Do your fingers tingle on one or both hands? Is the hand weaker, numb or painful? Do the difficulties worsen at night? Then carpal tunnel syndrome may be behind these symptoms.
This is the most common strait syndrome. It involves oppression of the median (median nerve) in the area of the carpal tunnel on the wrist. The carpal tunnel consists of wrist bones and ligament – ligaments. carpi tranversum, between them passes into the palm of the tendon of muscles, vessels and nerves. If, for some reason, there is a thickening of the tendons and swelling of the ligaments. carpi transversum, begins to be oppressed and irritated n. medianus and appears pain, numbness, tingling or tingling, especially in the area of the 1st to 4th finger or the whole hand.
Problems can worsen if the upper limb is raised above the head, they often appear at night, when they wake up from sleep and it is necessary to relieve yourself by shaking your hand. The muscular strength of the hand is weakened when pressing and grasping, and there may be failures in the surface sensitivity of the skin. Mostly it is a chronic disease, but it can also occur acutely, for example, after an injury.
The most common causes of occurrence:
- Excessive one-sided overloading of the hand – work with hand tools, work with mouse and keyboard, playing a musical instrument
- Vibration with transmission to the hand – work with a jackhammer, chainsaw, etc.
- Hormonal causes – that’s why it often affects women in menopause
- Hand injuries, even those that happened a long time ago
- And other diseases such as: diabetes mellitus, gout, obesity
The most common cause is the above overload. There is a thickening of the tendons of the finger and wrist benders (so-called flexors), which are too stressed and remain permanently in increased tension. Our hands are generally overloaded, constantly either holding something, stirring, lifting or doing long-lasting delicate work – e.g. typing on a keyboard.The muscles of the forearm and hand are often not even able to relax, they are constantly ready for action. This leads to their hypertrophy, later swelling and oppression in the narrow canal together with the nerve and vessels. If this condition lasts longer, then degenerative changes occur on the nerve itself, and the muscles of the hand weaken.
Try to realize how often you subconsciously clench your fist and palm and fingers are in tension.
Diagnostics:
Many will tell the typical symptoms ( tingling of the hand in the morning, shaking, numbness, etc. will help). However, it will confirm with certainty the carpal tunnel syndrome up to EMG. That is, a method by which it is measured how well the impulse is conducted by the nerve. EMG will also confirm the level of oppression and how much the nerve is already damaged. If you do not have problems for a long time and do not have numbness or blackouts, then there is a great chance that carpal tunnel syndrome will be managed conservatively.
If the trouble lasts longer, it is likely that the oppression of the nerve in the strait is great and there will be no other way than to have this channel released surgically.
Operative treatment with long immobilization:
Let’s start with operative treatment. This most often consists of cutting part of the leagues. carpi transversum and thus in the release of pressure on the n. medianus. However, then there is at least 6 weeks of long immobilization, i.e. fixing the hand so that the tissues can heal well. But the results of the operation tend to be good.
Conservative treatment with physiotherapy can completely solve the problem if started on time
You can delay the operation or avoid it with timely conservative treatment. If you are at the beginning and you only have trouble tingling your hand in your sleep or in the morning, the chance of a conservative cure is great. First of all, it is necessary to relax the muscles – the so-called hand benders (wrists and fingers). Relaxation is done by so-called soft tissue techniques, stretching and very intense but very effective fascial manipulation.Thanks to these techniques, we will induce overloaded muscles to relax and regenerate. Together with regime measures (not overloading the hand, regular exercise), swelling may begin to decrease. Then we also need to look at the true cause of the problem – whether the forearm overload is not a role in the non-ideally built shoulder, thoracic spine and non-ideal involvement of the center of the body. It seems that such distant parts of the body cannot be related, but the opposite is true. You can read more about it here:
https://dev.bebalanced.cz/jak-se-telo-vyrovnava-se-zranenimi/
However, prevention works best. How to do it?
Regularly stretch the muscles of your hand and forearm, try to ergonomically adjust the working environment and working position, take regular breaks at work, you can massage the wrist and palm area, last but not least, it is advisable to include compensatory exercises for the correction of muscle imbalances.
If you do not know what to do with prevention or you are already solving this problem, do not hesitate to visit us. Our team of physiotherapists will be happy to advise and help you.
