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Sunday, February 19, 2012

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome-What is carpal tunnel syndrome?

Carpal tunnel syndrome is caused by median nerve compression in the carpal tunnel and finger numbness and other symptoms. When the local fracture and dislocation of the tendon, ligament thickening or tube swelling, swelling caused by carpal tunnel relatively narrow, causing the wrist to the middle of chronic nerve injury carpal tunnel syndrome. Carpal tunnel syndrome, also known as delayed median nerve palsy, a "cumulative trauma disorders" disease occurs in 30 to 50 age group, women in the office, in the median nerve into the palm of the body's meridians by compression of the index finger, middle finger pain, numbness and thumb muscles powerlessness embolism Hou.

Carpal tunnel syndrome - Disease OverviewBony fiber tube carpal tunnel is a bony tube of the fiber, the radial side of the scaphoid and trapezium; ulnar pisiform bone and hook of bone; dorsal as the skull, the scaphoid and the trapezoid; the palm side for the transverse carpal ligament. Flexor hallucis longus tendon, superficial flexor tendon, referring to the deep flexor tendon and median nerve within the carpal tunnel. Any squeezing or narrowing the carpal tunnel capacity for any reason can be compression of the median nerve and cause carpal tunnel syndrome. Coles fracture of lunate dislocation, infection or trauma caused by soft tissue edema, thickening of the transverse carpal ligament, ganglion cyst, lipoma, xanthoma, some systemic diseases such as obesity, diabetes, thyroid disorders, amyloidosis or Reynaud disease sometimes associated with carpal tunnel syndrome.The initial presentation of the median nerve edema and congestive lesions gradually due to compression ischemia caused by fibrosis in the nerve axons to compression and medullary phospholipid sheath disappear last nerve tissue into fibrous tissue, the neural tube disappeared and collagen organization in place of the irreversible change. The reason why this disease has rapidly become an increasingly prevalent disease of modern civilization, the main reason is the modern way of life drastically changed, more and more people every day prolonged exposure, use of computers.
Carpal tunnel syndrome - causes of illnessSchematic of carpal tunnel syndrome is generally caused by acute or chronic injury. More common in middle-aged women. The carpal tunnel is a palm roots a tunnel formed by the carpal and transverse carpal ligament, and how the root of the tendons and median nerve through the carpal tunnel. Since the damage caused by the tendons or synovial edema is the compression of the median nerve is the most common causes, such as thickening of the transverse ligament or a small number of tumors also allows the median nerve compression.Carpal tunnel syndrome, mainly the fingers and hands numb, and at night is often the thumb and three fingers pain awakened by the violent wrestling hand after reduce. Numbness mainly in the index finger, middle finger, thumb and ring finger. Acupuncture have hypersensitivity or abnormal slow. Little finger and ring finger the ulnar completely normal. The tapping the center of the palm or palm roots carpal tunnel can cause numbness of the fingers.
A small number of patients with thenar muscle atrophy, paralysis, thumb in the palm side of not rotate. The major cause is due to the use of computer populations such as the Internet family daily access to a computer for a long time, repeating the typing on the keyboard and move the mouse, the wrist due to long-term, intensive, repetitive and excessive activity, and gradually formed the paralysis and pain of the wrist. Long ignored, this symptom may lead to nerve damage, muscle atrophy of the hand.
Carpal tunnel syndrome, carpal tunnel syndrome is not only susceptible to computer users, and other frequent use of the hands of workers such as musicians, teachers, editors, reporters, architects, miners, and so may be suffering from this disease. The data show that women are the biggest victims of carpal tunnel syndrome, this is because the female wrist tube usually smaller than the male, the median nerve is easy to be oppressed. In addition, some pregnant women, patients with rheumatoid arthritis, diabetes, hypertension and thyroid dysfunction in people suffering from carpal tunnel syndrome.When you find that your hands have the following characteristics, you need to pay more attention, including: one or both hands feel somewhat powerless in the fingers or the palm of your hand paralysis or stimulate a sense of stiffness, wrist pain, without stretching the thumb freely and pain.
