndrome

After the diagnosis is made, they resort to conservative therapy, surgical treatment can be immediately prescribed only in isolated cases, for example, when nerve compression is caused by trauma or growth callus after a broken wrist.

First of all, you need to get rid of all possible factors that could cause disease. It is important to ensure complete rest for the hand for a period active phase treatment. To immobilize the limb as much as possible, you can use special dressings, bandages and. You also need to take care of the ergonomics of your workplace. If you work with a computer, you need to follow some rules for the position of hands on the keyboard and mouse.

There are also various gadgets that allow you to maintain the desired position of the hands during work and prevent further injury to the median nerve, for example, vertical mice, silicone mats with gel pads, and other devices.

Such a simple gadget will ensure the correct position of the hands when working with a conventional computer mouse and will be an excellent prevention of the development of tunnel syndrome

Of the medications, analgesics and anti-inflammatory drugs are used. In more complex cases and with pronounced painful sensations resort to blockade using glucocorticosteroids. AT complex treatment also apply therapeutic exercises, physiotherapy, massage, acupuncture.

If conservative measures were ineffective, then surgery will help to cure neuropathy. In this case, a surgical dissection of the carpal ligament of the canal is performed and the nerve is released from the trap. There are several ways to carry out surgery, in modern clinics even endoscopic equipment is used for this purpose, which allows you to avoid a big problem. surgical incision. The recovery period takes up to 3 months.

Important! Treatment for carpal tunnel syndrome should be started in a timely manner. If no measures are taken for a long time, irreversible changes can occur in the tissues of the median nerve, which will lead to a complete loss of function of the nerve fiber.

Cubital tunnel syndrome

Among the tunnel syndromes of the upper limb, the cubital canal syndrome should also be distinguished, which occurs as a result of infringement of the ulnar nerve in the cubital canal.

The cubital canal contains the ulnar nerve, which can be infringed with the development of compression-ischemic ulnar neuropathy.

Due to the superficial passage of the nerve fiber in this place and the high mobility of the elbow, the ulnar nerve is prone to damage in the area of the cubital canal. This pathology is in second place among carpal tunnel syndromes after carpal tunnel injury.

Zone of innervation of the ulnar nerve

Most often, the cause of the development of pathology is damage to the nerve fiber due to prolonged static overvoltage and pressure on the nerve, for example, the habit of talking on the phone for a long time, resting your elbow on the table, etc. Also, the disease is promoted by metabolic and endocrine diseases, injuries, surgeries on the elbow joint, arthritis and arthrosis of this joint.

Symptoms of neuropathy also include three main points:

The characteristic position of the hand in neuropathy of the ulnar nerve according to the type of "clawed paw"

pain in the zone of innervation of the ulnar nerve;
sensory disorders - insemination, paresthesia, decreased sensitivity;
movement disorders that occur as the disease progresses - weakness of the 4th and 5th fingers of the hand, atrophy of the muscles of the hypotenor and interosseous muscle fibers, the characteristic position of the hand as a clawed paw.

In the treatment of such a pathology, they are used as conservative methods as well as surgical. It is important to fix your arms in an extended position, for this there are special splints that can be worn at night while sleeping at home. In combination therapy, medical preparations, physiotherapy, folk remedies, exercise therapy.

Operation is appointed in case of inefficiency conservative treatment. During the manipulation, the ligament is dissected, which covers the cubital canal from above and, thus, the nerve is released, which gradually restores its functions on its own (if the disease has not gone too far).

Radial nerve neuropathy

The radial nerve can be compressed in several places along its course, but most often this occurs at the level of the distal parts of the shoulder canal.
At the same time, there are signs complete defeat radial nerve trunk:

paralysis of the muscles that extend the hand and fingers ("drooping hand");
sensory disorders on the back of the forearm and on the back of the radial half of the hand (1 and 2 fingers);
pain on palpation of the affected area.

Neuropathy of the radial nerve is manifested by the syndrome of "hanging brush"

This disease is also called Saturday night paralysis, honeymoon paralysis.

How to treat radial neuropathy? Treatment can be conservative and surgical. In case of inefficiency of the complex of various therapeutic measures resort to surgery.

Neuropathy of the peroneal nerve

Most often, the infringement of this nerve occurs between the head fibula and the edge of the long tibial muscle. This situation is observed with a sharp plantar flexion of the foot, in case of sprain ankle joint.

As a result, an injury to the fibular nerve occurs, which can become chronic with the development of neuropathy. Also, nerve compression can be observed when performing certain types of work on your haunches, sitting in a cross-legged position, when applying a tight plaster cast.

In this case, there is paralysis of the muscles that unbend the foot and toes, a decrease in the sensitivity of the outer surface of the lower leg, the back of the foot and 1-4 fingers. If neuropathy persists for a long time, atrophy of the anterior and posterior muscle groups of the leg develops. On palpation and percussion of the affected area, the patient feels pain and the occurrence of paresthesia.

Roth disease

This is one of the common carpal tunnel syndromes. lower limb. This results in a compression-ischemic lesion of the lateral skin femoral nerve. The nerve performs only a sensitive function and does not contain motor fibers; it innervates the skin of the anterolateral surface of the middle third of the thigh.

In Roth's disease, the lateral femoral cutaneous nerve is compressed

The main symptom of the pathology is numbness and burning pain in the corresponding zone of innervation. In the late stages of the development of pathology, there is total loss sensitivity of this area of the skin. When the hip is extended, the pain increases, when it is flexed, it decreases.

Usually, this violation does not cause serious inconvenience to the patient, but in some cases the pain becomes very pronounced. This situation is an indication for surgical operation in the region of the inguinal ligament.

