People who work a lot at the computer, or those who, due to the nature of their activity, often have to bend and unbend their wrist (playing the piano, cello, construction work, sports, etc.) often face such a problem as carpal tunnel syndrome, which arises from excessive squeezing or pinching the median nerve. The most susceptible to carpal tunnel syndrome are people with somatic diseases. In addition, women have this problem more often than men, since they have a narrower carpal tunnel.

Although carpal tunnel syndrome is not a health hazard, the condition negatively affects the quality of life and work. In some cases, it may even be necessary to change the type of activity. Therefore, at the first signs of illness, you must consult a doctor.

Causes of the disease

The causes of this disease include the following factors:
- professional activity a person associated with constant monotonous hand movements;
- various injuries, fractures, dislocations of the hand, as a result of which the median nerve is compressed;
- stagnation of fluid in the body due to pregnancy or taking hormonal contraceptives;
- genetic predisposition;
- diseases of the thyroid gland;
- diabetes;
- inflammatory and rheumatic diseases of the hand;
- abnormal bone growth (acromegaly).

Symptoms of the disease

The first symptoms of the onset of the disease are pain, tingling, burning and numbness of the fingers. At first, they appear from time to time and quickly disappear, but after a while the patient begins to feel them constantly. With the further development of tunnel syndrome at night, pain occurs in the fingers, which can radiate to the forearm and elbow joints... After rubbing or shaking the brush, the discomfort disappears. In addition, the patient's fingers may become less sensitive, muscles become weaker, and it becomes difficult for a person to hold small objects.

Diagnosis of carpal tunnel syndrome

It is difficult for a non-specialist to diagnose neurological diseases, the symptoms of which are similar. And only an experienced doctor will be able to make the correct diagnosis on the basis of a survey and examination.

Diagnosis of carpal tunnel syndrome mainly consists of three tests:

1. Tinel's test. With a light tap on the wrist from the inside, the patient feels tingling in the fingers.

2. Phalen's test. If, when flexing and extending the hand for less than one minute, the patient begins to feel pain and numbness in the palm and fingers, then the diagnosis of carpal tunnel syndrome is confirmed.

3. Cuff test. The cuff of the blood pressure monitor is placed on the patient's arm. When pressure is pumped in it slightly above normal and held for about a minute, a person with this disease feels numbness and tingling in the fingers.

Other research methods may be required, such as:

1. Electrodiagnostic, during which the speed of electrical conductivity of the median nerve is measured and recorded.
2. MRI - a method that allows you to get a detailed picture of the state of human organs without internal interference using magnetic waves. In this case, take pictures cervical spine.
3. X-ray - research using radiation. This method is used to take pictures of bones.
4. Ultrasound - a method that uses sound waves to measure the width of the median nerve. This may be needed, for example, to guide injections for conditions such as carpal tunnel syndrome.

Treatment

First of all, it is necessary to treat neurological diseases that underlie the formation of the tunnel syndrome. For example, with hypothyroidism, replacement therapy is carried out, while the restoration of disturbed functions occurs quite quickly. A different method of contraception is offered for women using birth control pills. If, due to occupational stress, carpal tunnel syndrome occurs, treatment involves a change in the type of activity.

Physiotherapeutic methods give a good effect: electrophoresis with nicotinic acid, phonophoresis with hydrocortisone, laser therapy, mud therapy.

For successful treatment, it is recommended to limit the load, to give the affected arm a rest for at least a couple of weeks. In some cases, a splint is applied to the wrist to prevent flexion. As anesthetic and anti-inflammatory drugs, drugs such as aspirin, ibuprofen, diclofenac, nimulide, etc. are used. To reduce swelling of the hands, cold compresses are applied, and diuretics are also used.

Good results are obtained by manual manipulations over the hand, which are carried out in order to restore the correct position of the bones of the wrist, as well as the introduction into the carpal canal of a mixture of an anesthetic (lidocaine, novocaine, etc.) with a corticosteroid hormone (diprospan, hydrocortisone). Usually, after the first injection, the patient feels significant relief. For recovery, as a rule, three injections of the medicine are sufficient.

In situations where carpal tunnel syndrome is chronic and persistent, surgeons recommend surgery.

Surgery

The operation is performed under local anesthesia in a day hospital.
There are two ways surgical treatment: endoscopic procedure or open surgery. Depending on the patient's condition, the doctor decides what kind of intervention is needed. In open surgery, the skin is cut from the wrist to the palm and the ligament of the wrist is excised, which limits the space in which the median nerve is located. After all the necessary manipulations, stitches are applied to the wound.

