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What is carpal tunnel syndrome?

carpal tunnel syndrome

Carpal tunnel syndrome is a median nerve that is pinched and inflamed. It manifests itself in a violation of the sensitivity of the hands and a gradual loss of motor activity. The cause of the disease is compression of the median nerve in the anatomical canal.

Vessels, nerves, synovial membranes, tendons pass through the carpal canal. Here is the median nerve, the main nerve of the hand, which runs from the brachial plexus to the fingertips. Responsible for coordinating movement, fine motor skills of the hands, constriction, and expansion of blood vessels from external stimuli, regulates the work of sweat glands. The width of the canal is limited on three sides by the bones and the transverse ligament.

The carpal tunnel itself is quite narrow, which contributes to the formation of various pathologies. Any additional narrowing entails squeezing the nerve fibers and blood vessels; blood supply is disrupted. Pathological processes proceed slowly, begin with a loss of physiological sensitivity, and lead to motor and trophic disorders. The clinical picture of the disease has clear symptoms, which makes it easy to make a diagnosis even at the initial stage.

Tunnel syndrome symptoms

  1. Decreased brush sensitivity. At first, patients begin to notice numbness in the fingers immediately after waking up. Over time, the periods of paresthesia increase, and feelings of burning, pain, cold, or heat are added to it. Carpal tunnel syndrome is characterized by a simultaneous, radically opposite change insensitivity. In one area, it rises, but the other part of the palm does not feel anything.
  2. Burning pain in palms, with shooting in fingers. Initially, pain is felt in the zone of the pinched nerve; then, it gradually begins to affect the entire arm from the shoulder to the fingertips. This is accompanied by swelling of the wrist. As a rule, the dominant hand hurts the right hand in the right-hander, the left in the left-hander, but there are also bilateral symptoms.
  3. Muscle weakness and impaired motor activity. As a result of prolonged pinching and inflammation of the nerve fibers, the hand loses muscle strength, restricting movement. It becomes difficult to handle small objects, as when buttoning up. The function of grasping and then holding objects weakens. A gradual decrease in the working capacity of the hand leads to muscle atrophy and deformity of the hand.
  4. Lesions of the autonomic nervous system. This is expressed in a pale and sometimes cyanotic color of the hand, dry skin, brittle nails, cold hands.

Naturally, carpal tunnel syndrome affects the general physical and mental state of the patient. He loses his ability to work, the quality of life decreases. Regular pain and constant discomfort increase at night, which interferes with normal sleep, causing insomnia.

A characteristic feature of this disease is that the patient can relieve discomfort on his own without resorting to medications. It is enough to put your hands down, move your fingers, shake your hands, stretch them, do massage, gymnastics. These manipulations help restore blood supply, but, unfortunately, not for long since they do not eliminate the causes.

Carpal tunnel syndrome diagnostics

Carpal tunnel syndrome diagnostics

It is easy to diagnose this disease; it is enough to interview the patient and conduct several tests since carpal tunnel syndrome has vivid distinctive features. Among them are the symptoms described above and the preservation of the functions of the little finger, which is not affected when the nerve and blood vessels in the carpal canal are pinched.

The doctor also conducts palpation and the following tests:

  • Hoffman Tinel test. Tapping the median nerve area. With carpal tunnel pathology, the patient feels numbness, tingling, burning with his palm.
  • Phalen’s test. By maximally bending the hand at the wrist joint, the patient feels pain and numbness in the palm.
  • It is difficult to hold the arms raised above the head for more than 1 minute; pain syndrome and numbness of the extremities begin.
  • It is impossible to connect (touch) the thumb with the little finger.

To determine the degree of damage and associated complications, additional examinations are prescribed to confirm the correctness of the diagnosis:

  • Electroneuromyography to assess the conduction of nerve impulses is the gold standard for diagnosing tunnel syndrome.
  • Ultrasonography helps detect damage and inflammation.

A neurologist, physiotherapist, and hand surgeon can diagnose and treat.

