The hand aches and does not obey: tunnel syndromes and methods of its treatment. Carpal tunnel syndrome (carpal tunnel syndrome)

Vitamin B12. Useful for increasing the body's defenses, reducing paresthesia and chilliness.
Vitamin B6. Restores nerve fibers, reducing swelling in the joint area and pain symptoms.
Vitamin WITH. It has an anti-inflammatory and strengthening effect, enhances the effectiveness of B vitamins.
Vitamin D3.
Vitamin E.

The most popular complexes:

“Dihydroquercetin Plus” – contains valuable natural antioxidant– dihydroquercetin , obtained from the bark of the Siberian larch. As part of the drug, the effect of dihydroquercetin is enhanced by vitamin C and vitamin E, the combined action of which helps restore blood microcirculation in the affected area of the hand and wrist.

“Osteo-vit” – contains vitamin D3 And drone brood. D3, when acting together with B6, participates in mineral metabolism body.

3. Local treatment– injection of drugs into the joint

Direct injection of medication into the carpal tunnel– most effective method treatment of carpal syndrome. To do this, a mixture of painkillers Lidocaine and Novocaine with the addition of corticosteroids is injected into the carpal tunnel with a special long needle. Most often, after introducing the medicine into the cavity, the pain will disappear.

In some cases, it may intensify, but after a day or two it will go away completely. The course of treatment is up to three weeks and consists of two injections.

If the pain does not go away at all, the procedure is repeated at two-week intervals.

4. Non-drug treatment

Besides medicinal method effects, doctors use other techniques to achieve good results. The most common impact options include: acupuncture, manual therapy and yoga.

5. Treatment of the disease that led to the syndrome

For treatment to be truly effective, care must first be taken to rid the patient of the diseases that caused carpal syndrome (if any). Otherwise, the applied techniques will not give any results, and a relapse may occur. Each type of pathology will require individual treatment:

Treatment rheumatoid diseases associated with damage to the hand joint;
Hypothyroidism requires hormone replacement therapy;
During menopause, hormonal therapy is prescribed, but provided that the woman is not yet 60 years old and her last menstruation was no later than 10 years ago;
For diabetes mellitus, treatment is used that is aimed at preventing surges in the patient's sugar level;
Chronic renal failure involves providing assistance to the patient to improve the process of removing fluid from the body or end products of protein metabolism;
At high blood pressure HPF inhibitors are used.

6. Physiotherapy

IMPORTANT: This technique cannot be used for people with contraindications (oncology, heart failure, pregnancy and other problems).

Various procedures are prescribed as physiotherapeutic treatment, for example, electrophoresis or local cryotherapy.

7. Ultraphonophoresis

The procedure is carried out in conjunction with medications and is a technique in which special ultrasonic vibrations influence the body. It leads to better penetration of drugs into cells, and also allows you to accelerate blood flow in the capillaries. With this treatment of the carpal tunnel, the vessels dilate, pain disappears and swelling subsides. As medicine Dimexide is used.

The procedure aims to reduce pain and inflammation in the treatment of carpal tunnel syndrome. One session takes up to 30 minutes, and treatment course is 8-12 sessions.

8. Shockwave therapy

This method treatment of carpal tunnel syndrome has established itself as a fairly effective and proven technique.

UVT has a complex effect on the entire body and promotes breaking up calcium deposits and uric acid , which narrow the channel when rheumatic diseases. The therapy has a positive effect on the blood supply to the affected area, allowing swelling to be relieved and the patient to be relieved of pain.

CAUTION: SWT cannot be prescribed to patients under the age of 18 to avoid problems associated with pathology of bone development.

Surgery

Surgery is recommended only when all other methods have failed. Surgery required in case when the form of carpal syndrome is advanced, and the patient experiences constant relapses or muscle atrophy.

The operation involves dissection of the carpal ligament, and in some cases, excision of scar tissue. Surgery may be open or endoscopic. The second option is more gentle a technique after which the scar is practically absent.

With open surgery, the surgeon has full access to the damaged area, which provides more opportunities to relieve pressure on the carpal tunnel.

This operation is not considered difficult, so the likelihood of complications is minimal.

As a result of numerous operations, experts came to the conclusion that it is worth giving preference to the endoscopic technique under local anesthesia. This approach requires less time for patient rehabilitation.

