Wrist pain, beware of carpal tunnel syndrome

Did you know that carpal tunnel syndrome is a "naughty ghost" that always quietly "squeezes" the median nerve in our hands, making our hands "uncontrollable". Imagine that the carpal tunnel is like a narrow tunnel, and the median nerve is the "poor little thing" squeezed in the corner.

Our daily life and work habits are like invisible pushers, aggravating this "squeezing" again and again. Using computers and mobile phones for a long time, or keeping the wrist bent for a long time, are the culprits of carpal tunnel syndrome. You may think that this is just temporary fatigue and you can rest for a while. However, it is this negligence that gives carpal tunnel syndrome an opportunity to take advantage of.

Imagine that one day, you suddenly find that the flexibility of your fingers has been greatly reduced, and even the simplest typing has become difficult. You may be surprised, what is going on? This is the "warning" given to you by carpal tunnel syndrome. If you don't pay attention to it, the situation may get worse. Your fingers may feel numb, painful, and even affect your sleep quality.

1. Exploring the causes and the reasons behind the disease The causes of carpal tunnel syndrome are numerous and complex, among which external factors play a very important role. On the one hand, continuous or sudden external pressure may lead to scarring of the transverse carpal ligament or skin, which in turn becomes a key factor in inducing this disease. On the other hand, the volume of the lumen may be significantly reduced due to the occurrence of various pathological conditions such as endocrine diseases and wrist fractures, creating conditions for the occurrence of carpal tunnel syndrome.

In addition, the growth of abnormal proliferation tissues such as ganglion cysts and neurothectomy tumors inside the canal cavity may also lead to limited space, thereby increasing the risk of carpal tunnel syndrome. These abnormal proliferations not only affect the normal structure inside the carpal tunnel, but may also compress or stimulate the surrounding nerves, causing a series of symptoms.

More importantly, long-term occupations that require frequent use of the wrist, such as carpentry and cooking, put the wrist under high load for a long time, increasing the risk of carpal tunnel syndrome. This high load state may cause damage and inflammation of the internal tissues of the carpal tunnel, which in turn causes the disease.

Therefore, understanding and identifying the triggers of carpal tunnel syndrome is crucial to preventing and treating this condition.

2. Detailed analysis of symptoms Carpal tunnel syndrome is a common neurological disease that often affects middle-aged people between 30 and 60 years old, especially women. Once the disease occurs, the patient suffers from tingling pain, numbness and swelling in the wrist, radial side of the palm, and radial side of 3 or 4 fingers. In the silence of the night, these symptoms often become particularly severe, making it unbearable for the patient to toss and turn and unable to fall asleep.

Under the doctor's precise examination, some abnormal signs of the hands gradually appear. First, the skin sensation will become abnormal, and tactile hypoesthesia or hyperesthesia may occur. Secondly, the atrophy of the thenar muscle cannot be ignored. The weakening of muscle strength will directly affect the normal function of the hand. Finally, the weakening of the thumb's palm function is also a major symptom. Patients may find themselves clumsy when performing some hand operations.

These symptoms and signs not only bring physical pain to patients, but also may cause many inconveniences in their daily life and work. Therefore, the prevention and early treatment of carpal tunnel syndrome are particularly important in order to timely relieve the discomfort of patients and ensure their quality of life.

3. Effective methods for diagnosing carpal tunnel syndrome In the field of medical diagnosis, for carpal tunnel syndrome, a common disease, when evaluating patients, doctors will focus on the perception of the median nerve area of ​​the arm, especially the numbness and discomfort that occurs at night. In addition to the patient's self-report, doctors will also use a variety of examination methods to assist in diagnosis, such as the Phalen test (wrist flexion test), electromyography, imaging examinations, and nerve ultrasound examinations. These examination tools play a vital role in helping doctors determine whether patients have carpal tunnel syndrome. Once a patient is found to have decreased or absent finger sensation, as well as symptoms such as thenar muscle atrophy, treatment should be initiated immediately. To ensure the accuracy of the diagnosis, doctors will use these examination methods in combination, striving to provide patients with accurate diagnosis and treatment plans.

1. Wrist flexion test:

1. The wrist flexion test is an intuitive and simple diagnostic method used to preliminarily assess the functional status of the carpal tunnel.

2. After the patient flexes his wrist, the doctor will observe whether there are any abnormal reactions or signs. The doctor will ask the patient to bend his wrist to the limit and observe whether numbness of the fingers occurs within 60 seconds. However, it is worth noting that since many people feel numbness when their wrists are bent, this examination also has certain limitations.

(ii) Electrophysiological examination (electromyography):

1. Electrophysiological testing is a precise diagnostic technique that allows for detailed measurement of nerve conduction velocity.

2. It helps determine whether the nerve is damaged, the degree of damage, and the compression point, which is crucial for the diagnosis of carpal tunnel syndrome and the formulation of subsequent treatment strategies. However, it should be noted that this test may have false negatives or false positives, and it is not the only basis. When making a diagnosis, the doctor will comprehensively consider the test results and clinical manifestations to ensure that the diagnosis is accurate and reliable.

3. Other diagnostic methods:

1. Through carpal tunnel imaging, doctors can determine whether there is a change in the volume of the carpal tunnel.

2. Ultrasound testing of carpal tunnel syndrome focuses on edema and hypertrophy in the flexor retinaculum and median nerve pathway.

3. During the diagnosis process, doctors also need to differentiate it from other neurological diseases such as intracranial tumors and syringomyelia.

Taken together, these diagnostic methods provide strong support for the accurate diagnosis and appropriate treatment of carpal tunnel syndrome.