Interestingly, Sigmund Freud suffered from neuropathy of the lateral cutaneous nerve of the thigh, believing that this pain is psychogenic in nature.

In the case of the development of tarsal tunnel syndrome, it is compressed tibial nerve. Compression occurs predominantly in the area of the bone-fibrous tarsal canal (tarsal).

Most often, the pathology develops due to injuries in the ankle joint, in some cases the cause of compression cannot be determined

The main symptom of the disease is pain that is felt in the sole of the foot and toes. Painful sensations arise or intensify when walking, there is a symptom of intermittent claudication. Also, the pain occurs on its own at night and contributes to the awakening of the patient. Very often, the pathology is bilateral.

piriformis syndrome

In the case of the development of compression-ischemic neuropathy of the sciatic nerve, they talk about. It arises as a result of spastic contraction of the latter, due to which sciatic nerve pressed against the sacrospinous ligament. A similar situation is often observed in patients with degenerative-dystrophic lesions of the spine.

Among the signs of the disease, one can note burning pain, the development of paresthesias in the zone of innervation of the common tibial nerve. Patients also have a decrease in the Achilles tendon. Over time, weakness of the calf muscles develops.

The development of carpal tunnel syndrome significantly affects the quality of life of patients. But the prognosis with a timely diagnosis and proper treatment is favorable. That is why you do not need to delay the visit to the doctor if you are concerned about the symptoms described in the article. It should be understood that there are a lot of diseases of the peripheral nervous system, while finding out the cause and putting accurate diagnosis only a specialist can.

People with somatic diseases are most susceptible to carpal tunnel syndrome. In addition, this problem is more common in women than in men, since their carpal tunnel is narrower.

at the first sign of illness, you should consult a doctor

Causes of the disease

The following factors can be attributed to the causes of this disease:

professional activity of a person associated with constant monotonous hand movements;
various injuries, fractures, dislocations of the hand, resulting in compression of the median nerve;
stagnation of fluid in the body due to pregnancy or taking hormonal contraceptives;
genetic predisposition;
thyroid disease;
diabetes;
inflammatory and rheumatic diseases of the hand;
abnormal bone growth (acromegaly).

Symptoms of the disease

Pain in fingers

The first symptoms of the onset of the disease are pain, tingling, burning and numbness of the fingers. At first they appear from time to time and quickly disappear, but after a while the patient begins to feel them constantly.
At further development carpal tunnel syndrome, pain occurs in the fingers at night, which can radiate to the forearm and elbow joints. After rubbing or shaking the brush, the discomfort disappears.
In addition, the patient may decrease the sensitivity of the fingers, become weaker muscles, it becomes difficult for a person to hold small objects.

Carpal Syndrome Treatment at Home

Exercises

Home remedies have been used by people for many years to treat conditions such as carpal tunnel syndrome.

Symptoms will not bother you if you change your position while working and take a break for 15 minutes. If your muscles rest more, then your health will improve.
You can perform simple exercises, such as squeezing a rubber ball.
A good effect is refusing to apply ice to the wrist area.

Folk recipes

In some cases, they are used various plants for treatment, the use of which helps to reduce pain in the fingers. Of course, before doing this, you need to consult a doctor.

Infusion of cucumber and wild rosemary– excellent folk remedy, which helps to normalize blood circulation and relieve numbness in the fingers. Pickled cucumbers (3 pieces) should be cut into small pieces and mixed with three pods of red pepper. All this is filled with vodka (0.5 l). The infusion must be put in a dark place for 7 days, then strain and rub the sore wrist.

Sea buckthorn treatment- a remedy from sea buckthorn helps to cope with pain in the hands of people with a disease such as carpal tunnel syndrome. The treatment is as follows. The berries are crushed and mixed with water. The resulting mixture should be opaque. Then it must be heated to 37 degrees and soar hands for half an hour. It is good to do a light massage before this.

After the procedure, the hands must be thoroughly wiped and insulated. You can use woolen mittens or gloves. Treatment is carried out for a month, then you need to take a break for two weeks.

pumpkin compress- A wonderful remedy that can alleviate the condition of the patient is pumpkin. A compress of pumpkin porridge is applied to the sore hand, wrapped with cellophane on top and wrapped in a warm woolen scarf. Such warming wraps are done once a day. The duration of treatment is five to six days.

Treatment with ammonia and salt- From numbness of fingers and burning sensation in case of tunnel syndrome, such a healing agent relieves: a tablespoon of salt, 50 grams of ten percent ammonia and 10 grams camphor alcohol dissolve in 1 liter of water.

Pepper oil rub- ground black pepper is able to defeat carpal tunnel syndrome. How to treat using this remedy? The recipe is simple: pour 100 grams of pepper with a liter vegetable oil and heat over low heat for at least half an hour. The resulting product in a warm form is rubbed into the affected joint several times a day.

Cowberry decoction- relieves pain in the hands and swelling of such a folk remedy as a decoction of lingonberries. The leaves of the plant (several teaspoons) should be poured with water (one glass) and boiled for 15 minutes. The product removed from the stove must be filtered. Take one sip several times a day.

How to Reduce Puffiness

Edema - another unpleasant symptom a condition such as carpal tunnel syndrome. Treatment consists in the use of diuretic infusions.

The use of an infusion of parsley roots gives an excellent result. One tablespoon of raw materials should be poured with boiling water (0.5 l) and left to infuse until morning. Healing infusion drink during the day in a sip.

A similar effect has a remedy from the leaves of white birch. A few tablespoons of leaves should be poured with boiling water (one glass) and brewed for about three hours. The infusion should be consumed in four doses of 1/3 cup before meals.

