1.What is carpal tunnel syndrome?
Carpal tunnel syndrome is also known as median nerve entrapment syndrome. The median nerve is a nerve in the upper extremity that passes through the carpal tunnel of the wrist to innervate the movement and sensation of the hand. If the nerve becomes thickened with edema (e.g., in diabetes, menopause, during pregnancy, or in patients with hemodialysis) or if the tendons surrounding the nerve become thickened (e.g., rheumatoid), the volume in the carpal tunnel becomes smaller and the nerve is compressed, resulting in symptoms. The median nerve controls sensation and muscle activity in the thumb, index finger, middle finger and part of the ring finger. It causes numbness and pain in the hand, weakness, or atrophy of the hand muscles.
2.What are the symptoms of carpal tunnel syndrome?
The most typical symptom is waking up at night (both hands) with numbness or pain. The symptoms are reduced after shaking hands. Eventually the muscles atrophy.
Early stage late stage
3.Who is prone to carpal tunnel syndrome?
Women are three times more likely to suffer from carpal tunnel syndrome than men. The reasons are 1. women have smaller carpal tunnel; 2. frequent hand activities, such as working on household chores; 3. women have more changes in hormone levels due to physiological reasons (pregnancy or menopause). The highest incidence is found in people who work mainly with their hands, most commonly women who handle poultry feathers in markets (the incidence of Raynaud’s disease is also high in this group), housewives, cleaners, etc.
4. How is carpal tunnel syndrome diagnosed?
Pain and numbness need to be seen immediately, until the muscle atrophy is treated poorly.
Diagnosis mainly relies on physical examination and electromyography. In particular, some patients diagnosed with mild cervical disc herniation or cervical spondylosis due to hand numbness should think about the possibility of misdiagnosis and carpal tunnel syndrome when traction treatment is ineffective.
5.How can patients check themselves?
Have you ever been woken up by numbness at night?
Can the symptoms be relieved by shaking the hand when the hand is numb?
Is it true that you can’t hold on to your wrist even for a minute by flexing it?
If you answer yes to all three questions, you need to go to the hospital to see a doctor.
6.How to treat carpal tunnel syndrome?
The first step is to rest and avoid moving the wrist, which can be fixed with a splint. Secondly, hormones can be injected into the carpal tunnel (closed) to reduce the inflammatory reaction in the carpal tunnel. Finally, surgery is the treatment. Because most of the causes of carpal tunnel syndrome are long-term, such as diabetes, internal rheumatism, menopause and work and life habits, so conservative treatment is rarely effective, some statistics have closed therapy 80% effective, but the relapse rate of more than 50% within three months, the reason is very simple, long-acting hormones can only deal with a moment, repeated injections eventually still need surgery, so personal tendency to rest for a period of time without relief. It is not recommended to close the hormone, because repeatedly closing the treatment will increase the adhesions in the carpal tunnel, and the cholesterol crystals precipitated by hormone preparations have been reported abroad to be harmful to the nerves. The only case that can be treated completely conservatively without surgery is hand numbness and hand pain during pregnancy, and the symptoms will disappear automatically after delivery.
7.Non-surgical treatment
Rest
Pain medication
Neurotrophic drugs
Hormonal closure
8.Surgery
Carpal tunnel syndrome is close to 300,000 cases a year in the United States, but very few cases in China. The key is that the Chinese people do not pay enough attention to it and the medical knowledge is not popular, many people already have myasthenia gravis at the time of consultation, and the effect of surgery is very poor. In fact, the damage of surgery is very small, and it can be performed under local anesthesia, with almost no bleeding, clear results, a long-term recurrence rate of less than 4%, and a low incidence of complications. Small incision open surgery is performed by making an incision of about 3 cm, severing the transverse carpal ligament and enlarging the carpal tunnel. Open surgery is still recommended for patients who require epineural release.