Disease prevention should focus on the establishment to create a healthy working environment and proper operation of self-protection. Such as personal seat to be adjusted to the proper height, the people sitting there enough space for stretching the legs and feet; Do not sit or stand for too long; sit back should be straight and close to the back, and do not cross your feet, so as not to affect the blood circulation. Computer keyboard typing should be facing you, if the ramp is set aside, may result in excessive wrist bending tension; keyboard display height and distance away from the body parallel should be adjusted to feel comfortable and ease a typing position; 30 minutes of each operation should be suspended for a while, the hands and eyes appropriate to relax or rest.


Carpal tunnel syndrome - symptoms of the diseaseClinical manifestations of carpal tunnel syndrome schematic carpal tunnel syndrome, median nerve compression and index finger, middle finger and ring finger numbness, tingling, or was burning kind of pain during the day and at night exacerbate labor pain, and even sleep wake; localized pain often radiating to the elbow and shoulder; thumb abduction muscle strength is poor, with occasional side objects, extract, and suddenly missed. Check: compression or percussion transverse carpal ligament, dorsiflexion of the wrist pain worsened; course of the elderly, thenar muscle atrophy.Wrist, palm side, thumb, index finger, middle finger numbness, pain, or accompanied by hand movements are not flexible, weak; pain at night or early morning increase, may radiate to the elbow, shoulder, active during the day and walk away alleviate; above parts of the feeling diminished or disappeared; even hand muscle atrophy, paralysis. If there is such a situation, and for several days does not alleviate, the experts recommended to see a doctor must go to regular hospitals as soon as possible, in order to make a diagnosis at an early date, to take measures.
Clinically, the proportion of patients due to chronic disease, leading to the thumb under the thenar muscle atrophy; there may even be intermittent skin pale, and cyanotic; there may be serious thumb, index finger, cyanosis, fingertip necrosis or atrophic ulcers irreversible change.
Carpal tunnel syndrome occurs in the 30-50 age group, women are five times that of men. Bilateral disease, about 1/3 to 1/2, bilateral onset female: male is 9:1. Food due to compression of the median nerve, thumb and middle finger resulting in pain and numbness. Early manifests itself fingertip sensory dysfunction, often because of numbness or burning pain Erzhi wake, activity, relieved by a few hours after falling asleep. A small number of patients due to the longer course of neurotrophic disorders, the occurrence of thenar atrophy, intermittent skin pale, cyanosis, severe thumb, index finger cyanosis, finger necrosis or atrophic ulcers. The examination may be tapping the wrist palm side middle, resulting in the median nerve, numbness, pain, namely, Tinel sign was positive. Some patients with wrist flexion for 60 seconds after abnormal fingers feel heavier, this is the Phalen test was positive. The use of sphygmomanometer pressure in the upper arm to the distal limb vein expansion can trigger the onset of symptoms.
Carpal tunnel syndrome - treatment of diseaseCarpal tunnel syndrome - physical therapy treatment can be divided into conservative treatment, surgical treatment. In the conservative treatment, usually serving the anti-inflammatory drugs. If the result is not satisfactory may also consider the local micro-component steroid injection.
Chinese medicine treatment, frequent computer users more prone to tenosynovitis, known as "mouse hand" in the general habits. Chinese medicine treatment of mouse hand to follow the blood circulation, swelling and pain principle, get rid of the wind, cold, wet, evil, dredge the meridians, qi and blood, the blood running smooth and improve local circulation, repair damaged tissue and enhance tendon The tendon sheath to withstand the trauma strain, and then completely cured mouse hand. Sheath An anti-inflammatory paste administered through the surface of the skin, the drug directly to the lesion, the effective relaxation of the surface of the skin blood vessels, promote blood circulation, eliminate blood stasis, accelerate blood stasis absorbed to the blood circulation of qi, pass through the walking network, wing raising the efficacy of the bones, thus effectively eliminate the pain, swelling, range of motion, inconvenience, cord-like bulge and other symptoms, so that patients get rid of the pain of the mouse hand.
On the other hand can also be physical therapy, commonly used methods of ultrasound and hyperthermia, to release adhesions and increase blood circulation.
Can also use a special wrist supporting the wrist, the activities of the wrist to reduce or mitigate it to withstand the load. Less load, more than the rest, self-healing mechanisms of the body will naturally start. Leave to a period of time will slowly improve. However, if the storm of the above conservative treatments do not make the condition to be satisfied with the recovery, or too serious, they need to consider surgical therapy.
Surgical therapy, the general purpose is to release the adhesion between the organizations, and the transverse carpal ligament release at the top of the carpal tunnel, so that the carpal tunnel space to expand. This, of course you can make the condition to be good nerves so that the oppressed to recover.