Bearberry has excellent diuretic and anti-inflammatory properties. The medicine is prepared in this way: the leaves of the plant (1 tbsp) are brewed with one glass of boiling water for several hours. Means drink a tablespoon several times a day.
Prevention of carpal tunnel syndrome

Prevention of carpal syndrome

To reduce your chances of developing a condition such as carpal tunnel syndrome, consider the following guidelines.

When working at a computer, give preference to the touchpad, trying to use the mouse less often. If it is impossible to refuse to use the mouse, try to keep the brush straight while working. Pay attention to the position of the arm - from the elbow to the hand, it should lie on the table.

Use comfortable mouse and keyboard models, a wrist support is a good purchase, which will reduce the strain in the hand when working. If you have to spend a lot of time at the computer, change your chair to one that has armrests.

If you often type text on a laptop or netbook keyboard, connect a keyboard from a desktop computer to them from time to time.
If you start to feel tired, take a break for a little gymnastics so that your hands rest. Squeeze and unclench your fingers several times, make rotational movements with your hands in different directions, clap your hands, clasp your fingers in the lock. You can keep a toy on your desktop that will remind you of the need to warm up and which can be used for gymnastics. The rosary is great for this purpose, sorting through the beads one at a time, you will relieve tension in your hands. You can roll two balls in the palm of your hand.
If you know that you have to for a long time load your wrist, pre-warm up your hands by doing gymnastics. You can take a bath with hot water.

Carpal tunnel syndrome makes life much more difficult. In most cases, we earn it by doing our normal business. Using our advice, you can protect yourself from this pathology or alleviate your condition if the symptoms of the disease have already manifested themselves.

Carpal tunnel syndrome () develops mainly in people who have to make frequent movements brushes. Tunnel neuropathy of the hand occurs due to compression of the median nerve in the carpal tunnel. This can lead, for example, long work at the computer, playing the piano and other reasons. If symptoms of carpal tunnel syndrome occur, a consultation with a neurologist is necessary.

About Carpal Tunnel Syndrome

Carpal syndrome develops against the background of compression or pinching of the nerve of the hand. In this condition, there is a decrease in the sensitivity of the fingers (more often than the first three). To understand the causes and symptoms of carpal tunnel syndrome, it is necessary to turn to anatomy.

The carpal tunnel runs along the palm and connects to the local bones. The median nerve, passing between the transverse ligament (runs between the bones of the wrist), appears in the palm of your hand. In this part of the hand are tendons that respond to the movements of the fingers. In the absence of pathological processes, an impulse is transmitted along the median nerve, giving a signal for flexion and extension of the phalanges. In addition, local fibers provide sensitivity to part of the palm and 1-4 fingers.

The reasons

The development of carpal tunnel syndrome is mainly due to acquired causes. But the likelihood of such a violation depends on anatomical features person.

So, in women, the carpal tunnel is narrower than in men, so a pinched nerve often provokes carpal tunnel syndrome.

Common causes of carpal tunnel compression include:

bruises;
dislocations;
fractures;
post-traumatic edema.

Post-traumatic edema also develops with endocrine pathologies, kidney failure and during pregnancy. In addition, prolonged use of hormonal drugs leads to swelling of the soft tissues of the hands and, as a result, to tunnel syndrome.

Nerve pinching also occurs in inflammatory diseases:

arthritis;
gout;
turberculosis of the joints;
synovitis and others.

The nerves of the hand are affected by various tumors that form in the wrist area:

hygroma;
lipoma;
chondroma;
synovioma.

Chronic inflammatory process in the tissues of the hand, leading to nerve compression and the development of carpal syndrome, often associated with professional activity. Such problems are often faced by pianists, packers or carpenters. Some researchers identify the relationship between daily work at the computer and tunnel syndrome.

Among probable causes compression of the nerves of the palm highlight an anomaly in the development of tendon sheaths, which, due to genetic factor do not produce enough lubrication, which provokes inflammation of local tissues.

Due to compression of the carpal nerve, the blood supply to the hand is disrupted. At the initial stage of development of a tunnel syndrome, sensory disorders are noted. In the future, the patient loses the ability to move his fingers. In the absence adequate treatment nerve fibers are gradually replaced by connective tissue.

Symptoms

Symptoms of a pinched nerve in the hand develop gradually. Moreover, at the initial stages, the carpal tunnel syndrome manifests itself only during actions with the hands. Later Clinical signs become permanent.

In the case of the development of carpal tunnel syndrome, the following symptoms appear:

tingling and numbness in 1-3 and half of 4 fingers;
pain;
feeling of weakness and goosebumps.

The innervation of the hand extends predominantly upward. However, the pain can radiate to the fingers. At the initial stage, the innervation of the hand often manifests itself at night. The pain is intense, causing the patient to wake up. To get rid of discomfort, during this period it is enough to grind or lower the brush.

As you progress pathological process the pain begins to disturb during the day, both when moving the brush, and at rest. Tunnel syndrome of the hand has an important feature: the unpleasant sensations characteristic of compression of the carpal tunnel are not observed in the area of the little finger.

Inflammation of the nerve of the thumb or other areas provokes malnutrition of local tissues. This leads to the fact that signals from the central nervous system to the limbs arrive more slowly. Due to inflammation and compression of the nerve, the muscles of the hand weaken, and movements become inaccurate. In particular, it becomes difficult to hold small objects with your fingers.

Compression of the median nerve also reduces the sensitivity of the fingers. AT advanced cases Patients do not feel needle pricks.

Progression of median nerve compression causes muscle atrophy. In extreme cases, the brushes are deformed. In addition, due to malnutrition, the skin turns pale in places where the median nerve affects the tissues.