Endoscopic surgery is no less effective, in addition, with such an intervention, the scar is not particularly noticeable. Using an endoscope, which is inserted into the skin incision, the surgeon excises the ligament.

Postoperative period

To avoid edema, keep the operated arm in an elevated position. Special exercises will help to improve the mobility of the fingers. After the anesthetic wears off, the sensitivity of the hand will gradually recover.

Self-absorbable sutures applied to the wound disappear within 10 days. If the stitches were performed with non-absorbable sutures, they will be removed at the clinic in 10-14 days.

The rehabilitation process takes about two months. Most patients after surgery return to their usual way of life. For a person with carpal tunnel syndrome, surgical treatment completely relieves the symptoms of the disease, relapses are very rare.

Folk remedies for the treatment of tunnel syndrome

Home remedies have been used by people for many years to treat conditions like carpal tunnel syndrome. Symptoms will not bother you if you work to change your position and take a break for 15 minutes. If your muscles rest more, then your health will improve. You can do simple exercises, such as squeezing a rubber ball. Applying ice to the wrist area is not a bad effect. In some cases, various herbs are used for treatment, the use of which can help relieve pain in the fingers. Of course, before this you need to consult a doctor.

Infusion of cucumber and wild rosemary

Excellent folk remedy, which helps to normalize blood circulation and relieve numbness in the fingers. Pickled cucumbers (3 pieces) must be cut into small pieces and mixed with three pods of red pepper. All this is filled with vodka (0.5l). The infusion must be placed in a dark place for 7 days, then strain and rub the sore wrist.

Sea buckthorn treatment

The sea buckthorn remedy is good for treating pain in the hands of people with a condition such as carpal tunnel syndrome. The treatment is as follows. The berries are kneaded and mixed with water. The resulting mixture should be opaque. Then you need to warm it up to 37 degrees and steam your hands for half an hour. It's a good idea to do a light massage before doing this.

After the procedure, hands must be thoroughly wiped and insulated. You can use woolen mittens or gloves. Treatment is carried out within a month, then you need to take a break for two weeks.

Pumpkin compress

A wonderful remedy that can alleviate the patient's condition is pumpkin. A pumpkin porridge compress is applied to the sore arm, wrapped in cellophane on top and wrapped in a warm woolen scarf. These warming wraps are done once a day. The duration of treatment is five to six days.

Treatment with ammonia and salt

From numbness of fingers and burning sensation with tunnel syndrome, such a remedy relieves: a tablespoon of salt, 50 grams of ten percent ammonia and 10 grams of camphor alcohol, dissolve in 1 liter of water.

Pepper-oil rubbing

Ground black pepper can fight carpal tunnel syndrome. How to treat using this remedy? The recipe is simple: pour 100 grams of pepper in a liter vegetable oil and heat over low heat for at least half an hour. The resulting product is rubbed in warm form into the affected joint several times a day.

Lingonberry broth

Relieves pain in the hands and swelling of such a folk remedy as lingonberry decoction. Plant leaves (a few teaspoons) need to be poured with water (one glass) and boiled for 15 minutes. The product removed from the stove must be filtered. Drink one sip several times a day.

How to reduce puffiness

Swelling is another unpleasant symptom of a condition such as carpal tunnel syndrome. Treatment consists in the use of diuretic infusions. Drinking an infusion of parsley roots gives excellent results. One tablespoon of raw materials must be poured with boiling water (0.5 l) and left to infuse until morning. Healing infusion is drunk during the day by sip.

A similar effect is produced by a remedy made from white birch leaves. Pour boiling water over a few tablespoons of the leaves (one glass) and brew for about three hours. The infusion should be consumed in four doses, 1/3 cup before meals.

Bearberry has excellent diuretic and anti-inflammatory properties. The medicine is prepared in this way: the leaves of the plant (1 tablespoon) are brewed with one glass of boiling water for several hours. The remedy is drunk in a tablespoon several times a day.

Prevention of Tunnel Syndrome

To reduce your chances of developing a condition such as carpal tunnel syndrome, consider the following guidelines.

When working on the computer, give preference to the touchpad, trying to use the mouse less often. If it is impossible to refuse to use the mouse, try to keep the brush straight while working. Pay attention to the position of the hand - from the elbow to the hand, it should lie on the table.

Use comfortable models of a mouse and keyboard, a wrist rest will be a good purchase, which will reduce tension in the hand when working. If you have to spend a lot of time at the computer, switch your chair for one that has armrests.