Although the treatment of this disease partially closed can temporarily alleviate symptoms, but many can not be simply lifted. Should find out the causes of the disease to take appropriate therapeutic measures, such as anti-rheumatic treatment or surgical release. The patients themselves can do local heat or massage to firmly massage the midpoint of the palm stripes, each 15 minutes, three times a day, often can receive good results.


Generally used in treatment, nothing more than oral blood stasis class or class of pain medications, acupuncture, massage; some adjuvant therapy such as hyperthermia, after the spa, paraffin, ultrasound or hot packs, give pain with electrical stimulation, more experienced physical therapists will guide patients to do home exercise, but this effect is still very limited.
Use of laser acupuncture knife adhesion within the carpal tunnel (carpal tunnel), fibrous tissue lysis, thereby improving the compression of the median nerve, reducing the shackles of the flexor muscle and tendon of the flexor hallucis longus muscle, so as to reduce or even eliminate the pain symptoms.Points: gu labor intrauterine Guan Yang River
Carpal tunnel syndrome - Tuirou method steps1, the patient sitting(1) rubbing gu, Laogong Neiguan, Yang River, per hole about 1 minute.(2) Tuirou law. Patients with limb straight, palm inward. Doctors who single-handedly boosting the risk of elbow, forearm, the thenar of the other hand, the thumb and index finger efforts along the hand lunar lung through the line line of hand Shao Yin Heart Sutra and the pericardium by the finger tip, push the edge rubbing repeatedly the treatments minutes. Then hold in one hand and suffering from wrist the other hand the thumb gently ease the the kneading wrist and palm radial side two minutes.(3) The grant of extension method. The doctors who single-handedly hold the limb distal forearm with one hand to hold the metacarpophalangeal Ministry, his hands in a slow and small in the opposite direction of traction, grip the metacarpophalangeal the hand proper dorsiflexion of the wrist and wrist flexion activities 5-7 times.(4) tremor law. The doctors who single-handedly hold the limb distal forearm with one hand to hold the metacarpophalangeal Ministry, his hands at the same time in a slow and small in the opposite direction of traction, grip the metacarpophalangeal hand repeated the tremor activity for 1-2 minutes.(5) Le France. Healer left hand holding the wrist, eat right hand middle finger of the Section II held hostage limb finger with remote jerking slip the developed huskily. 2,3,4 refers to in turn.Two control methods:The ① plaster splint wrist in mild dorsiflexion for 1-2 weeks, to ensure adequate rest.② carpal tunnel injection of hydrocortisone acetate or triamcinolone 0.5 ml, once a week, about 4 times. After injection, a small number of patients may have pain response, but in general that go away in 2 days.③ surgery: when the illness has been a long time, the gypsum fixed and given 4 times invalid, may consider surgery. The majority of patients can be discharged in a few days after symptoms or significantly reduced.
The experts suggest that current treatment methods are: a, external fixation, symptoms, and fixed with plaster or splint the wrist in mild dorsiflexion 1-2 weeks. Carpal tunnel closed: procaine and prednisolone (steroid) and injected into the carpal tunnel, once a week, a total of 3-4 times. Three, serving anti-inflammatory analgesic drugs. Surgery: non-surgical treatment fails or symptoms get worse or thenar muscle atrophy, should be early surgical treatment, such as cutting off the transverse carpal ligament, the lifting of the oppression of the median nerve. But most patients with carpal tunnel closed, can be supplemented by anti-inflammatory analgesic drugs.
Carpal tunnel syndrome - Disease PreventionCarpal tunnel syndrome - prevention As the saying goes: Prevention is better than cure. This sentence is also very can be applied in the carpal tunnel syndrome. Study of its final causes, exhaustion made excessive, that is not consciously a long time without rest to use the wrist and fingers, resulting in fatigue response. With this in mind management, prevention of the road, it is very obvious, is to try to avoid prolonged repetitive hand operation. During this period every 15 to 30 minutes to take a break, a change of action. Such as typing every fifteen minutes, we have to stop for the moment, stretching the tendons of the fingers and wrist, stretch a few different directions.If feasible, may wish to workers arranged to different operating alternately. For example, typing 30 minutes after they converted to file processing. For some time, went back to typing. So that we can use different operating content, so that different muscles and tendons in turn work and rest.