Diagnostics

With compression of the nerve channels of the wrist, it is necessary to differentiate the disease from other pathologies. There are several tests for this:

With the help of the described tests, you can identify the problem at home. Clinic for confirmation preliminary diagnosis apply:

x-ray;
electroneuromyography.

In addition to these procedures, additional analyzes and tests are carried out, with the help of which the factor that led to the carpal syndrome is established.

How to treat carpal tunnel syndrome?

Carpal tunnel syndrome develops under the influence of various factors. When the nerve channels are pinched, the patient experiences numbness of the palms and fingers, intense pain.

In the treatment of a pathological condition, a complex of drugs and methods of physiotherapy are used.

When symptoms of carpal tunnel syndrome appear, it is recommended to remove the load from the problem area. For this you need:

wrap the wrist with an orthopedic fixator;
abandon activities that provoke pinching of the median nerve in the carpal tunnel;
apply ice regularly problem area.

These actions will reduce the intensity pain syndrome. In the future, treatment tactics are selected based on the nature of the lesion and the causative factor.

Benevron

Medical therapy

When a nerve is pinched in the wrist, the following drugs are indicated:

B vitamins;
non-steroidal anti-inflammatory drugs ("Neurobeks", "Benevron", "Milgamma");
diuretics ("Diakarb", "Hypothiazid", "Furosemide");
vasodilators ("Trental", "Pentilin", nicotinic acid);
anticonvulsants ("Pregabalin", "Gabapentin");
muscle relaxants ("Mydocalm", "Sirdalud");
antidepressants.

For the treatment of compression of the nerves of the wrist joint, these drugs are prescribed in tablets. The type and dosage of the drug is selected taking into account the neglect of the case.

To stop the swelling and inflammation of the tissues in the palm, a variety of compresses are used, which include medications. In the case when the neuritis of the hand is accompanied by intense pain, the only way treatment is to inject corticosteroids directly into the carpal tunnel. For this, mixtures of "Diprospan" or "Hydrocortisone" are used. After a course of treatment with injections, the symptoms of carpal syndrome disappear, and the condition of the limb is restored.

If a drug therapy does not give positive results, applied hand surgery. There are two options for the procedure: open method and endoscopic intervention. The first method involves cutting the brush in the problem area and crossing the problem ligament. Endoscopic intervention is carried out according to a similar scheme. The difference lies in the fact that after this procedure, the duration of the rehabilitation period is reduced.

Physiotherapy

Drug treatment of carpal tunnel syndrome is often supplemented by physiotherapy. This approach is also used after surgery for a pinched radial nerve in the hand.

To restore the nerve channels of the wrist, acupuncture is prescribed, shock wave therapy, manual massage and other procedures.

Physiotherapeutic intervention eliminates clinical phenomena and suppresses the inflammatory process that caused tunnel syndrome.

Treatment at home

It is not recommended to carry out therapy without establishing the cause of the development of carpal tunnel syndrome. Therefore, treatment at home is allowed after a specialized examination.

To restore the functions of the wrist, apply:

Each of these funds must be applied to the problem area. To relieve swelling, the treatment of carpal tunnel syndrome can be supplemented with an infusion of parsley roots. This remedy is used internally.

Also, a pinched nerve of the hand is eliminated with the help of special exercises, which should be selected by the doctor, taking into account the nature of the lesion.

Prevention and prognosis

The prognosis for carpal tunnel syndrome is determined by the timeliness of therapeutic intervention. Approximately 10% of patients require surgery to repair a pinched nerve.

To prevent carpal tunnel syndrome, it is recommended to abandon activities that involve a high load on the hands. If this is not possible, breaks should be taken during the work. To prevent a pinched nerve, injuries and fractures of the extremities should be treated in a timely manner.

If you are reading these lines, then it will be quite natural to assume that you spend at the computer on at least several hours a day or more. This mode of work brings with it a fairly strong load on our hands, which can cause pain in the hands, wrists and fingers. Such pains are caused by the so-called "tunnel syndrome" (carpal tunnel syndrome, carpal tunnel syndrome, carpal tunnel syndrome) - a chronic disease.

In this article, we will try to understand the causes of carpal tunnel syndrome, possible ways treatment and ways to prevent this undesirable phenomenon. This article will contain quite a lot of subjective deviations from the formal definitions and formulations that are available on various medical sites, since spending a significant amount of time at the keyboard over the past eight years, I have tasted the consequences of carpal tunnel in all its manifestations.

How carpal tunnel syndrome develops and how we feel about it

So what causes this unpleasant phenomenon? Carpal (tunnel) syndrome is caused by compression of the nerve of the hand (median nerve), which runs in special channels formed by bones and ligaments. Naturally, when squeezing the nerve, we feel pain, which can be felt in the joint of the hand, but not only in it. Now we will go through all the stages of the discussed syndrome and try to connect physiological processes with what we can feel when working at a computer.

From personal experience, first there is a weak Blunt pain, numbness or discomfort in the very joint of the hand after several hours of work. If you stop work and just stretch your hands, the pain disappears for half an hour - an hour. Unchanging hand position, coupled with intensive work, leads to stagnation of blood, which causes this stage only bad feelings.

If you do nothing and continue to work as before, then in a year or two the next stage will come - a burning sensation in the hand, which appears by the end of the working day and no longer goes away, as before, but continues to haunt us at home, two or three hours, gradually turning into a dull one, mild pain. This happens due to thickened tendons, which are already inflamed and begin to put pressure on the nerve (the diameter of the channel has decreased) with a problematic position of the hand. Around the same time, pain may appear in the hand itself (the outer side of the palm) and in the phalanges of the fingers, especially the index and middle fingers, which are used most when working with the mouse.

In addition to all the delights of working for standard place work, it becomes problematic to lift loads when the brush is in a certain position. Interestingly, the degree of pain does not depend on the severity of the load, but mainly only on the position of the hand. But let's not get distracted, let's move on.