Diet

Proper nutrition for carpal tunnel syndrome is very important for the patient, because this will make up for the lack of vitamins, minerals and essential microelements. It is best to supplement the menu with products rich calcium And vitamin B. This will strengthen the bone and nerve tissue. Fast food should be excluded from the menu, everything fatty, fried, spicy and overly salty.

Treatment at home

If you diagnose the problem in a timely manner and begin treatment at home, then it is quite possible to exclude the development of irreversible complications. In addition to the described techniques, doctors recommend that patients engage in special therapeutic exercises for arm training. Going to the pool gives excellent results. It is important that the water is warm and covers the entire limb up to the shoulder. Also, experts recommend To do yoga, or other types therapeutic techniques aimed at developing the joint.

Even if you have mild symptoms of carpal syndrome, it is important to stop doing the work that caused the disease.

This alone will give you much more than all the pills, believe me. If you work at home (for example, at the computer) and have problems with the carpal tunnel, take a break. Do something that relaxes the tension in the channel:

Wash the dishes. Warm water perfectly relaxing.
Do a wet cleaning of the floor. Be sure to use your hands and warm water.
Wash the windows.

And be sure to do it regular physical exercise, which strengthen the joint and muscles of the wrist.

Folk remedies

Before turning to folk medicine, it's worth visiting first experienced doctor. Only he can advise on this or that folk recipe. Folk remedies may not give the desired result or even cause complications. If folk recipe can really help, it's worth trying. The most famous ones include:

Tincture from a string. The composition of string, burdock leaves, hop cones, birch leaves, verbena and elderberry flowers should be brewed in a thermos and left for 2-3 hours, and then taken 150 ml four times a day.
White clay. Dilute the white clay with water, transfer the pulp to gauze and apply to the affected area of the wrist.
Make a compress from fresh goat milk.
Tincture of cucumber and wild rosemary. Grind 2-3 red peppers and 3 cucumbers in a blender, add half a liter of water and let it brew for about a week. Rub it on your wrist: the tincture will improve blood circulation and relieve the feeling of numbness in your fingers.
Pumpkin compress. Turn the pumpkin into a mushy state and apply it to your wrist, wrapping it in cellophane.
Sea buckthorn. Grind the berries, add water and heat. Soak your hands in the broth, and then be sure to wipe them so that they do not cool down.
Pepper rub. Pour 150 grams of pepper with vegetable oil and simmer over low heat for half an hour. Once it cools down, rub it into your wrist.

Conclusion

Video with a set of exercises

Be sure to watch the video from useful exercises for treatment:

Carpal tunnel syndrome or carpal tunnel syndrome is a disease of a neuralgic nature. Included in the group of tunnel neuropathies. It manifests itself as prolonged pain and numbness of the fingers. The most common cause is prolonged compression of the median nerve between the bones and tendons of the wrist.

It occurs much more often in women than in men. The consequence of the manifestation of pain is a pinched nerve, which, in turn, can be caused by a thickening of the tendons that run very close to the nerve, as well as thickening or swelling of the nerve itself. This occurs as a result of constant stress on the same wrist muscles. Often the first ones arise discomfort at long-term operation computer mouse when the hand is in a suspended state.

In cases where a person is engaged in office work for a long time or in activities that involve high pressure on the wrists, the disease can cause a complication in the form of cubital tunnel syndrome.

Etiology

In fact, any condition or process that reduces the size of the carpal tunnel or increases the volume of tissue within the tunnel itself can cause the symptoms of carpal tunnel syndrome. The most common causes are wrist sprains, dislocations and fractures. In addition, the causes may be:

pregnancy. During this period, too much fluid accumulates in the body, which leads to swelling;
. A person develops problems with nerve fibers if this disease progresses;
changes in the functioning of the thyroid gland, in the case of extraction of half or all of the gland. The person begins to gain weight, which increases pressure on the wrist. Change hormonal levels also has an adverse effect on nerve fibers.

If a person has any of the above problems, then he will experience unpleasant and tingling sensations when:

prolonged use of force;
uncomfortable body position;
incorrect positioning or support of the wrists;
repeating the same actions with your hands;
elevated body temperature;
prolonged vibration (for example, when traveling by car or bus);
keeping the wrist suspended for a long time (working at a computer).