Maintain a good operating posture is the best way to avoid injury. The keyboard should be placed in the body in front of a central location, flat near the height of the keyboard or using the mouse, can prevent carpal tunnel injury; wrist as flat posture keyboard, neither bending nor drooping; elbow angle should be greater than 90 degree in order to avoid the median nerve compression in the elbow. Forearms and elbows should be close to your body and relax as much as possible, avoid using the mouse body to lean forward; sure to use the mouse wrist straight, sitting straight and use the best quality back cushion, your feet should be flat on the floor or the mat. Screen placed in front of the body height to make the head move up and down is appropriate, sit still, his eyes after the screen is parallel to the straight line, to ensure that the display brightness and superb. Often work during stretching and relaxation operator, slowly bend wrist, repeated for 10 seconds per hour; every hour for 10 seconds fist activities.
Carpal tunnel syndrome - the prevention of work location, arrangements can not be ignored, because the appropriate position should allow the wrists in the most relaxed and least pressure position. To typing as an example, the tilt of the keyboard should be the work of Xu wrist at about 30 degrees of extension and position. In this position, the pressure on the wrist is at least, near the tendon can not over-stretching or tightening, and therefore the work will be more relaxed and comfortable.All day the face of the white-collar workers and young people often play games of the computer, sometimes feel the palm of your hand numb, or index finger to drag the mouse easy to cramp, these symptoms are 'mouse hand'. The long-term use of the mouse, keyboard wrist nerve compression, leading to muscle or joint hemp, swelling, pain, cramps. These actions is the main training and wrist strength and dexterity to ease the muscles are stiff. Of course, suffer from "mouse hand" side of the shoulder strain, pain and other symptoms than the other side of the shoulder, shoulder training is also essential.
1, the action made of watches assistive devices, wrists 25 times clockwise and counterclockwise rotation. Efficacy: relieve wrist muscle soreness feeling.
2, Action 2 hand with a load of water bottles, first of all palms up grip bottle, do drooping from the natural to lift the action, and then palms down grip the bottle to do the movement from bottom to top, each 25 times, exercise the wrist flexor. Efficacy: prevention and treatment of wrist bone spurs proliferation, enhanced wrist strength.
3, action 3 stretch various parts of the body, but also hard to expand the hands of five fingers, each 20-30 seconds, do 2-3 times. Effects: increased joint resistance, improve blood circulation.

Carpal tunnel syndrome - treatment of four action suck enough air force fist, forced expiratory rapid turn stretched little finger, ring finger, middle finger and index finger. The left and right 10 times each. Efficacy: the exercise of hand joints, relieve stiffness.
, Action, index finger and thumb of one hand kneading the other hand fingers thumb, each refers to 10 seconds, smooth breathing. Efficacy: to promote blood circulation and relax.
6, Action 6 hands the ball (tennis), or holding the palm of your hand can hold things (such as fruit, etc.), up and down turning the wrist 20 times. The weight of the ball according to their strength. Effects: increased wrist strength, exercise, physical coordination, ability.7, action 7 palms together even before and after the campaign friction caused by the micro heat. Efficacy: to promote blood circulation of the hand. Neck to the left shoulder: the left arm to the right tension, stretching, pay attention to the arm is not too high, and chest have a certain distance, do not pressure. For 30-45 seconds each, for the right arm. How to prevent a computer caused carpal tunnel syndrome. "
Maintain a good operating posture is the best way to avoid injury.
Carpal tunnel syndrome - treatment of a keyboard should be placed in the body in front of a central location, flat near the height of the keyboard or using the mouse, can prevent carpal tunnel hurt;2, the wrist as far as possible flat posture keyboard, neither bending nor drooping;3, elbows working angle should be greater than 90 degrees, in order to avoid the median nerve compression in the elbow;4, forearm and elbow should be close to your body and relax as much as possible to avoid using the mouse body to lean forward;5 Be sure to use the mouse wrist straight, sitting straight and the best use of high-quality back cushion, your feet should be flat on the ground or floor mats.Screen placed in front of the body height to not make the head move up and down is appropriate, sit still, eyes on the screen in parallel lines to ensure that the brightness of the display moderate.7, during regular stretching and relaxation operator can slowly bend wrist, repeated for 10 seconds per hour; every hour for 10 seconds fist activities.