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Carpal Tunnel Syndrome
contents
- definition
- symptoms
- causes
- diagnosis
- Treatment of carpal tunnel syndrome
- Naturopathy
definition
The carpal tunnel syndrome describes a compression of the median nerve, which extends from the area of the 6th cervical vertebra to the first thoracic vertebra and extends along the inside of the upper and lower arm to the fingers. At the level of the wrist or the inside of the wrist, the nerve passes through the carpal tunnel, which is enclosed by the carpal bones and the carpal ligament. As a result of the cramped structures, compression of the median nerve, which leads to the symptoms of the carpal tunnel nerve, can easily occur here.
The carpal tunnel is characterized by discomfort and pain that can radiate from the hand to far up the arm. (Image: SENTELLO / fotolia.com) symptoms
The median nerve provides the palm of the hand and the back of the hand with the fingertips (up to the first joint) from the thumb to the ring finger. Motorically, he also innervates the flexor muscles of the forearm. He is extremely important, as he provides for the gripping function of the thumb and forefinger. According to his course and his care are also the complaints: The affected complain of discomfort and pain in the fingers and on the inside of the hand, which can radiate into the upper arm, shoulder and neck. Especially women before or during menopause are increasingly affected.
The symptoms usually appear after heavy strain on the hands or wrist and begin with numbness or tingling in the median nerve supply area. Also pain in the form of the so-called brachialgia paraesthetica nocturna (pain during the night and in the early morning hours) is a typical symptom in the Fühstadium. Likewise, sometimes a high pressure sensitivity is observed. In the further course of the carpal tunnel syndrome, muscle impairments, which are caused by the median nerve, are often seen. Particularly in the morning, the thumb, forefinger and middle finger feel stiff, the grip strength is missing, the sense of touch is limited and a pronounced numbness is noticeable. A breakdown of the musculature (atrophy) sets in and above all the Daummenballen begins to shrink clearly visibly.
In the relatively narrow carpal tunnel, compression of the nerve can easily occur, which causes nerve cell death and recurrent sequelae. An operation may be necessary here. (Image: Henrie / fotolia.com) causes
The median nerve can be squeezed and irritated in several places on its way out of the cervical spine: Muscles on the side of the neck, between the first rib and collarbone, under the small pectoral muscle, in a muscle of the forearm and in the canal on the wrist (carpal tunnel) in which also the tendons of the finger flexors run. The most common cause of nerve compression is a misuse or overuse in all places.
Thus, the carpal tunnel syndrome in most cases by heavily stressful activities with the hands (for example, in craftsmen) or prolonged bad posture (eg on long bike rides) triggered. The associated swelling of the tissue in the already narrow carpal tunnel leads to a pressure on the median nerve, which leads to a death of the nerve cells. Risk factors for carpal tunnel syndrome include anatomical impairments such as bone fractures (carpal bones, spokes), arthrosis in the wrist or tendonitis and rheumatic complaints, as well as systemic factors. Here are especially diseases such as diabetes, hypothyroidism or kidney problems. Also, an increased risk during pregnancy is considered proven.
diagnosis
One problem is that many people do not respond at the first sign and seek help, but only late in the disease when the symptoms become unbearable. Often there are long phases with sensory disturbances or tingling and "falling asleep" of the hands. Not infrequently, a doctor is consulted only when the fingertips have become so insensitive in the advanced stage that affected people can no longer perform finer work. Here, it is important to react as soon as possible at the first signs of a carpal tunnel syndrome.
On the basis of the symptoms, the diagnosis of the carpal tunnel syndrome can usually be made relatively easily. Certain tests, for example, in which the wrist is greatly bent or overstretched, can provoke the discomfort and the mobility of the thumb, index and ring fingers provide further evidence for the diagnosis. Also, the appearance of the so-called Hoffmann-Tinel signs while tapping along the nerve course is a relatively sure sign of carpal tunnel syndrome. To determine the extent of damage to the median nerve, however, a measurement of the nerve conduction velocity remains essential. In addition, imaging techniques such as x-rays and ultrasound are used to determine any anatomical causes of carpal tunnel syndrome.
The immobilization of the wrist with a splint can in many cases achieve a resolution of the discomfort. (Image: belahoche / fotolia.com) Treatment of carpal tunnel syndrome
If you react early enough, a temporary protection of the wrist is often enough to relieve the symptoms. If necessary, a wrist splint can be used for immobilization. The use of cortisone is intended to reduce tissue shrinkage during massive compression of the median nerve. With so-called nonsteroidal anti-inflammatory drugs (NSAIDs) can be addressed in severe forms against the pain and inflammation.
Not infrequently, those affected are also advised to surgically open the carpal tunnel, which will surgically separate the fascia of the carpal tunnel. Although the various types of surgery are now routine operations and will help to resolve the problem in the long term for most sufferers, they do not help all patients and it is advisable to try manual treatment throughout the nerve before surgery.
Using various surgical techniques, the carpal tunnel can be opened to relieve compression of the nerve. The chances of success are quite good here. (Image: Kenny / fotolia.com) Naturopathy
In addition to manual therapies such as osteopathy or Rolfing, various alternative methods for relieving the symptoms of a carpal tunnel syndrome are also used in natural medicine. For example, acute pain can often be relieved with cold treatment. For this purpose, crushed ice cubes can be packed in a plastic bag and wrapped with a cloth or it can be used ready-made cryo-packs from the pharmacy. Furthermore, wounds can be used, for example, based on healing clay, which should also bring about alleviation of existing inflammation. Also acupuncture with needles or with the laser is very helpful.
In order to avoid the risk of new complaints in the long term, occupational therapy is highly recommended, especially for those who occupy their wrists professionally. Thus, those affected learn to avoid errors and overloads. (tf, fp; updated 06.09.2016)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)