In this position, our body will try to cope with the unfavorable situation, and lymphatic fluid begins to accumulate between the cartilage, designed to flush out the affected and inflamed cells. At normal development events, such a process achieves its goal (cells are washed out) and the liquid resolves itself. If the load on the hands is prolonged, then the inflammation, as you might already guess, does not stop, but quite the opposite. With this development of events natural process treatment itself can lead to the opposite result - swelling of the lymphatic fluid in the joints. From personal experience, again, one can determine with highly likely whether you have reached this stage or not. The flushes of lymphatic fluid are most significant at night, so if the pain is worse at night, you have already arrived at the destination station. Well, if joint pains also wake you up at night - “dry the oars, gentlemen”, it’s time to do something urgently, otherwise very soon the only way out will be surgery.

Before we discuss stationary medical treatment, let's first see what we can do on our own, reduce the healing of our body to physiotherapy, or to extreme case limited to outpatient treatment.

Exercises to prevent carpal tunnel syndrome

These exercises can / should be done every few hours, and each of them should be repeated many times, a dozen or two.

1. Strongly clench your fingers into a fist and also strongly unclench.

2. Clench your fists and rotate first in one direction, then in the opposite direction.

2a. You can perform the same exercise with a special ball, inside of which there is a rapidly rotating disk (for example, PowerBall or with any more or less heavy object). I have tried such a thing - it noticeably resists changing the position of the ball along any axis and thus trains the muscles and accelerates the blood more, which, in fact, is what we are trying to achieve. You can rotate your hand not only along the elbow-wrist axis, as shown in the picture, but also by fully arching the hand.

3. Pressing your palms together, spread your elbows to the sides, assuming a position like a prayer. The forearms in this position are parallel to the floor. Then, try to lower your palms as low as possible without opening them and leaving your elbows still high. It is likely that pain will be felt in the hands, palms or even in the phalanges of the fingers if the disease under discussion has already reached you. It is important not to put your hands far away from you.

4. If you have a special soft ball (these are often given away as free gifts at various gatherings and presentations) for hands, squeeze it in turn with all fingers, palm and between hands, as shown in the pictures.

5. Repeat the previous exercise, only without the ball, offering resistance thumb all fingers in turn.

6. Straighten your arms in front of you, as shown in the picture, rest your palm on your palm. When resisting, try to straighten your bent palm.

Exercises to treat carpal tunnel syndrome at home

The exercises that will be described here border on a little “real” physical therapy, but please tell me, why should we wait for someone and something when we can help ourselves? So, let's start with the easiest, but again, from personal experience, the most effective.

1. Fill a deep bath with warm, almost hot, water and, clenching your fists, slowly rotate them in the water. It is important that the water warms the hands high enough, above the wrist joint. This exercise greatly relieves pain and initial stage, and with progressive. Optimal duration for this exercise it is 10-15 minutes, no less. At the end, wrap your hands, including your hands, in a towel - do not quickly cool them. If the apartment is cold enough, then even use a warm scarf.

2. Repeating the previous exercise to some extent, you can apply an alcohol warming compress at night, just do not make it strong, otherwise you will burn the skin on your hands - an unpleasant experience.

3. Massage. In a situation where the fingers and hands hurt from any effort, it will be difficult to massage yourself. It is best to ask someone, it does not require special skills, the main thing is desire. You need to massage the entire arm, starting from the outside of the palm, continuing up, outside forearms (trying to move in the middle of the arm, where a small depression is felt between the forearm bones).

4. Regarding the advice in this paragraph, I can not say anything, neither for nor against, because I did not use this approach. If it helps you, it’s good, but if not, it’s okay, water massage, and it’s about it that will be discussed now, does not carry anything destructive in itself. Hydromassage is offered as a treatment on some sites dedicated to this issue, and it is suggested to use it twice a day - in the morning (cool and warm water) to massage the collar of the back, shoulder blades, shoulders, forearms and hands, and in the evening (only with warm water) according to the same scheme.

Physiotherapy exercises to treat carpal tunnel syndrome

We are beginning to slowly cross the border of self-treatment and outpatient treatment, since physiotherapy, although not some kind of active treatment, at least in my opinion, but nevertheless it is prescribed by a doctor and the course of physiotherapy should be completed completely to achieve any sane result. Everything that will be described in this chapter should not be taken as a recommended course of treatment, and even more so, I hope that everyone understands that my personal experience in no way replaces a full-fledged prescription from a doctor, a specialist in this matter, and responsible for the result thereof. .

1. Again ... massage. Yes, as one of the means, physiotherapy will offer you massage again. I don’t know how much its location (in the office or at home) affects the quality of the massage, it didn’t help me much in both the first and second cases.

2. Warming paraffin baths. Remember point one of the home exercises? It's almost the same, but instead of hot water you will be offered to dip your hands in hot paraffin and, after two or three dips, wrap your hands in a warm towel. The result will be the same - the joint and tendons are warmed up, only here your hands will look like large ritual candles. There is nothing terrible in this, on the contrary, it is funny then to shoot such casts of hands on a scale of 1: 1.

3. Shortwave heating. With this type of treatment, the joints of the hand are heated by radiation in the range of several gigahertz (if I remember correctly). I didn’t like this thing and I refused after one session. A personal microwave oven on hand did not seem to me to be something particularly useful, and deep heating can be achieved at home.

4. Exercises for the muscles of the arms and back. Sometimes the disease under discussion can arise due to incorrect posture during work, therefore, as one of the options for physical therapy, you may be offered simple physical exercises, it all depends on your physique and posture. Since the suggested exercises are quite simple, no special meaning describe them in detail. Yes, in my opinion, this item is quite a candidate for transfer to the previous chapter - at home you can certainly wave light dumbbells and stretch the elastic band.

