From: 09/16/2019 3:50 PM
Tingling, tingling and numbness in the thumb, forefinger and middle finger are typical features of carpal tunnel syndrome. An important nerve of the joint was caught. Movement pain in particular can occur on the thumb, which can feel like a weak electric shock and radiate into the arm. At an advanced stage of the disease, atrophy, disassembly of the thumb thumb muscle can occur.
Identify the causes
The cause of the discomfort is a narrowing of the carpal tunnel, a bone groove on the inside of the joint. There the median nerve flows into the thumb, forefinger and middle finger. He is responsible for the sensation and control of the muscles. Narrowing is triggered, for example, by the following:
- manual stress (for example, prolonged use of forearm crutches, extended bicycle tours)
- Hormonal changes due to pregnancy or menopause
- Diseases such as diabetes and hypothyroidism
Carpal tunnel syndrome: Simple tests
A doctor can often tell by simple tests whether this is carpal tunnel syndrome:
- when faucets of dough The doctor will check that knocking on the median nerve leads to an electrifying feeling that shoots in the arm.
- Phalentest it causes nerves to dive, leading to a feeling of throbbing, tingling in the fingers.
Diagnosis of current and ultrasound
To diagnose carpal tunnel syndrome, the doctor measures nerve conduction and ultrasound examines the area. To measure nerve conduction (electroneurography), a neurologist uses electrodes to send impulses of low current through the arm. The impulse on one side of the carpal tunnel must lead to a muscle reaction on the other. If conductivity is impaired, it speaks for carpal tunnel syndrome. If the examination shows a normal finding, there is no carpal tunnel syndrome. High-resolution mercury ultrasound scanning may be useful if electroneurography is not clear or if surgery of the carpal tunnel syndrome does not produce the desired results.
Eliminate other triggers for discomfort
If ultrasound examination does not show narrowing and swelling of the nerves, the symptoms must have another cause:
- This could be one, for example autoimmune disease whether it leads to inflammation of the nerves.
- Also tense the muscles of the neck. common cysts or clogged arteries may cause symptoms that initially indicate carpal tunnel syndrome.
- Rarely, a tingling sensation in your fingers can also be a consequence of poor healing broken collarbone after one accident be initiated or malicious tumorwhich grows into a nerve plexus (pancoast tumor).
Muscle atrophy syndrome as a trigger
If a doctor can feel painful trigger points, this indicates a so-called muscle tightening syndrome:
- On the path from the cervical spine to the arm, the medial nerve goes through some bottlenecks: At the base of the neck, the nerve bundle goes through a small gap between the scalenus muscles. In the narrowing at this point we speak Scalenus syndrome.
- Below, the nerve on the chest crosses the pectoral muscle. If it is tense, for example, because of poor posture, it can squeeze the nerve – the result is a Chest muscle minor syndrome.
Both syndromes lead to discomfort in the arm and sometimes in the arm. Such muscular atrophy syndrome is easy to treat by better posture and greater stretching of the chest and neck muscles.
Treat carpal tunnel syndrome
As symptoms increase, this indicates that the medial nerve is under pressure. Treatment is important because otherwise there is a risk that the nerve fibers will die irreversibly. At the onset of carpal tunnel syndrome, symptoms can usually be treated conservatively – with vitamin B6, cortisone injections, manual therapy, and specially tailored, worn only at night.
Surgery should only be done if there is a clear diagnosis
If treatment is not started, surgery is required. However, electrophysiological diagnosis should have clearly confirmed carpal tunnel syndrome. Again and again, according to surgery experts, although a clear diagnosis is lacking.
Two different surgical procedures
In the classic open procedure, the surgeon cuts the wrist and restrictive connective tissue to release the nerve. The process takes 10 to 15 minutes. The problems with the lack of bracelets are not to be expected. After surgery, the arm must be temporarily immobilized. In a minimally invasive procedure, the endoscope is inserted through a small incision at the end of the forearm and advances into the carpal tunnel. There the surgeon from below spreads the roof of the carpal tunnel with a knife.
Work not without risk
After the procedure, the patients are quite patient: sometimes the regression of symptoms takes three to four months. If symptoms increase, electro-diagnostics or, if necessary, an ultrasound examination should be performed after two months. Both methods have advantages and disadvantages: In open surgery, the skin is torn where some people have fine skin nerves. The scar can be very sensitive. After minimally invasive surgery, patients can reuse their hands faster, but this procedure also poses risks: nerve and blood vessel injuries can cause permanent damage and pain.
If the operation fails
In some cases, surgery for carpal tunnel syndrome is unsuccessful, for example, when the median nerve is not clamped on the wrist but on the elbow or cervical spine. Another disease that causes symptoms similar to carpal tunnel syndrome is Wartenberg syndrome. The radial nerve is trapped on the forearm.
Tips & Warnings Prevent carpal tunnel syndrome
- Neutral position of hands: Repeated flexion of the joint induces carpal tunnel syndrome. Therefore, one should pay attention to the neutral position of the hands – like shaking hands.
- Use common protectors: Pharmacy wrist guards help maintain a neutral arm position at work or during sleep. This is important because many people sleep with their wrist tight.
- Place a chair on the table: Adjust the chair on the table so that the forearms are aligned with the keyboard while seated. The arms and wrists should form a line with the forearms. Do not rotate or push the body permanently.
- Take breaks: During activities such as typing on a keyboard or cutting vegetables, take a break every 10 to 15 minutes, stretching your wrists and squeezing them.
- Avoid monotonous activities: Do not spend too long in the same position and, if possible, change activity every 20 to 40 minutes.
- Save energy: Those who work with as little effort as possible avoid joint overload. When working out, pay attention to the right size tools: a mouse that is too big or too small can overload the joints. Install the ergonomic handlebars with the steering wheel backrest.
- Keep your hands warm: When working in a cold environment, your hands will become stiff and injured. Therefore, gloves should be worn.
- Apply watering: Cold or lukewarm water that flows from the hands into the forearm provides additional relaxation.