Q1 “What is carpal tunnel? What is carpal tunnel syndrome?”
The carpal tunnel is a fibrous canal made up of the carpal bone and the flexor retinaculum. The former forms the radial, ulnar, and dorsal walls of the carpal tunnel, while the latter forms the volar wall. The top of the carpal tunnel is the flexor retinaculum that spans between the ulnar hamate and triquetral bone and the radial scaphoid and trapezium. The median nerve and flexor tendons pass through the carpal tunnel (flexor hallucis longus, 4 superficial flexor digitorum, 4 profundus flexor digitorum).
Epidemiological Investigation:
It is more common in middle-aged and elderly women, and men often have occupational medical history. The bilateral disease can be as high as 30% in the affected population, and among them, menopausal women account for 90% of the bilateral disease.
Q2 Why do you get sick?
Any factors that affect the necessary space for the median nerve in the carpal tunnel may lead to carpal tunnel syndrome. These factors include fractures, dislocations, local hematomas, etc. caused by wrist trauma, as well as occupational factors, long-term use of the wrist for repetitive movements. In addition, basic physical problems such as obesity and changes in hormone levels are also risk factors for this disease.
Q3 The main harm of this disease?
As the disease progresses, without intervention, it will lead to nerve damage and muscle atrophy in the hand, and in severe cases, it can cause permanent loss of some functions of the hand.
Q4 How to treat?
Clinical treatment methods are divided into non-surgical treatment and surgical treatment. Including wrist brace immobilization, local drug injection, oral drug management, physical therapy, decompression through surgery, etc.
►Notes on life
The patient should avoid repeating the same movement of the hand. Try not to play mahjong, knit sweaters, ride a bicycle for a long time, do not twist hard when washing clothes, choose light cookers, etc.
If the nature of work is mainly wrist activities, patients should pay attention to hand rest, and take a few minutes of rest every half an hour to relax their hands and learn to rest properly. Attention should be paid to using the mouse correctly during work and keeping the wrist in a normal biomechanical state during work.
►►►Rehabilitation
1. Drug treatment: In the acute stage, local injection of corticosteroids is performed at the compressed area to reduce local inflammation and edema;
2. Other treatments: early wearing carpal tunnel brace for fixation treatment, reducing repetitive flexion, extension and rotation of the wrist in daily life;
3. Physical factor therapy: The treatment process can be combined with ultrasonic therapy and computer intermediate frequency therapy to increase local blood flow and tissue metabolism;
4. Rehabilitation training: stretching training including flexion and extension of the wrist joint and stretching of the radial and ulnar muscles, 15s*3 per group;
5. After the pain is relieved, perform resistance training in all directions of the wrist joint for 10s*10 times/group;
6. Finger joint grasping and tendon sliding training 3*10/group;
7. Traditional rehabilitation treatment: Carpal tunnel syndrome belongs to the category of "arthritis" in traditional Chinese medicine. Acupuncture, massage, traditional Chinese medicine fumigation and other methods can be used for treatment to achieve the effects of warming and dredging meridians, promoting blood circulation and removing blood stasis, and expelling wind and dampness.