All of the above factors can lead to the progression of serious problems. In addition, drinking alcohol, smoking or obesity can worsen the situation.

Also, the causes of occurrence can be processes in the body, such as:

hormonal disbalance;
hereditary predisposition;
age category;
infections and fractures.

Symptoms

At an early stage of progression, carpal tunnel syndrome is manifested by trembling, itching and slight tingling. Some symptoms may appear much later, after the end of any active action wrist. The late stage of the disease is characterized by significant numbness, pain and heaviness in the hands, sensitivity in the hands decreases, and a tingling sensation in the fingers increases, which becomes unpleasant and irritating.

Often, people with carpal tunnel syndrome experience insomnia, which is associated with pain and cramps in the hand. With the most advanced syndrome, muscle atrophy is observed, the person can no longer clench his hand into a fist. His hands and arms stop “obeying” him. People exposed to the symptoms of the syndrome lose the ability to lift heavy things or use mobile phone, read a book by weight, long time devote more than 15 minutes to working on a PC, and sit behind the wheel of a car. They also have problems with fine motor skills.

Doctors note that the symptoms of the syndrome often appear during sleep. In any case, on initial stage the symptoms are temporary; changing the position of the hands and shaking them helps to get rid of the discomfort. On late stages progression pathological process Such measures are not effective and do not eliminate discomfort.

Diagnostics

The patient himself will not be able to diagnose carpal tunnel syndrome, since the average person will not be able to distinguish the usual short-term numbness from the painful syndrome. Therefore, you should visit a highly qualified specialist.

At the appointment, the doctor will conduct full examination and prescribe appropriate tests (may vary depending on the reason for the unpleasant sensations). During the examination, the doctor has the opportunity to identify:

numbness of the entire palm or some fingers - thumb, index, middle and partially ring fingers. The little finger remains unaffected, which can be a problem for specialists important factor in making a diagnosis;
swaying over the affected area. There is also a sharp manifestation of tingling in the fingertips;
the maximum degree of wrist flexion for one minute leads to complete numbness, colic or weakening of the hand muscles;

For additional diagnostic purposes, doctors may use a small current to determine the speed of nerve conduction. They also resort to radiographic examination, which makes it possible to exclude other diseases or inflammatory processes.

Treatment

Treatment for carpal tunnel syndrome is possible in several ways. The choice of one of them directly depends on the stage and symptoms of inflammation of the nerve fiber. Treatment may be:

independent, but based on the doctor’s recommendations. Typically used in most simple cases(at an early stage). To do this, use warming ointments and a fixing bandage for the wrist. It helps relieve symptoms while a person sleeps and also helps them disappear completely. TO independent methods treatment can also include a change in working conditions;
medicinal. The simplest anti-inflammatory drugs will help reduce pain and discomfort. Steroid injections have their place, but are only temporary. Some simple wrist exercises will give additional benefits;
contacting a physiotherapist. The treatment that he can offer for his part is to optimize the patient’s workplace, advise on correct position the body at work in general and the wrists in particular. Will give advice on what physical exercises should be performed to relieve symptoms and suggest methods of prevention;
surgical intervention. Such a radical method of treatment is resorted to only in case of manifestation of the most advanced symptoms when a person cannot perform practically any movements with his hand. Open surgery involves making a small incision in the transverse carpal ligament, after which the skin is sutured and the ligaments are left separated. This is an operation simple type, after which the patient can go home on the same day. Symptoms of carpal tunnel syndrome are minimized immediately after surgery. But full recovery may take from a month to a year, depending on the stage of development of the syndrome.

Prevention

IN modern society great amount conducts people most days at the computer. Therefore, the main preventive method is the correct arrangement of things in the workplace where the computer and keyboard are located. It follows from this that the main measure to prevent the occurrence of the syndrome is to adjust the height of the chair in relation to the table, which, in turn, depends on the person’s height. A work chair must have armrests. Positive effect gives a special (or maybe homemade) wrist rest. It is also important to give your joints a break for at least 1-2 minutes per hour of working on equipment.

