Carpal tunnel syndrome is a clinical syndrome caused by prolonged overactivity of the wrist, which leads to compression of the median nerve in the carpal tunnel, mainly manifesting as muscle weakness in the thumb and pain and numbness in the index and middle fingers. Symptoms may be intermittent in the early stages of the disease, and then worsen progressively, especially at night or in the early morning.
Carpal tunnel syndrome is the most common peripheral nerve entrapment disease in clinical practice, with a very high incidence.
Alias: delayed median nerve palsy, carpal tunnel syndrome, median nerve entrapment syndrome, median nerve crush at the wrist, mouse hand, keyboard wrist
Hazards
1. Pain
Different degrees of hand dysfunction
Affect work and life, resulting in loss of social and medical resources
2.Influencing factors
Occupational factors
Occupational factors are important influencing factors for the severity of carpal tunnel syndrome disease, with high incidence of heavy physical loads, poor wrist and hand posture, repetitive operations, and long hours of work.
(1) Farmers are the most severely affected group
(2) Manual laborers (excessive wrist flexion or extension)
(3) Clerical workers (highly frequent use of mouse and keyboard)
(4) Housewives (heavy housework)
3, age factor
As age increases, osteophytes further reduce the volume of the carpal tunnel, aggravating the compression of the median nerve and causing carpal tunnel syndrome.
Conservative treatment of carpal tunnel syndrome
Carpal tunnel syndrome is divided into 3 types: mild, moderate and severe. For mild and moderate carpal tunnel syndrome, conservative treatment is mostly advocated in clinical practice.
1. Rest and proper wrist exercise
Carpal tunnel syndrome itself has a certain self-healing rate. Some studies have shown that even without any treatment, 21% of patients will have their clinical symptoms relieved after 10~15 months of rest.
2.Brake fixation
Wrist brace immobilization is the most commonly used conservative therapy to relieve the pressure on the median nerve, allowing early to moderate patients to have significant improvement in their clinical symptoms.
3.Rehabilitation therapy
Rehabilitation therapy has been more often used in clinical practice in recent years.
Chinese traditional rehabilitation therapy
1.Tui na: massage around the wrist joint can relieve pain and loosen adhesions.
2.Acupuncture: Research has found that acupuncture and moxibustion have obvious advantages in the treatment of carpal tunnel syndrome. Their main effects are to improve local blood circulation, improve the function of the nervous system, and promote tissue regeneration, etc.
Nerve relaxation: Nerve relaxation can effectively promote nerve displacement, reduce scar tissue adhesions, enhance blood circulation around the nerve, promote axoplasmic transport, facilitate the elimination of inflammatory and pain-causing substances and nutrient absorption, thus reducing the mechanical sensitivity of the nerve. It can relieve the symptoms of nerve compression and pain in the affected area.
4.Intramuscular effect patch: Intramuscular effect patch improves sensory abnormalities by increasing sensory input. The intramuscular patch also plays the role of supporting or relaxing soft tissues through the different directions and tensions of the patch and the interaction between the patch and soft tissues during the limb movement, and also reduces edema, improves circulation, reduces local inflammatory reactions and alleviates pain.
5.Physical factor treatment
Cold therapy: applicable to the acute stage of the disease, can analgesic and swelling.
Heat therapy: applicable to the acute stage after the onset of pain and swelling.
Ultrasound, ultrashort wave, medium frequency pulse, etc.: clinically more common, but with limitations.
6.Exercise therapy
Intermittent active wrist movement, flexion and extension of the fingers can reduce the pressure in the carpal tunnel. Median nerve and tendon gliding exercises include two parts: tendon gliding exercises and nerve gliding exercises.
Tendon gliding exercises: 5 hand movements: extension, hook, fist, tabletop, and flat fist.
Median nerve gliding exercises: wrist in neutral position, lightly clench fist; wrist in neutral position, extend fingers; extend fingers and wrist, make hand into dorsal extension, fingers together; thumb abduction; forearm rotation back; opposite side fingers gently press the thumb.
Daily rehabilitation training
1.Wrist flexion and extension
Wrist extension action – extend the left hand, palm outward, fingers down. Hold the four fingers of the left hand in the right hand and apply force backward. Hold your breath and maintain the movement for 30 seconds. Switch to the right hand. Repeat 2 to 3 times.
Wrist flexion – Extend the left hand with the palm facing inward and fingers down. Press the right hand into the back of the left palm and apply force inward. Hold your breath and maintain the movement for 30 seconds. Switch to the right hand. Repeat 2 to 3 times.
2.Straight arm stretch
Extend your arms to shoulder level, then cross your left and right hands tightly and clasp your ten fingers. Inhale, stretch your arms upward and maintain the position for 15~20 seconds. This will enhance the flexibility of the wrists, stretch the upper back and upper chest, and reduce shoulder pain.
3.Wrist rotation
Stretch your arms flat, clench your fists, and rotate your fists inward with your arms as the axis for 15~20 seconds. After completing, do it again in the opposite direction for 1 time. This relaxes the wrist muscles, keeps the wrist flexible and relaxes the arm nerves.