Treatment for carpal tunnel syndrome

Treatment for carpal tunnel syndrome

All measures aimed to eliminate the cause of the disease, complete or partially eliminate the median nerve’s compression. The method of therapy depends on the severity of the tunnel syndrome: it may be conservative and surgical treatment. Also, the doctor’s tasks include identifying the cause of the disease’s onset to limit movements that worsen the symptoms.

Conservative treatment 

Patients are prescribed wearing an orthosis, which keeps the wrist joint in a safe position for blood vessels and nerves. It is recommended to wear it constantly, during the day and at night. According to statistics, orthotics are effective in the early and middle stages of the disease. It is recommended to switch to a salt-free diet and limit fluid intake to reduce swelling.

Medications are also prescribed:

  1. Non-steroidal anti-inflammatory agents to reduce pain and inflammation.
  2. Oral or injectable corticosteroids to relieve pain and restore joint mobility.
  3. Vascular drugs to improve tissue blood supply.
  4. Diuretics to relieve swelling.
  5. Vitamin B6 relieves symptoms and increases the effectiveness of treatment.

Physiotherapy, electrophoresis, UHF, magnetotherapy, and other methods help speed up tunnel syndrome therapy to achieve a positive result faster. Physical therapy and massage are often prescribed. The complex combination of these therapy methods and the use of medications leads to remission in 59% of patients. The rest are forced, on average, after 1-2 years to turn to a wrist surgeon for an operation.

Surgery treatment

If conservative treatment is ineffective and if the disease is neglected, a surgical operation is prescribed. They are dealt with only by hand surgeons, narrow-profile specialists who conduct surgical aids on the hand. The purpose of the operation is to release the median nerve, relieve pressure. There are two ways to open the carpal tunnel:

  1. Open surgery, in which an incision is made in the wrist. Having gained access, the surgeon dissects the ligament, increasing the volume of the carpal tunnel.
  2. Endoscopy has a shorter incision length but is performed in two places. They are necessary for the introduction of a micro camera, using which the ligament can be dissected.

Both types of surgery are performed under local anesthesia. Sometimes excision of tissue around the nerve and tendons is required, with cicatricial changes, ovaries, and strands. On average, the procedure is carried out within 20 minutes.

At first, the patient may feel pain in ​​the scars and physical weakness in the wrist. It will take several months to recover fully; the period is individual in each case. Rehabilitation consists of gymnastics, massage, physiotherapy. During the recovery period, many have to give up their activity if it affects recovery.

According to statistics, up to 90% of patients who underwent surgical treatment completely restore the physical activity of the hands and get rid of the symptoms of carpal tunnel syndrome. Relapses occur in 8-12% of cases.

Alternative treatments 

You can relieve the symptoms of tunnel syndrome without medication and surgery. This requires:

  1. Reduce the stress on the hands and wrists, exclude activities that worsen the condition.
  2. Fix the arm with a splint, orthosis, or an elastic bandage to restrict movement.
  3. Remove swelling with ice, limit fluid and salt intake.
  4. Perform arm gymnastics aimed at stretching the joints. We recommend exercising under the supervision of a physiotherapist.

If there is no improvement, then you should not delay seeking medical attention.

Carpal tunnel syndrome is not life-threatening; it is a slowly ongoing pathological process. The disease has a favorable prognosis for recovery, but some people are in no hurry to visit a doctor due to the neglect of their health. Over time, this leads to decreased motor activity, muscle strength, and fine motor impairment. If left untreated, irreversible processes will begin, the median nerve will atrophy. This will lead to the loss of the functionality of the brush, which will no longer be possible to return.

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Lone Star Neurology
4.4
Based on 659 reviews
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Edward Medina
Edward Medina
15:34 30 Jun 22
Just such an amazing staff that makes you feel like part of their family. I’ve been going there for over 5 years now... and each visit I get the very best care and treatments that I have ever received in the 20+ years that I’ve been dealing with severe debilitating migraines. Since i started seeing them the number of my migraines has dropped from 15-20 a month to 2-3 every 3 month. I highly recommend them …they will change your life!read more
Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been prepared.read more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well together.read more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your business.read more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
Steve Nabavi
Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any cookies.read more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going there.read more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my treatment.read more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to finish.read more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 stars.read more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his staff.read more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best treatment.read more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my doctor.read more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding solutions.read more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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