4. Diagnosis and differentiation: The symptoms of many diseases may be similar to those of carpal tunnel syndrome, such as numbness and pain in the fingers. Therefore, careful differentiation must be made during the diagnosis process to avoid misdiagnosis.

1. When making differential diagnoses, we must be alert to the two diseases of peripheral neuritis and radiculopathy. Peripheral neuritis is characterized by numbness of the fingers, usually accompanied by symmetrical sensory disturbances, which require special attention. Radicular cervical spondylotic radiculopathy is characterized by pain radiating from the neck and shoulders to the hands, and the nature of the pain is closely related to neck movement.

2. Doctors need to be particularly careful in differentiating between cervical radiculopathy and carpal tunnel syndrome. Although the two have similar symptoms, the treatments are completely different. To complicate matters, the two diseases may sometimes occur simultaneously in the same patient, making the differentiation more difficult. Therefore, doctors need to ensure an accurate diagnosis and develop an appropriate treatment plan through detailed examinations and evaluations.

3. In addition, doctors also need to identify other diseases, such as peripheral neuritis, diabetic peripheral neuritis, etc. These diseases may also cause similar symptoms, so a comprehensive and detailed evaluation must be conducted to ensure that the patient receives the correct diagnosis and treatment. Of course, the following is another continuation of the previous content:

4. During the diagnosis process, doctors also need to pay special attention to the patient's living habits and working style. Long-term repetitive movements, such as typing, operating a mouse, or doing handicraft activities, may aggravate the symptoms of carpal tunnel syndrome. Similarly, poor sitting or neck posture may also be a cause of radiculopathy.

5. For suspected cases, especially those with atypical or complex symptoms, doctors may need to invite colleagues from other professional fields for consultation. Multidisciplinary consultation can integrate the knowledge and experience of various professions to improve the accuracy of diagnosis and the effectiveness of treatment.

6. When formulating a treatment plan, doctors should not only consider the severity of the disease and the location of the lesion, but also the patient's overall health and psychological state. For some patients with underlying diseases or heavy psychological burdens, doctors need to consider the feasibility of the treatment plan and the patient's acceptance more carefully.

5. Treatment options revealed Does carpal tunnel syndrome cause you wrist discomfort? Don't worry, we have targeted treatment options for you to choose from.

1. If your symptoms are mild, we recommend non-surgical treatments. By combining medication and physical therapy, you can effectively promote recovery and get rid of your discomfort as soon as possible.

2. When pain gets worse or non-surgical treatment fails to relieve it, surgery may be a viable option. Depending on your specific situation, the doctor will perform precise surgical procedures, such as removing a cyst or cutting a ligament, to relieve pressure and relieve pain.

3. In the treatment process, combining drug therapy and physical therapy is also an effective means. For example, medium frequency electrical therapy, functional magnetic stimulation, ultrasound therapy, heat therapy, ultrashort wave short wave therapy, etc. can significantly relieve pain and promote nerve repair.

4. Rehabilitation training is an indispensable part of restoring hand function. In professional rehabilitation training programs, manual traction and joint loosening training for the small joints of the wrist occupy an important position. Once the small joints of the wrist become disordered, timely manual reduction will become very important. It can effectively help patients restore hand function and regain the convenience of daily life.

5. In addition, traditional Chinese medicine treatment methods are also worth a try. Acupuncture, cupping, and Chinese medicine that promotes blood circulation and dredges the meridians can relieve the symptoms of carpal tunnel syndrome and promote recovery. Combined with external application of Chinese medicine, it can relieve local pain and accelerate the recovery process.

6. During the treatment process, doctors need to maintain good communication and trust with patients. It is very important to answer patients' questions in a timely manner, provide necessary support and comfort, and encourage patients to actively participate in the treatment process.

VI. Prevention and Rehabilitation Tips 1. Early Detection: Learn to detect the symptoms of carpal tunnel syndrome early, such as wrist pain, finger numbness, etc., and take timely intervention measures to prevent the disease from worsening.

2. Prevention first, posture improvement: Improving and maintaining a correct posture is crucial to reducing wrist pressure and helps reduce the risk of related diseases. Improve the working environment and reduce the burden on the wrist, such as using ergonomically designed office equipment and chairs, and maintaining a correct sitting and wrist posture.

3. Take a proper rest: Properly arrange work and rest time, avoid using electronic devices for a long time and keep the same posture, which is an effective way to prevent carpal tunnel syndrome. Regularly perform wrist stretching exercises to increase wrist flexibility and blood circulation.

4. Rehabilitation plan: For patients with carpal tunnel syndrome, developing a personalized rehabilitation plan is key, including physical therapy and rehabilitation training to restore hand function.

6. Education and promotion: Strengthen health education and promotion of carpal tunnel syndrome to raise public awareness of wrist health issues. Popularize prevention and treatment knowledge through publicity, lectures, etc.

7. Regular health check-ups: Regular health check-ups are essential for your wrist health. Such checks can reveal and address potential wrist problems in a timely manner, thereby effectively preventing wrist-related diseases such as carpal tunnel syndrome. Keeping your wrists healthy is the guarantee for your daily activities and work to proceed smoothly.

In summary, preventing carpal tunnel syndrome requires us to work together in many aspects, including education promotion, early detection, work environment optimization, lifestyle adjustment and regular health checks, so as to comprehensively protect wrist health and improve the quality of life.

Author: Hui Nan, Guo Caiying (Xi'an Xianhua Rehabilitation Hospital)

Reviewer: Zhang Yan (Secretary-General of the Orthopedic Rehabilitation Committee of the Chinese Rehabilitation Medicine Association, Department of Orthopedics, Department of Traditional Chinese Medicine, Sixth Medical Center, PLA General Hospital)

Editor: Zhu Xiaoqing (Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine)