Carpal tunnel syndrome, or, differently, carpal tunnel syndrome – this is clamping, swelling, or pinching of the nerve that controls the sensitivity of the palm, thumb, index and middle fingers. Symptoms this disease can be very painful.
Carpal tunnel syndrome is a very common disease, especially among women: about 10% of all the weaker sex members on our planet face it during their lifetimes. Men also suffer from this disease, but very rarely – about 10 times less often than women.
Carpal tunnel syndrome can occur at any age, but most often this disease begins during the period of hormonal adjustment of the body, after 40-45 years. At the age of 30 years, carpal tunnel syndrome is very rare, about 15 times less than in the age group of 40-60 year olds.
The disease develops most often gradually. Usually, one hand suffers first, as a rule, the dominant one (the right one in right-handers and the left hand in left-handers). Over time, the second hand can join it, but the dominant one still, as a rule, suffers much more than the other hand.
At the onset of the disease, most patients complain of numbness in the fingers in the morning, immediately upon waking. By noon, this condition usually passes.
A little later, the above complaints are added nocturnal numbness in all fingers except pinky, as well as pain, nstabbing or burning in these fingers. Moreover, the fingers do not hurt in separate joints, as with polyosteoarthrosis of the hands, but entirely along the entire length – from the tips of the fingers to their base. Sometimes numbness, burning and pain spread to the whole palm, to the wrist or to the elbow. Very often, these symptoms are so pronounced that they disturb the sleep of the sick: every night at 3-4 hours a person wakes up from pain, burning or numbness in his hands.
Fortunately, in many cases, pain, burning and numbness pass quickly, if you lower your hands and move them, that is, thus improve blood circulation in your fingers. However, in the morning the discomfort, albeit to a lesser extent, usually reappears.
Over time, “day complaints” are added to the night and morning symptoms: the sick person has severe numbness and pain in the fingers if he (or she) holds his arms for a long time. For example, reading a book or newspaper, holding them in front of him; talking on the phone; when driving in public transport for more than 2–3 minutes, holds a hand raised up, holding the handrail, etc. Weakness and clumsiness hands: A sick person becomes more difficult to hold small objects in her fingers, such as a needle, a pin, a ballpoint pen, etc. Objects often fall out of their hands against their will.
In the future, with severe damage to the median nerve, a noticeable is added to the numbness, tingling, burning sensation and pain. reduced finger sensitivity, up to a complete loss of sensations from a light touch, pinprick, etc. In addition, some people have different reactions to a change in ambient temperature, for example, to cold – when the temperature in the hands changes, painful numbness or burning occurs. In one third of the cases, as the disease progresses, even skin discoloration: hands look paler than usual.
In some cases, a strong compression of the median nerve in the carpal canal leads to the fact that pain and numbness go not only to the fingers, but spread up the arm, to the elbow, and sometimes higher up to the shoulder or neck. Such a proliferation of symptoms confuses doctors and leads to diagnostic errors: doctors in such situations often diagnose cervical osteochondrosis with radicular syndrome (because the symptoms are very similar) and prescribe appropriate osteochondrosis treatment. And then they are puzzled for a long time when such treatment fails.
A case from the practice of Dr. Evdokimenko.
At the dawn of my medical practice, a 45-year-old woman came to work as an accountant complaining of burning pain all over her right arm – from the tips of the fingers to the shoulder. At the time, many doctors knew almost nothing about carpal tunnel syndrome, because the disease was not as common as it is now. And because the doctors of the clinic, where the woman had previously applied, diagnosed her with osteochondrosis of the cervical spine with radicular syndrome.
By the time of the appeal to me, the woman had already managed to treat her “cervical osteochondrosis” in two clinics, but to no avail. Despite this, I started therapy with the same diagnostic error: I began to put in order the cervical and thoracic spine (in fairness, I must say that the patient’s neck was in fact not quite in order – a sedentary lifestyle affected). However, after spinal therapy, the woman noted that yes, the neck and head began to spin better, the shoulders became looser, but the arm still hurts. Then I realized that in this case something did not correspond to the established diagnosis, and sat down at special medical reference books.
In the end, I found in one of them a new article on the ways of spreading pain in carpal tunnel syndrome, and the picture became clear to me. Taking into account the therapeutic manipulations that have already been done, we only had to give the patient only one (!) Injection into the carpal canal region, as the pain abruptly subsided. In the following days, the patient took vasodilators, made compresses with dimexide on her wrist, and after two weeks we noted an almost complete recovery. Discomfort in the hand of a woman no longer repeated.
Article of Dr. Evdokimenko © for the book “Pain and numbness in the hands” Published in 2004, edited in 2011. All rights reserved.