If you often type on the keyboard of a laptop or netbook, connect a keyboard from a desktop computer to them from time to time.

If you start to feel tired, take a short exercise to rest your hands. Squeeze and unclench your fingers a few times, do rotational movements hands in different directions, clap your palms, interlock your fingers. You can keep a toy on your desk that will remind you to warm up and can be used for gymnastics. Rosary beads are great for this purpose, sorting through the beads one by one you will relieve tension in your hands. You can roll two balls in the palm of your hand.

If you know that you will have to load your wrist for a long time, pre-warm your hands by doing gymnastics. You can make a hot water bath.

Carpal tunnel syndrome makes life much more difficult. In most cases, we earn it by doing our usual business. Using our advice, you can protect yourself from this pathology or alleviate your condition if the symptoms of the disease have already manifested themselves.

Stumbled upon a more general study of the roots of this phenomenon and how to treat / prevent it. Tunnel Syndrome (yes, this is it) is a nasty thing, and in the material below you will understand that you just cannot overcome it. Daily routines / workouts only. At the end, I will draw my brief conclusions, but for now let's turn to the primary source on Habrahabr.

We wrote, we wrote, or what to do when tunnel syndrome overtakes us

If you are reading these lines, it would be natural to assume that you spend at least a few hours a day at your computer, if not more. This mode of operation brings with it a fairly strong load on our hands, which can cause pain in the hands, wrists and fingers. Such pains are caused by the so-called "carpal tunnel syndrome" (carpal tunnel syndrome, carpal tunnel syndrome) - a chronic disease.

In this article, we will try to understand the causes of tunnel syndrome, possible treatments and ways to prevent this undesirable phenomenon. This article will contain quite a lot of subjective deviations from the formal definitions and formulations that are available on certain medical sites, since having spent a significant amount of time at the keyboard over the past eight years, I have tasted the consequences of tunnel syndrome in all its manifestations.

How Tunnel Syndrome Develops and How We Feel

So what gives rise to this unpleasant phenomenon? Carpal (tunnel) syndrome It is caused by compression of the nerve in the hand (median nerve), which runs in special channels formed by bones and ligaments. Naturally, when a nerve is squeezed, we feel pain, which can be felt in the joint of the hand, but not only in it. Now we will go through all the stages of the syndrome under discussion and try to connect physiological processes with what we can feel when working at a computer.

From personal experience, at first there is a mild dull pain, numbness or discomfort in the joint of the hand after several hours of work. If you interrupt work and just stretch your hands, the pain disappears for half an hour - an hour. The unchanging position of the hand, coupled with intense work, leads to stagnation of blood, which at this stage only causes unpleasant sensations.

If you do nothing and continue to work as before, then in a year or two the next stage will come - a burning sensation in the hand, which appears by the end of the working day and does not go away as before, but continues to haunt us at home, two or three hours, gradually turning into a dull, weak pain. This is due to thickened tendons that are already inflamed and begin to press on the nerve (the diameter of the canal has decreased) when the hand is in a problematic position. Around the same time, pain may appear in the hand itself (the outer side of the palm) and in the phalanges of the fingers, especially the index and middle, which are used most when working with the mouse.

In addition to all the delights of working at a standard place of work, it becomes problematic to lift weights when the wrist is in a certain position. Interestingly, the degree of pain does not depend on the severity of the load, but mainly only on the position of the hand. But let's not get distracted, let's go further.

In this position, our body will try to cope with the unfavorable situation, and lymphatic fluid begins to accumulate between the cartilages, designed to flush out the affected and inflamed cells. Under the normal course of events, such a process achieves its goal (the cells are washed out) and the liquid is absorbed by itself. If the load on the hands is prolonged, then the inflammation, as you can already guess, does not stop, but quite the opposite. With this development of events, the natural process of treatment itself can lead to the opposite result - swelling of the lymphatic fluid in the joints. From personal experience, again, you can determine with a high probability whether you have reached this stage or not. The rush of lymphatic fluid is most significant at night, so if the pain is worse at night, you have already arrived at the destination station. Well, if joint pains also wake you up at night - "dry the oars, gentlemen", it's time to urgently do something, otherwise very soon the only way out will be surgery.

Before we discuss inpatient medical treatment, let's first see what you can do on your own, reduce the healing of our body to physical therapy, or, in extreme cases, limit ourselves to outpatient treatment.

Exercises to Prevent Tunnel Syndrome

These exercises can / should be done every few hours, and each of them should be repeated many times, a dozen or two.