The most effective method prevention of carpal tunnel syndrome is considered light gymnastics for a brush. Exercises are performed 10 times on each hand:

clench your hand tightly into a fist and with the same force open your palm as wide as possible;
rotational movements of each finger clockwise and counterclockwise;
clench your hands into fists and perform circular movements wrist in all directions;
bring your palms together, then move all your fingers as far as possible, and then cross them forcefully;
put your palms together, pressing tightly, and move each pair of fingers in turn;
Cross your fingers in a lock, both palms are horizontal. Bend your fingers down, thereby raising your wrists up;
alternately connect the pad of the thumb with all fingers on the hand;
join your palms in front of your chest and, without unclenching them, slowly lower your hands below waist level, and then return to the starting position;
Position your palms as in the point above and squeeze them with force.

Is everything in the article correct from a medical point of view?

Answer only if you have proven medical knowledge

Diseases with similar symptoms:

Syndrome scalene muscle- a set of symptoms that result from compression of nerves or blood vessels due to deformations in the area of the scalene muscle. Manifests pain syndrome, numbness and weakness in the neck, shoulder or arm.

Apathy is what it is mental disorder, in which a person does not show interest in work, any activities, does not want to do anything and, in general, is indifferent to life. This state very often comes into a person’s life unnoticed, since it does not manifest itself. pain symptoms- a person may simply not notice deviations in mood, since the causes of apathy can be absolutely any life process, and most often a combination of them.

Wilson-Konovalov disease is a hereditary pathology that is characterized by a disorder of copper metabolism in the human body. Moreover, this element tends to accumulate in various organs, leading to disruption of their functioning. This pathology affects both men and women. But representatives of the stronger sex suffer from it 4 times more often. The progression of the disease does not depend on lifestyle and place of residence. IN medical literature This condition is also called hepatocerebral dystrophy or hepatolenticular degeneration.

Carpal tunnel syndrome is a set of symptoms resulting from compression of the median nerve in the carpal tunnel.

The course of the disease, which is called carpal syndrome, is accompanied by weakness of the hand and numbness of the fingers. This common name neuropathic conditions in which the nerve trunk is compressed.

The nerve is located in a canal of hard tissues that protect it from external influences. However, it suffers from deformation of the canal walls, which is caused by overstrain of tendons and ligaments, causing deterioration of trophism in the tissues. If the overstrain is constant, then the tissues of the carpal tunnel become thicker, looser and more swollen.

As a result, there is no free space left in the canal and the pressure on the nerve increases. This leads to dysfunction of the nerve; it stops conducting motor signals. Sometimes carpal tunnel syndrome can be caused by swelling of the nerve. This occurs due to salt poisoning of the body heavy metals, arsenic, mercury vapor.

Causes of the disease

Carpal syndrome often occurs due to monotonous, regular load on hand.

But besides mechanical factors, there are several more:

professional activity with the same type of extension-flexion movements;
age-related changes. After age 50, changes occur in the bones and bone structures;
genetic factor. If there is a family history of arthritis, arthrosis, or osteochondrosis, the risk of the disease increases;
illnesses endocrine system. In the presence of diabetes mellitus, dysfunction thyroid gland the regenerative capacity of tissues decreases;
microtrauma of the wrists.

Before the start of active computerization of the population, carpal tunnel syndrome was diagnosed in 3% of women and 2% of men. But after computers firmly entered our lives, the disease was called occupational.

Carpal tunnel syndrome is the most common type of tunnel neuropathy. But this condition develops when various nerve trunks are infringed (suprascapular, digital plantar, median, palmar, ulnar, radial, median carpal).

Compression of any of the above nerves leads to carpal syndrome and has similar symptoms. Symptoms will increase gradually, since the disease also does not develop immediately.

At initial stage There is a feeling of slight discomfort when the joint is overloaded. As the disease progresses, the canal narrows and greater impairment of nerve function occurs.

Types of disease

There are several types of carpal syndrome.

Carpal tunnel syndrome or compression-ischemic neuropathy of the median nerve of the wrist

This syndrome most often occurs and develops on the dominant hand. It appears more often in women. Its occurrence is caused by heavy physical labor with constant overload of the hands and forearms, and congenital narrowness of the carpal tunnel.

Also leads to this disease other concomitant diseases(myxelema, rheumatoid arthritis, venous stagnation).

Previous injuries to the wrist play an important role, after which a callus forms in the wrist area. Carpal tunnel syndrome often appears during pregnancy and menopause.

A person begins to be bothered by a feeling of tingling, numbness, “goosebumps”, which are felt in the thumb, index, middle fingers, and may be in the ring finger, but never affect the little finger. The pain may radiate to the shoulder or forearm.