- flat, arc-shaped, divided ("broken") for the right and left hands separately, such as Microsoft Natural Ergonomic Keyboard 4000

- vertically curved, arc-shaped, such as Microsoft Natural Multimedia or Microsoft Natural Keyboard Elite. Beware, however, of being too arched in vertical plane keyboards - it becomes completely inconvenient to work on them.

From personal experience, last view clearly preferable - the hand is in a more natural position. We will discuss the question of the natural position of the hand in more detail in the chapter on substitute mice, but for now we will leave this statement at the level of a temporary axiom.

In addition to those listed, there are a number of "unusual" ergonomic keyboards, which I would probably even classify as exotic:

- adjustable split (physically into two halves) keyboard, such as Kinesis Maxim Adjustable Keyboard

Mice and mouse-like

Regarding ordinary mice, you can briefly give very few recommendations. Firstly, the mouse should not be small so that you have to hold it straining thumb and little finger, and secondly, it is desirable that the mouse be tall enough to support inside palms so that the latter is not overhanging all the time. Moving away from the topic of the mice themselves, it's time to find out why the position of the hand when working with the mouse is problematic.

According to personal observations, which are partly confirmed by various publications that caught my eye, the natural position of the hand and wrist when we stand will be 45 degrees to our hips - not completely parallel to them, nor, however, perpendicular. If you try to just stand up and freely lower your arms, they will take exactly this position.

Now, still standing, let's do a very simple action - bend our elbows, keeping our arms relaxed as much as possible. Note that the hands and wrists that were at an angle to our body now maintain the same angle to the horizontal surface. If you turn the hands along the longitudinal axis of the arms, so that the latter take a horizontal position, the bones of the forearm will not be parallel, as before.

Also our muscles and tendons will be in b about more stress than before. Note that this is the position our hands are in when working with ordinary mice - this is the first of two reasons for the disastrous state of our hands after N-th number of years of continuous work. We will talk about the second reason regarding the position of the fingers a little lower.

Well, now the fun begins. Let's see what exactly we can replace these friendly-hostile tailed creatures with.

Vertical mice - 1

There is a rather unusual type of mouse that tries to maintain the natural position of the hand and wrist in a horizontal position, suggesting that we rotate not our hands to the plane of the mouse, but the plane of the mouse to the position of our hands.

From personal experience, working with such a mouse relieves the load on the mouse-holding hand and I can say that at least one of my colleagues, such a mouse helped get rid of pain in the wrist on entry level inflammatory process.

Vertical mice -2

Another type of vertical mouse offers an even more unusual approach, not only rotating the mouse to the plane of the hand, but also replacing all hand movements with movements of the entire forearm.

Based on my own experience, I can see that although working with such a mouse improves the position of the wrist, on the other hand it forces our entire hand to move to move the cursor. In this situation, the load on the shoulder and related muscles increases, which negatively affects the entire process of work. I could not work with such a device precisely because of the intense load on the shoulder, but I know one person who considers such a manipulator to be the most correct alternative to a conventional mouse.

Cat Mice: Trackballs

On sale you can find two types of trackballs - with a ball under the thumb and with a ball under the index, middle and ring finger.

Having tried both, I can't recommend either one. Why, you ask. The answer is simple. When working with trackballs, the problematic position of the wrist on the table does not disappear, and the load on the fingers is simply modified. In the first case, the thumb will be heavily loaded, in the second, all movements and clicks will be made with straightened fingers, which, as already mentioned, is often one of the components of our big problem.

Anti-mouse: Virtual Pencils / Drawing Tablets

If we return for a second to the question of the natural position of the hand at the table, then the only mouse replacement gadget that will not contradict the principles described above, we will find in ... designers. It is this cohort of people who use graphic tablets, on which everything that needs to be transferred to the screen is virtually drawn with a wireless “pencil”. If you look closely, then sitting position when working with such a stylus, the hand just repeats the free state of the hand and palm - not parallel and not perpendicular to the body, but about 45 degrees to the table surface. In addition, our fingers holding the stylus are not fully extended, as they are when working with a regular or vertical mouse, but are in a half-bent state and, therefore, apply efforts to gain in a less stressful position.

It would be useful to add that the most frequent action of the left "click" is replaced when working with the stylus by pressing on its virtual rod (pressing with the whole hand towards the tablet), bringing additional relief to our long-suffering hands. The right click is made by pressing the stylus button located under the thumb, thus freeing and middle finger from load.

Returning again and again to bitter personal experience, I can notice that working with such a device, you can stop pain in your wrist and fingers almost instantly.

Semi-medical solutions: elastic bandages

If you are unable to change your mouse/keyboard to one of the ergonomic solutions described above, then you can take a half-hearted approach - try to maintain the correct hand position when working with the wrong device. Correct hand position can be achieved with the help of a medical elastic bandage supporting the hand and wrist. Not every dressing will be useful to us, but only containing a rigid or springy metal element.

Bandage with rigid element

Bandage with a spring element

From experience, it is quite convenient to work with both bandages, except that the first option provides less freedom of the hand, which, however, is hardly a disadvantage in our case. An example of such bandages of the company

» came across more general study the roots of this phenomenon and ways to treat/prevent it. Tunnel syndrome (yes, yes, this is it) is a nasty thing, and in the material below you will understand that you can’t overcome it just like that. Only daily routines/workouts. At the end, I will draw my brief conclusions, but for now let's turn to the original source on Habrahabr.

