2024-02-22 10:54:30
For those who use computers excessively… watch out for carpal tunnel syndrome
Students and employees, who constantly use their hands to complete their work and projects, often complain of a feeling of numbness and tingling in the hands, and their complaints may reach the point of things falling from their hands, sometimes, because they are unable to grip them well. These include those in professions that require working on computers all day long, and those who constantly use their hands to the point of fatigue and exhaustion, such as farmers, truck drivers, factory workers, builders, and others. They are diagnosed with “Carpal Tunnel Syndrome”!
Carpal tunnel syndrome
What is carpal tunnel syndrome? What are the reasons for its occurrence? Can it be prevented and prevented?
Constantly working hard with your hands can cause pain, numbness and weakness, says Dr. Kristin Karim, MD, an orthopedic surgeon who specializes in finger, hand and forearm injuries at Mayo Clinic in Minnesota. Carpal tunnel syndrome is one of the medical conditions that can affect many people who work in difficult professions that depend on the hands.
Carpal tunnel syndrome is a common condition that occurs when the tunnel narrows or when the tissue surrounding the flexor tendons (known as the synovium) swells, causing compression of one of the main nerves in the hand – the median nerve – located in the wrist and as it travels across the wrist. It reduces its blood supply and causes numbness, tingling, and pain in the hand and forearm. This nerve provides sensation to the thumb, index, middle, and ring fingers, and also sends signals to the muscles around the base of the thumb.
Dr.. Christine Karim
the reasons
Studies indicate that women and the elderly are most susceptible to carpal tunnel syndrome, and that most cases result from a combination of risk factors that include the following:
* Genetics, this is likely an important factor. The carpal tunnel may be naturally smaller in some people, or there may be anatomical differences that change the amount of space allocated to the nerve – and these traits can run in families.
* Repeated use of the hand, as repeating the same hand and wrist movements or activities over a long period of time may exacerbate the functioning of the tendons in the wrist, causing swelling that puts pressure on the nerve, including environmental conditions, or workplace conditions that include repeated hand gripping or Strong, heavy machinery and vibrating hand tools.
* Hand and wrist position. Doing activities that involve extreme flexion or extension of the hand and wrist for a long period of time can increase pressure on the nerve.
* Pregnancy. Hormonal changes during pregnancy can cause swelling that puts pressure on the nerve.
* Health conditions. Diabetes, gout, rheumatoid arthritis, thyroid imbalance… are conditions commonly associated with carpal tunnel syndrome, as well as infections, lumps, and severe wrist injuries.
Symptoms
In most cases, symptoms of carpal tunnel syndrome begin gradually, without a specific injury. Many patients find that their symptoms come and go at first. However, as the condition worsens, symptoms may occur more frequently or may last for longer periods of time.
Nocturnal symptoms are very common; Because many people sleep with their wrists bent, symptoms may wake the affected person from sleep. During the day, symptoms often occur when holding something for a long period of time with the wrist bent forward or backward, as is the case when using a computer or phone, driving, or reading a heavy book. Many patients find that moving or shaking their hands helps relieve their symptoms.
Symptoms, according to Dr. Christine Karim, include:
* Numbness and tingling in the fingers.
* Swelling and discomfort in the hands and fingers.
* Weakness, especially when pinching or holding.
* Dropping things.
* Waking up during the night to shake hands.
* Feeling numb in the fingers as soon as you wake up in the morning.
Diagnosis
In most patients, carpal tunnel syndrome gets worse over time. If left untreated for a long time, it can lead to permanent hand dysfunction, including loss of sensation in the fingers and weakness. For this reason, it is important to diagnose and treat carpal tunnel syndrome promptly.
To determine if the injury is indeed carpal tunnel syndrome, the orthopedist will discuss with the patient a history of symptoms, perform an examination of the hands and wrists, and may order other tests, including:
* Sensation discrimination test when pricking at two points on the fingertips to determine which finger has weak sensation.
* Tinel’s sign test, which is done by tapping on the carpal tunnel nerve to see if it causes tingling in your fingers.
* Durkan’s test, which involves pressing your thumb once morest the carpal tunnel nerve to see if the numbness or tingling feeling gets worse.