Because of such unpleasant symptoms the person is very uncomfortable sleeping; he has to constantly get up and shake or rub his hand to get rid of the feeling of numbness.

When lowering the hand, the pain subsides, and when raising it intensifies. Pain occurs when performing stressful work wrist joint.

Pronator syndrome

Provoked by carrying heavy loads from constant pressure on the forearm. TO characteristic symptoms may include: pain in the forearm, intensifying when writing or raising the arm up.

Characterized by numbness, a crawling sensation in the fingers and palms. There is weakness of the short muscles that abduct the thumb, and the sensitivity of the hand is impaired.

Supracondylar shoulder syndrome

It is also called love paralysis, since the disease often occurs as a result of pressure from the head of a sleeping partner on the arm bent at the elbow.

Cubital syndrome

The cubital canal is damaged elbow joint hands. Therefore, the disease is called cubital tunnel syndrome.

The damage occurs due to regular flexion and extension of the elbow joint. Often diagnosed in thin women. Also if there was an elbow injury.

Moreover, cubital syndrome can develop after sufficient a long period time. Observed painful sensations V ring finger, little finger, in the elbow area when trying to bend or straighten it. The pain worsens in cold weather.

Guyon's bed syndrome

This syndrome is caused by the constant use of a cane, crutches, and tightening screws. This type of syndrome is characterized by atrophy of the hand muscles and disorders of its sensitivity.

Diagnostics

First of all, it is necessary to exclude other diseases that have a similar picture to tunnel neuropathy. These are neuralgia, myalgia, arthrosis, arthritis.

Initially, anamnesis is collected. The doctor asks about existing diseases to differentiate carpal syndrome. Finds out whether there have been injuries to the wrist, shoulder and neck.

Will ask about the profession to understand whether carpal tunnel syndrome is caused by a result professional activity. Testing is then carried out on the wrist, hands, forearms and shoulders.

Phalen test

The patient is asked to raise the elbow to shoulder level, turn inward back wrists, making sure that the wrists of both hands touch, and in this position you should hold your hands for a minute.

If symptoms such as pain, numbness or tingling occur during the test, this indicates carpal tunnel syndrome.

In this situation it is created maximum pressure on the area of the median nerve and on the carpal tunnel. When flexing and extending the hand, the patient feels numbness, pain, and “goosebumps” in the palms and fingers.

Tinel test

The doctor taps the skin of the arm over the area where the nerve passes. If tingling is observed in the fingers, this indicates the beginning of nerve regeneration.

Cuff test

A tonometer cuff is placed on the arm and the pressure is increased slightly above normal. Hold for 60 seconds. If numbness and tingling are felt in the fingers during this time, carpal tunnel syndrome is confirmed.

Sometimes other diagnostic methods are required.

Electrodiagnostic. Record the speed of electrical conduction of the nerve.
MRI. Allows you to get detailed clinical picture state internal organs. In this case, an MRI is performed cervical spine spine.
X-ray of the wrist joint. Allows you to exclude arthrosis and the consequences of injuries.
Ultrasound. Necessary for measuring the width of the median nerve in order to perform injections correctly.

Treatment of tunnel syndromes

If symptoms are mild, carpal tunnel syndrome can be treated at home.

primary goal home treatment- providing complete rest to the sore hand, alleviating existing symptoms.

Treatment for early stages helps stop the progression of carpal syndrome and prevent irreversible nerve damage.

Home treatment

At home, you should follow a number of rules:

stop activities that cause unpleasant symptoms;
Rest your wrist more often;
apply ice to your wrist 2 times a day;
take anti-inflammatory medications as prescribed by your doctor non-steroidal drugs to relieve pain;
peace is created for the sore hand and the preconditions for nerve injury in the tunnel are eliminated. For this purpose, a splint is applied. It will help relieve pressure on the median nerve. By wearing it at night, you can fix the affected joint in a neutral position. This prevents compression of the median nerve at night during sleep. Splints may also be worn during work that aggravates symptoms. The neutral position of the wrist is considered to be straight or slightly curved. If, after a couple of weeks of treatment at home, the symptoms do not improve, or even intensify, you should consult a doctor.

