Carpal tunnel syndrome is currently a common disease in society. The disease has a slow progression, a good prognosis, but if the disease moves to a severe stage, it will cause dangerous complications and severely affect the quality of life. Here are certain information you need to know about carpal tunnel syndrome to take measures to prevent and control it, to avoid the condition getting worse.
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Overview of carpal tunnel syndrome
Recently, MEDLATEC Thanh Xuan General Clinic under MEDLATEC Health System received a case of NTT patient (51 years old, Hanoi) who came to check with symptoms of numbness of the right palmar face, numbness of many fingers II, III. , increased at night and increased during exercise, decreased when waving the wrist, gradually increasing.
After the preliminary examination, the doctors conducted an ultrasound of the right wrist to detect that the median nerve passing through the right wrist joint increased in size and decreased in sound. The doctor diagnosed the patient with right carpal tunnel syndrome, was treated with corticosteroid injections and monitored.
Carpal tunnel or carpal tunnel syndrome, also known as carpal tunnel syndrome or median nerve compression syndrome. The disease consists of a collection of abnormal symptoms arising from the peripheral nervous system of the hand. This condition can occur in all subjects, women account for a higher proportion.
Causes and symptoms of carpal tunnel syndrome
* Reason:
Carpal tunnel syndrome is caused by compression of the median nerve in the wrist. This median nerve is located in the carpal tunnel, palmar surface (and part of the back of the hand) of the outer three and a half fingers: thumb, index finger, middle finger, and part of the ring finger). Besides, this median nerve also helps to extend the thumb. When the wrist is operated continuously, often too often, it often leads to a narrowing of the carpal tunnel that causes the median nerve to become trapped, causing hand numbness or paralysis.
* Symptom:
Typical symptoms of carpal tunnel syndrome include:
Sensory disturbances: numbness in hands and feet, paresthesia, stinging pain from needles, or burning in the skin innervating the median nerve (thumb, index finger, middle finger, and half of the ring finger) , these symptoms manifest from the wrist to the fingers. Sometimes pain can radiate up the forearm, even into the arm.
Movement disorders: difficulty grasping, reduced hand dexterity, or dropping objects.
Symptoms can occur at any time, often appearing at night. Over time, symptoms also appear more and more severe.
Diagnostic criteria for carpal tunnel syndrome
According to the American Society of Neurology, to accurately diagnose whether a patient has a disease, the doctor will coordinate between clinical and neurophysiological exploration. Diagnosis of the disease is based on the following criteria:
At least one of the functional symptoms includes: carpal tunnel pain; hand paresthesia; hand numbness; decreased or lost sensation in the median nerve region; weakness in the neck and hands, which may occur during the day, at night, or continuously throughout the day.
At least one physical symptom including a positive Phalen, Tinel, and Durkan test.
Phalen test: Have the patient bend the wrists 90 degrees together for at least 60 seconds. The reverse Phalen test is replaced by a wrist extension. The test is positive if the patient develops or increases sensory symptoms in the median nerve in the hand.
Tinel test: Percussion on the carpal tunnel area (can be used by hand or reflex hammer), a positive test when percussion will cause numbness or pain along the skin of the median nerve in the hand.
Durkan test: The examiner directly increases the pressure at the patient's wrist by pressing the middle of the carpal crease with the thumb. The test is considered positive when the patient feels numbness, pain increases according to the nerve distribution when pressing and holding for more than 30 seconds.
At least one of the two median motor and sensory indicators of the median nerve with the ulnar nerve is higher than normal.
Besides clinical and electromyography, ultrasound is also a method widely used in diagnosis. According to MSc. BSNT Dao Danh Vinh - Director of MEDLATEC Imaging Center said: “Ultrasound is a very good adjunct and supportive method in differential diagnosis of causes of carpal tunnel syndrome-like symptoms. However, electromyography remains the most important criterion for the diagnosis of carpal tunnel syndrome.”
Treatment for carpal tunnel syndrome
The choice of treatment method depends on the patient's condition. Treatment methods include:
Medical treatment: Indicated in the early stages of carpal tunnel syndrome clinically.
Your doctor may prescribe non-steroidal anti-inflammatory drugs, or oral corticosteroids; at the same time, limit movements that cause excessive flexion or extension of the wrist to reduce pressure in the carpal tunnel;
Injecting carpal tunnel syndrome under ultrasound guidance: Allows precise drug delivery to the injection site, avoiding damage to the median nerve and blood vessels.
Physical therapy: Apply wrist splints at night or continuously throughout the day. Studies show that using a wrist brace can improve symptoms after 4 weeks of treatment.
Surgical treatment: This method is applied to patients in severe stages to prevent irreversible nerve damage.
According to MSc. Dr. Dang Van Quan - Specializing in Surgery, MEDLATEC General Hospital, patients with carpal tunnel syndrome need surgical intervention in the following cases: Medical treatment after 6 months does not help; tissue atrophy, severe electrical disorders; caused by mechanical stress.