We wrote, we wrote, or what to do when we are overtaken by tunnel syndrome

If you're reading this, it's only natural to assume that you spend at least a few hours a day on your computer, if not more. This mode of work brings with it a fairly strong load on our hands, which can cause pain in the hands, wrists and fingers. Such pains are caused by the so-called "tunnel syndrome" (carpal tunnel syndrome, carpal tunnel syndrome, carpal tunnel syndrome) - a chronic disease.

In this article, we will try to understand the causes of carpal tunnel syndrome, possible treatments and ways to prevent this undesirable phenomenon. This article will contain quite a lot of subjective deviations from the formal definitions and formulations that are available on various medical sites, since spending a significant amount of time at the keyboard over the past eight years, I have tasted the consequences of carpal tunnel in all its manifestations.

How carpal tunnel syndrome develops and how we feel about it

So, what gives rise to this unpleasant phenomenon? Carpal (tunnel) syndrome It is caused by compression of the nerve of the hand (median nerve), which runs in special channels formed by bones and ligaments. Naturally, when squeezing the nerve, we feel pain, which can be felt in the joint of the hand, but not only in it. Now we will go through all the stages of the discussed syndrome and try to connect physiological processes with what we can feel when working at a computer.

From personal experience, at first there is a slight dull pain, numbness or discomfort in the very joint of the hand after several hours of work. If you stop work and just stretch your hands, the pain disappears for half an hour - an hour. The unchanging position of the hand, coupled with intensive work, leads to stagnation of blood, which causes only discomfort at this stage.

If you do nothing and continue to work as before, then in a year or two the next stage will come - a burning sensation in the hand, which appears by the end of the working day and no longer goes away, as before, but continues to haunt us at home, two or three hours, gradually turning into just a dull, weak pain. This happens due to thickened tendons, which are already inflamed and begin to put pressure on the nerve (the diameter of the channel has decreased) with a problematic position of the hand. Around the same time, pain may appear in the hand itself (the outer side of the palm) and in the phalanges of the fingers, especially the index and middle fingers, which are used most when working with the mouse.

In addition to all the delights of working at a standard job, it becomes a problem to lift loads when the hand is in a certain position. Interestingly, the degree of pain does not depend on the severity of the load, but mainly only on the position of the hand. But let's not get distracted, let's move on.

In this position, our body will try to cope with the unfavorable situation, and lymphatic fluid begins to accumulate between the cartilage, designed to flush out the affected and inflamed cells. In the normal course of events, such a process reaches its goal (the cells are washed out) and the liquid resolves itself. If the load on the hands is prolonged, then the inflammation, as you might already guess, does not stop, but quite the opposite. With such a development of events, the natural process of treatment itself can already lead to the opposite result - swelling of the lymphatic fluid in the joints. From personal experience, again, you can determine with a high probability whether you have reached this stage or not. The flushes of lymphatic fluid are most significant at night, so if the pain is worse at night, you have already arrived at the destination station. Well, if joint pains also wake you up at night - “dry the oars, gentlemen”, it’s time to do something urgently, otherwise very soon the only way out will be surgery.

Before we discuss inpatient medical treatment, let's first look at what we can do on our own, reduce the healing of our body to physical therapy, or in extreme cases limit it to outpatient treatment.

Exercises to prevent carpal tunnel syndrome

These exercises can / should be done every few hours, and each of them should be repeated many times, a dozen or two.

1. Strongly clench your fingers into a fist and also strongly unclench.

2. Clench your fists and rotate first in one direction, then in the opposite direction.

5. Repeat the previous exercise, only without the ball, resisting with your thumb to all fingers in turn.

6. Straighten your arms in front of you, as shown in the picture, rest your palm on your palm. When resisting, try to straighten your bent palm.

Exercises to treat carpal tunnel syndrome at home

1. Fill a deep bath with warm, almost hot, water and, clenching your fists, slowly rotate them in the water. It is important that the water warms the hands high enough, above the wrist joint. This exercise greatly relieves pain in both the initial and progressive stages. The optimal duration for this exercise is 10-15 minutes, no less. At the end, wrap your hands, including your hands, in a towel - do not quickly cool them. If the apartment is cold enough, then even use a warm scarf.

3. Massage. In a situation where the fingers and hands hurt from any effort, it will be difficult to massage yourself. It is best to ask someone, it does not require special skills, the main thing is desire. It is necessary to massage the entire arm, starting from the outer side of the palm, continuing up, the outer side of the forearm (trying to move along the middle of the arm, where a small depression is felt between the forearm bones).

4. Regarding the advice in this paragraph, I can not say anything, neither for nor against, because I did not use this approach. If it helps you, it’s good, but if not, it’s okay, water massage, and it’s about it that will be discussed now, does not carry anything destructive in itself. Hydro massage is offered as a treatment on some sites dedicated to this issue, and it is suggested to use it twice a day - in the morning (cool and warm water) to massage the collar of the back, shoulder blades, shoulders, forearms and hands, and in the evening (warm water only) in the same pattern.

Physiotherapy exercises to treat carpal tunnel syndrome

We are slowly starting to cross the border of self-treatment and outpatient treatment, since physiotherapy, although not an active treatment, at least in my opinion, is nonetheless prescribed by a doctor and a course of physiotherapy should be completed completely to achieve any reasonable result. Everything that will be described in this chapter should not be taken as a recommended course of treatment, and even more so, I hope that everyone understands that my personal experience in no way replaces a full-fledged prescription from a doctor, a specialist in this matter, and responsible for the result thereof. .

2. Warming paraffin baths. Remember point one of the home exercises? This is almost the same, but instead of hot water, you will be offered to dip your hands in hot paraffin and, after two or three dips, wrap your hands in a warm towel. The result will be the same - the joint and tendons are warmed up, only here your hands will look like large ritual candles. There is nothing terrible in this, on the contrary, it is funny then to shoot such casts of hands on a scale of 1: 1.

4. Exercises for the muscles of the arms and back. Sometimes the disease under discussion can arise due to incorrect posture during work, therefore, as one of the options for physical therapy, you may be offered simple physical exercises, it all depends on your physique and posture. Since the proposed exercises are quite simple, there is not much point in describing them in detail. Yes, in my opinion, this item is quite a candidate for transfer to the previous chapter - at home you can certainly wave light dumbbells and stretch the elastic band.

Hospital treatment

The gadgets that save us

We wouldn't be able to call ourselves geeks if we had a couple of pointed aces up our sleeves that would help us solve such problems, right? Well, if so, then it's time to discuss and tell what kind of gadgets save us in this situation.

Preventive

The simplest and effective way Solving a problem is not facing it. The easiest way, well known today, is a brush pad. Most often, gel pads are used and, it should be noted that even the cheapest of them do their job perfectly, straightening our hand joint as far as possible.

So wrong.

And so right.
But let's move on to more serious devices, and we'll start with keyboard modifications.

Ergonomic (Natural) keyboard

To date, there are three types of conventional ergonomic keyboards available:

- flat with arcuately placed buttons, such as

- flat, arc-shaped, divided ("broken") for the right and left hands separately, such as

- vertically curved, arc-shaped, such as or. Beware, however, of keyboards that are too curved in the vertical plane - it becomes completely uncomfortable to work on them.

From personal experience, the latter type is clearly preferable - the hand is in a more natural position. We will discuss the question of the natural position of the hand in more detail in the chapter on substitute mice, but for now we will leave this statement at the level of a temporary axiom.

In addition to those listed, there are a number of "unusual" ergonomic keyboards, which I would probably even classify as exotic:

- adjustable split (physically into two halves) keyboard, such as

Mice and mouse-like

Regarding ordinary mice, you can briefly give very few recommendations. Firstly, the mouse should not be small so that you have to hold it by straining your thumb and little finger, and secondly, it is desirable that the mouse be tall enough to support the inside of the palm so that the latter is not overhanging all the time. Moving away from the topic of the mice themselves, it's time to find out why the position of the hand when working with the mouse is problematic.

Well, now the fun begins. Let's see what exactly we can replace these friendly-hostile tailed creatures with.

Vertical mice - 1

From personal experience, working with such a mouse relieves the load on the mouse-holding hand, and I can say that at least one of my colleagues, such a mouse helped get rid of pain in the wrist at the initial level of the inflammatory process.

Vertical mice -2

Another type of vertical mouse offers an even more unusual approach, not only rotating the mouse to the plane of the hand, but also replacing all hand movements with movements of the entire forearm.

Cat Mice: Trackballs

On sale you can find two types of trackballs - with a ball under the thumb and with a ball under the index, middle and ring finger.

Anti-mouse: Virtual Pencils / Drawing Tablets

If we return for a second to the question of the natural position of the hand at the table, then the only mouse replacement gadget that will not contradict the principles described above, we will find in ... designers. It is this cohort of people who use graphic tablets, on which everything that needs to be transferred to the screen is virtually drawn with a wireless “pencil”. If you look closely, then in a sitting position, the hand, when working with such a stylus, just repeats the free state of the hand and palm - not parallel and not perpendicular to the body, but about 45 degrees to the table surface. In addition, our fingers holding the stylus are not fully extended, as they are when working with a regular or vertical mouse, but are in a half-bent state and, therefore, apply efforts to gain in a less stressful position.

It would be useful to add that the most frequent action of the left "click" is replaced when working with the stylus by pressing on its virtual rod (pressing with the whole hand towards the tablet), bringing additional relief to our long-suffering hands. The right click is made by pressing the stylus button located under the thumb, thus freeing the middle finger from the load.

Returning again and again to bitter personal experience, I can notice that working with such a device, you can stop pain in your wrist and fingers almost instantly.

Semi-medical solutions: elastic bandages

If you are unable to change your mouse/keyboard to one of the ergonomic solutions described above, then you can take a half-hearted approach - try to maintain the correct hand position when working with the wrong device. The correct position of the hand can be achieved with a medical elastic band that supports the hand and wrist. Not every dressing will be useful to us, but only containing a rigid or springy metal element.

Bandage with rigid element

Bandage with a spring element

Touchpad as another solution

As another solution for replacing a mouse, an external touchpad (usually USB) can be mentioned. Such a device, although it can to some extent be an alternative solution, but according to the experience of working on a laptop, it is not effective enough. Although hand movements will be limited, the position of the wrist on the table will still be problematic, and the fingers will be tense for trekking.

Conclusion

In conclusion, we can say only one very simple truth - take care of yourself. No one will ever know and feel what exactly is happening to you every day. If you feel that there is a problem during work - do not ignore it. The sooner you deal with it, the less blood you will cost, the benefit of most possible solutions and procedures, I tried to describe in sufficient detail, but simply and without unnecessarily tiring details.

I don’t know how to properly end such a long story, so I just hope that everything that has been described above will help you one way or another. Bye.

The first symptoms of carpal tunnel syndrome are pain, tingling and numbness in the hands, an unpleasant sensation when the hand, thumb and forefinger are bent.

p.s. Long, interesting story. Now we understand that a very long stay of the hand / wrist in one position pinches the nerve, which is why all these troubles occur. I'll add a couple of lines from myself.

1. Carpal expanders help. But - often lazy and forget.

2. Rugs with pads help, but weakly.

3. Tablets - well, this is not an option. I had three. From Wacom Intuos to small ones. Yes, drawing is convenient, but constantly working is still a hassle.

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