Conservative treatment

Treatment of the underlying disease

If carpal tunnel syndrome is caused by other diseases, then it is worth treating them. Treatment for hypothyroidism hormonal therapy. If the syndrome is associated with professional activity, then you should change jobs. Usually after this the functions of the hand are restored.

Medicines

Treatment with vascular, analgesic, and dehydration agents is prescribed. Apply novocaine blockades, as well as blockades with hydrocortisone, lidase into the tissue surrounding the nerve or into the canal.

At the same time, anesthetics and corticosteroids are injected into the carpal tunnel. After the first injections, a person already feels great relief, and three injections are enough for recovery.

Treatment is carried out with non-steroidal anti-inflammatory drugs: Ibuprofen, Indomethacin, to relieve pain and inflammation.

Hormonal drugs that are injected into the affected area with a syringe or smeared with ointment. Calcium chloride in the form of injections to eliminate inflammation and stabilize immune system reactions.

Physiotherapy

A good effect is achieved by manual manipulation of the hand, which is necessary to restore the correct position of the wrist bones. Phonophoresis and electrophoresis help well. Applications with lidase, Dimexide + Hydrocortisone.

If conservative techniques treatments do not help, then neuro is prescribed surgery.

Operation

Surgical treatment is needed when the severity of carpal syndrome does not allow doing housework or engaging in professional activities.

During the operation, the ligament located on top of the carpal tunnel is cut. This leads to an enlargement of the canal and the pressure on the nerve is relieved.

Surgical intervention eliminates unpleasant symptoms and completely eliminates side effects. This open surgery. The minimally invasive technique consists of endoscopic dissection of the carpal ligament, performed through a small incision using a camera and special surgical instruments.

Therapy with folk remedies

Treatment of carpal syndrome folk remedies at home is aimed at eliminating all unpleasant symptoms of the disease.

Sea buckthorn infusion

Sea buckthorn berries are mixed with water. Then the resulting mixture is heated to 37 degrees. You should steam your hands in the resulting mixture for 30 minutes.

After the procedure, dry your hands thoroughly and put on warm mittens. Brushes should be treated in this way for a month, then take a break for a couple of weeks.

Ammonia and alcohol

A tablespoon of salt is poured with 50 grams of 10% ammonia and 10 grams of camphor alcohol are added. Everything is dissolved in a liter of water. The resulting product is rubbed on sore limbs or used in the form of baths. The product will help get rid of numbness in your fingers and the feeling of goosebumps.

Pepper rub

Pour 100 grams of ground black pepper into a liter vegetable oil, heat for half an hour over low heat. The warm product is rubbed into the sore hand several times a day.

Prevention

Preventive measures include a number of rules:

When working at a computer, you should use the mouse less often. If it is impossible to work without a mouse, then you need to purchase a special mouse pad with a special wrist rest.
The arm from the elbow to the hand should lie on the table. A computer chair must have armrests.
If you feel tired in the wrist area, you need to do a little exercise for your hands and give them rest. You can clasp the fingers of both hands and rotate your hands in different directions. You can squeeze a rubber ball.
Before sitting down for long periods of work that involve straining your wrists, you need to warm up your hands with gymnastics.
Avoid similar movements that lead to compression of the nerve. It is better to perform all movements with a healthy hand.
It is better to sleep on the side opposite the sore arm. This will allow the affected limb to rest.

Carpal (carpal) syndrome, although not life-threatening, does make life significantly more difficult.

Mostly life modern man itself creates all the conditions for the development of this disease.

It is no longer possible to imagine your life without a computer. Namely, its use in most cases leads to the occurrence of carpal syndrome.

But if you follow the rules of prevention and use folk remedies, you can protect yourself from this pathology or relieve symptoms if they have already begun to appear.

Moisov Adonis Alexandrovich

Orthopedic surgeon, doctor highest category

Moscow, Balaklavsky prospect, 5, metro station "Chertanovskaya"

Moscow, st. Koktebelskaya 2, bldg. 1, metro station "Dmitry Donskoy Boulevard"

Moscow, st. Berzarina 17 bldg. 2, metro station "Oktyabrskoye Pole"

Write to us on WhatsApp and Viber

Education and professional activities

Education:

In 2009 he graduated from Yaroslavl State Medical Academy specializing in general medicine.