1. Strongly clench your fingers into a fist and also unclench strongly.

2. Clench your fists and rotate first in one direction, then in the opposite direction.

2a. You can perform the same exercise with a special ball, inside of which there is a rapidly rotating disc (for example, a PowerBall or with any more or less heavy object). I have tried such a thing - it noticeably resists changing the position of the ball along any axis and thus trains the muscles and accelerates the blood more strongly, which, in fact, is what we are trying to achieve. You can rotate your hand not only along the elbow-wrist axis, as shown in the picture, but also fully arching the hand.

3. Pressing your palms together, spread your elbows to the sides, taking a position like a prayer. The forearms in this position are parallel to the floor. Then, try to lower your palms as low as possible without opening them and leaving your elbows still high. It is likely that pain will be felt in the hands, in the palms, or even in the phalanges of the fingers, if the disease under discussion has already reached you. It is important not to put your hands away from you.

4. If you have a special soft ball (these are often given out as free gifts at various gatherings and presentations) for your hands, squeeze it in turn with all your fingers, palm and between your hands, as shown in the pictures.

5. Repeat the previous exercise, only without the ball, resisting all fingers in turn with your thumb.

6. Straighten your arms in front of you, as shown in the picture, rest your palm on your palm. When resisting, try to straighten your bent palm.

Exercises for treating tunnel syndrome at home

The exercises that will be described here border a little on "real" physiotherapy, but tell me please, why should we wait for someone and something if we can help ourselves? So, let's start with the easiest, but again, from personal experience, the most effective.

1. Fill a deep tub with warm, almost hot, water and clenching your fists, slowly rotate them in the water. It is important that the water warms the hands high enough, above the wrist joint. This exercise greatly relieves pain in both initial and progressive stages. The optimal duration for this exercise is 10-15 minutes, no less. When finished, wrap your hands, including your hands, in a towel - do not refrigerate them quickly. If the apartment is cold enough, then use even a warm scarf.

2. Repeating to some extent the previous exercise, you can apply an alcohol warming compress for the night, just do not make it strong, otherwise you will burn the skin on your hands - an unpleasant experience.

3. Massage. In a situation where fingers and hands hurt from any effort, it will be difficult to massage yourself. It is best to ask someone, it does not require special skills, the main thing is desire. It is necessary to massage the whole hand, starting from the outer side of the palm, continuing upward, the outer side of the forearm (trying to move in the middle of the hand, where a small depression is felt between the forearm bones).

4. Regarding the advice in this paragraph, I can not say anything, neither for nor against, since I did not use this approach. If it helps you - well, if not - it's okay, water massage, and it is about it that we will talk now, does not carry anything destructive in itself. Hydromassage is offered as a treatment on some sites dedicated to this issue, and it is suggested to use it twice a day - in the morning (cool and warm water) to massage the collar of the back, shoulder blades, shoulders, forearms and hands, and in the evening (only with warm water) according to the same scheme.

Physical Therapy Exercises To Treat Tunnel Syndrome

We are beginning to slowly cross the border of self-treatment and outpatient treatment, since although physiotherapy is not some kind of active treatment, at least in my opinion, it is nevertheless prescribed by a doctor and the course of physiotherapy should be taken completely to the end in order to achieve some sane result. Everything that will be described in this chapter should not be taken as a recommended course of treatment, and even more so I hope that everyone understands that my personal experience in no way replaces a full-fledged prescription of a doctor, a specialist in this matter, and who is responsible for the result thereof. ...

1. Again ... massage. Yes, as one of the remedies, physiotherapy will offer you massage again. I don’t know how much its location (in the office or at home) affects the quality of the massage, he didn’t help me much in both the first and second cases.

2. Heating paraffin baths. Remember step one of the home exercises? It's almost the same, only instead of hot water you will be asked to dip your hands in hot paraffin and after two or three dips they will wrap your hands in a warm towel. The result will be the same - the joint and tendons are warmed up, only here your hands will look like large ritual candles. There is nothing terrible in this, on the contrary, it is funny then to take such casts of hands in a 1: 1 scale.

3. Shortwave heating. With this type of treatment, the joints of the hand are warmed up by radiation in the range of several giga-hertz (if I remember everything correctly). I did not like this business and I refused after one session. A personal microwave oven on hand did not seem to me to be particularly useful, and deep heating can be achieved at home as well.

4. Exercises for the muscles of the arms and back. Sometimes the discussed disease can occur due to improper posture during work, therefore, as one of the options for physiotherapy, you can be offered simple physical exercise, it all depends on your physique and posture. Since the proposed exercises are quite simple, there is little point in describing them in detail. Yes, in my opinion, this point is quite a candidate for transfer to the previous chapter - at home you can certainly wave light dumbbells and stretch the elastic band.