* Performing X-rays of the affected hand, ultrasound imaging, and magnetic resonance imaging.
treatment
Although it develops gradually, carpal tunnel syndrome will worsen over time for most people who do not receive any form of treatment. For this reason, it is important that the patient is evaluated and diagnosed early, as it is possible to slow or stop the progression of the disease.
Dr. Christine Karim says that treatment methods are divided into non-surgical procedures and surgical procedures.
*First: Non-surgical procedures: for simple cases, including:
– Splinting, wearing a wrist support splint at night to prevent bending of the wrist during sleep. It is also useful to wear them during the day when doing activities that may aggravate symptoms.
– Changing or modifying daily activity, such as changing the work location.
– Nerve gliding exercises. Some patients may benefit from exercises that help the median nerve move more freely within the confines of the carpal tunnel.
– Non-steroidal anti-inflammatory drugs to relieve pain and inflammation.
– Steroid injections given into the carpal tunnel to relieve painful symptoms for a longer period, and help calm and worsen symptoms.
*Second: Surgical procedures: for severe cases, including:
– Surgical intervention to treat the syndrome with the aim of relieving pressure on the median nerve, where the carpal tunnel is incised to relieve pressure.
Surgical arthroscopy is a minimally invasive procedure, with little or no anesthesia. A small incision is made near the wrist, and a small camera is passed through the incision into the carpal tunnel. The surgeon inspects the tunnel and then uses a blade attached to a camera to cut the transverse carpal ligament — the surface of the tunnel — to relieve pressure on the nerve.
To obtain the best results following surgery, care must be taken to follow up with a hand orthopedic surgeon, especially when the feeling of numbness and tingling is still intermittent and not continuous.
*Third: The situation following surgery. For most patients, surgery will improve the symptoms of carpal tunnel syndrome. However, recovery may be gradual, and full recovery may take up to a year. If significant pain and weakness persist for more than two months, it may require switching to a hand therapist who can help maximize your recovery.
If another condition is causing pain or stiffness in the hand or wrist, such as arthritis or tendonitis, this may slow overall recovery. In long-term cases of carpal tunnel syndrome with severe loss of sensation and/or muscle wasting around the base of the thumb, recovery will also be slower. Sometimes, carpal tunnel syndrome can recur, although this is rare. If this happens, you may need additional treatment or surgery.
These are some of the recommendations of the American Academy of Orthopedic Surgeons, which has conducted advanced research in this area in order to help doctors manage carpal tunnel syndrome.
protection
Is carpal tunnel syndrome prevention possible?
*First: According to Mayo Clinic doctors, there are no proven methods to prevent carpal tunnel syndrome, but pressure on the hands and wrists can be relieved through the following steps:
– Reduce the strength of your grip and make sure it is relaxed. If your profession requires working on a cash register or a keyboard, press the keys gently.
– Take short, but frequent breaks. Extend your hands and wrists and gently bend them regularly. Switch between tasks if possible. This is especially necessary if you are using vibrating equipment or need to exert significant force. A few minutes every hour can make a difference.
– Pay attention to the position of the hand, avoid bending the wrist completely up or down. Staying in a moderately relaxed position is best.
– Improving body posture. The wrong posture when sitting in front of the screen leads to bending the shoulders forward, shortening the neck and shoulder muscles and putting pressure on the neck nerves, which affects the wrists, fingers and hands and also causes neck pain.
– Keep the hands warm, as a cold environment increases the possibility of hand pain and stiffness. If you can’t control temperatures in the workplace, wear open-fingered gloves to keep your hands and wrists warm.
*Second: Early symptoms can be alleviated with simple measures such as:
– Wear a wrist splint while sleeping.
– Exercises to maintain nerve movement.
– Avoid certain activities that aggravate symptoms.
– Steroid injections into the carpal tunnel.
However, if pressure on the median nerve continues, it may lead to nerve damage and worsen symptoms. To prevent permanent damage, surgery to relieve pressure on the median nerve may be recommended for some patients.
The final advice we offer to every reader is to consult an orthopedic specialist when feeling any of the symptoms of the syndrome to determine the best treatment, early, to maintain the health and safety of the hands in performing their functions well.
*Community medicine consultant
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