From 2009 to 2011, he completed clinical residency in traumatology and orthopedics at the base clinical hospital emergency medical care N.V. Solovyov in Yaroslavl.

Professional activity:

From 2011 to 2012, he worked as an orthopedic traumatologist at Emergency Hospital No. 2 in Rostov-on-Don.

Currently working in a clinic in Moscow.

Internships:

May 27 - 28, 2011 - Moscow- III International Conference “Foot and Ankle Surgery” .

2012 - training course on Foot Surgery, Paris (France). Correction of deformities anterior section feet, minimally invasive surgeries for plantar fasciitis(heel spur).

February 13 -14, 2014 Moscow - II Congress of Traumatologists and Orthopedists. “Traumatology and orthopedics of the capital. Present and future."

June 26-27, 2014 - took part in V All-Russian Congress of the Society of Hand Surgeons, Kazan .

November 2014 - Advanced training "Application of arthroscopy in traumatology and orthopedics"

May 14-15, 2015 Moscow - Scientific and practical conference with international participation. "Modern traumatology, orthopedics and disaster surgeons."

2015 Moscow - Annual international conference.

May 23-24, 2016 Moscow - All-Russian Congress with international participation. .

Also at this congress he was a speaker on the topic "Minimally invasive treatment of plantar fasciitis (heel spurs)" .

June 2-3, 2016 Nizhny Novgorod - VI All-Russian Congress of the Society of Hand Surgeons .

In June 2016 Assigned. Moscow city.

Scientific and practical interests: foot surgery And hand surgery.

Carpal tunnel syndrome

Carpal tunnel syndrome (carpal tunnel syndrome) is a set of symptoms caused by compression of the median nerve in the carpal tunnel. Accompanied by numbness of the fingers and weakness of the hand.

The carpal tunnel is quite narrow. The lower and two side walls are formed by the bones of the wrist. Top part The tunnel is covered by a dense carpal ligament (transverse carpal ligament).

Passes through the carpal tunnel median nerve, finger flexor tendons. The median nerve carries sensory branches to the first three fingers and half of the fourth, as well as motor branches to the short muscles of the first finger.

Causes of carpal tunnel syndrome

Carpal tunnel syndrome occurs when the tissues surrounding the flexor tendons in the wrist become swollen and put pressure on the median nerve. These tissues are called synovial membranes. IN synovial membranes a fluid is produced that lubricates the tendons, facilitating their movement in the tendon sheaths.

Many things contribute to the development of carpal tunnel syndrome:

Heredity is the most common factor in carpal tunnel syndrome.
Hormonal changes associated with pregnancy or menopause can cause water retention in the synovial membranes.
Age - the disease is more common in women after 50-55 years.
Some systemic diseases may cause. Such as diabetes, rheumatoid arthritis, thyroid dysfunction.

Fragment of the program “Health”. Tunnel syndrome (from Youtube.com)

Other factors that can lead to carpal tunnel syndrome include:

Fragment of the program “Miracle of Technology” (from Youtube.com)

Rheumatoid arthritis
Bone fractures and arthrosis of the wrist joints
Cysts or tumors that grow in the carpal tunnel area
Infections

Signs and symptoms of carpal tunnel syndrome:

Symptoms of Carpal Tunnel Syndrome may appear at any time. Numbness in the fingers often occurs during sleep. During the day, symptoms often occur when the patient is holding something in his hand: a phone, or while reading a book, or while driving. Changing the position of your hands or shaking your hands helps reduce symptoms.

Symptoms initially come and go, but over time they can become constant. Feeling awkward or weak may limit fine finger movements, such as difficulty buttoning a shirt, tying shoelaces, etc. This condition may affect the patient's professional activities.

During the examination, the doctor may determine:

Numbness in the palm thumb, index, middle finger and half of the ring finger.
Tapping the carpal tunnel area usually results in “shooting” in the fingers (this is called Tinel's sign)
Maximum wrist flexion for 60 seconds usually results in numbness, tingling or weakness (called the Phalen test)

Additional diagnostic methods:

Electroneuromyography (ENMG)
Nerve conduction velocity
X-ray of the wrist joint is performed to exclude other diseases (for example, arthrosis, consequences of injuries)

Treatment for Carpal Tunnel Syndrome

Exist following methods Treatment of tunnel syndrome (carpal tunnel syndrome):

1. Conservative treatment

If the disease is diagnosed and treated in the early stages, carpal tunnel syndrome can be relieved without surgery.

If conservative methods are not effective within 6 months, surgical treatment of carpal tunnel syndrome is recommended.

2. Surgery

The decision to undergo surgery is based primarily on the severity of symptoms.In more severe cases, surgery is performed immediately, because conservative methods of treating carpal tunnel syndrome are unlikely to help.

Exists traditional method operations - “open”, when the skin is incised directly above the carpal ligament. And there is a minimally invasive technique that is performed through a mini access using a camera and special instruments.

Surgical technique.In most cases, the operation is performed on an outpatient basis.conditions under local anesthesia.

During the operation, the carpal ligament (transverse carpal ligament) is cut, thereby decompressing the median nerve.

Recovery. Minor pain, swelling, and stiffness in the hand can be expected after surgery. To reduce possible postoperative consequences, we will develop customized rehabilitation programs, including a whole range of measures for high-quality restoration of hand function.

Minor pain in the palm usually persists for several months after surgery. This time is needed nerve fibers recovery.

Driving and your daily activities may be allowed by the doctor within a few days after the operation. The doctor will also determine when you can return to work.

Long-term results.Most patients' carpal tunnel syndrome symptoms improve immediately after surgery, but full recovery may be gradual.

Full recovery can take from 1 month to a year, if the disease has a long history and severe symptoms.

Read also the article about the disease:Dupuytren's contracture.

Don't self-medicate!

Determine the diagnosis and prescribe correct treatment Only a doctor can. If you have any questions, you can call orask a question about .

Pain and other symptoms originate in the median nerve, which provides sensation to the fingers and controls the thumb.

Causes of carpal tunnel syndrome

The immediate cause of carpal tunnel syndrome is compression of the median nerve at the wrist, where the nerve passes through a tunnel (carpal tunnel) formed by the carpal bones and transverse carpal ligament. Various situations can lead to inflammation and swelling within the joint, tendons, and muscles inside the carpal tunnel. This is most often a job that requires frequent, repetitive movements. Computer workers, typists, pianists and meat packers are especially susceptible. Other conditions include:

Or other rheumatic conditions affecting the hand and wrist area;
- wrist injury;
- activities that require a strong grip or grip;
- pregnancy or use of contraceptives (in both cases, fluid retention and swelling of the hands are possible);
- tumor of the median nerve;
- diabetes;
- diseases of the thyroid gland;
- (rare disease, characterized by pathological enlargement of the hands).

Symptoms of carpal tunnel syndrome

Diagnosis is based on motion analysis, which triggers symptoms if there is compression of the median nerve in the carpal tunnel area. The presence of carpal tunnel syndrome is indicated by positive tests Tinel (light tapping over the passage of the median nerve in the wrist, accompanied by a tingling sensation in the fingers and palm) and Phalen (with maximum flexion in the wrist for about 3 minutes, mild pain and tingling occurs on the palmar surface of the thumb, index, middle and partially - ring fingers).

In the initial stage, symptoms arise and are vague morbid character for several months. When they first appear, they do not arouse suspicion, and health care only required when they become more pronounced. Symptoms become constant and are characterized by severe pain. If left untreated, the muscles of the thumb gradually weaken and deplete.

Complications

From a medical perspective, carpal tunnel syndrome is not a serious health hazard, but it can significantly limit daily activities and may require changes in work patterns. It is recommended to begin treatment promptly to avoid permanent nerve damage.

What can you do

You should distribute your activity throughout the day in such a way as to avoid situations that may provoke the syndrome. For example, if you write or type, the hand will be in a bent state for quite a long time, which creates additional pressure on the median nerve. It is necessary to take regular breaks and keep the wrist area at rest. By doing homework Ironing should be avoided.

If swelling in the wrist area is associated with the use of oral contraceptives, then other methods should be considered.
If you experience symptoms consistent with carpal tunnel syndrome, see your doctor as soon as possible. At early diagnosis and timely treatment is started, there is a possibility of complete recovery. Delaying treatment, however, increases the risk of permanent nerve damage. Aspirin or other NSAIDs. If these drugs are ineffective, cortisone injections can be used.
If conservative treatments fail, surgery may be required to avoid nerve damage (surgery involves widening the carpal tunnel and releasing the median nerve).