Hospital treatment

The gadgets that save us

We couldn't call ourselves geeks if we had a pair of labeled aces up our sleeve that would help us solve such problems, right? Well, if so, then it's time to discuss and tell what kind of gadgets save us in this situation.

Preventive

The easiest and most effective way to solve a problem is not to face it. The simplest method, quite well-known today, is a brush pad. Most often, gel pads are used and, it should be noted that even the cheapest of them do their job perfectly, straightening our hand joint as much as possible.



So wrong.

And that's right.
But let's move on to more serious devices, and we'll start with keyboard modifications.

Ergonomic (Natural) keyboard

Today, there are three types of conventional ergonomic keyboards in stock:



- flat with bow-shaped buttons, such as

- flat, arcuate, divided ("broken") for the right and left hands separately, such as

- vertically curved, arcuate, such as or. Beware, however, keyboards that are too curved in the vertical plane - they become completely inconvenient to work on.

From personal experience, the latter type is clearly preferable - the hand is in a more natural position. We will discuss the question of the natural hand position in more detail in the chapter on replacement mice, but for now we will leave this statement at the level of a temporary axiom.

In addition to the listed ones, there are a number of "unusual" ergonomic keyboards, which I probably would even classify as exotic:



- adjustable split (physically into two halves) keyboard, such as

Mice and mouse-like

There are very few recommendations about ordinary mice. First, the mouse should not be small, so that you have to hold it by straining thumb and the little finger, and secondly, it is desirable that the mouse is high enough to support the inner side of the palm, so that the latter is not overhang all the time. Moving a little from the topic of the mice themselves, it's time to find out why the position of the hand when working with a mouse is problematic.

According to personal observations, which are partially confirmed by various publications that caught my eye, the natural position of the hand and wrist when we stand will be 45 degrees to our hips - not completely parallel to them, and indeed not perpendicular. If you try to just stand up and lower your arms freely, they will assume exactly this position.

Now, still standing, we will do a very simple action - bend our arms at the elbows, keeping our arms relaxed as much as possible. Note that the hands and wrists, which were at an angle to our body, now maintain the same angle to the horizontal surface. If you turn the hands along the longitudinal axis of the arms so that the latter take a horizontal position, the bones of the forearm will not be parallel, as before.

Also, our muscles and tendons will be in b O more tension than before. Note that this is exactly the position our hands are in when working with ordinary mice - this is the first of two reasons for the disastrous state of our hands after N number of years of continuous work. We will talk about the second reason regarding the position of the fingers below.

Now the fun begins. Let's see what exactly we can replace these friendly-enemy tailed creatures with.

Vertical mice - 1

There is a rather unusual type of mouse that tries to maintain the natural position of the hand and wrist in a horizontal position, offering to rotate not our hands to the plane of the mouse, but the plane of the mouse to the position of our hands.

From personal experience, working with such a mouse relieves the load on the mouse-holding hand, and I can say that at least one of my colleagues such a mouse helped to get rid of pain in the wrist at the initial level of the inflammatory process.

Vertical mice -2

Another type of vertical mouse offers an even more unusual approach, not only rotating the mouse to the plane of the hand, but also replacing all movements of the hand with movements of the entire forearm.

Based on my own experience, I can see that although working with such a mouse improves the position of the wrist, on the other hand it forces our entire hand to move to move the cursor. In this situation, the load on the shoulder and accompanying muscles increases, which negatively affects the entire process of work. I could not work with such a device precisely because of the intense load on the shoulder, but I know one person who considers such a manipulator to be the most correct alternative to a regular mouse.

Cat Mice: Trackballs

There are two types of trackballs on sale - with a ball under the thumb and with a ball under the index, middle and ring.

Having tried both one and the other, I cannot recommend either of them. Why, you ask. The answer is simple. When working with trackballs, the problematic position of the wrist on the table does not disappear, and the load on the fingers simply changes. In the first case, the thumb will be heavily loaded, in the second all movements and clicks will be performed with straightened fingers, which, as already mentioned, is often one of the components of our big problem.

Anti-mice: Virtual Pencils / Graphic Tablets

If we return for a second to the question of the natural position of the hand at the table, then the only mouse replacement gadget that will not contradict the above principles, we will find in ... designers. It is this cohort of people who use graphic tablets, on which virtually everything that needs to be transferred to the screen is drawn with a wireless "pencil". If you look closely, in a seated position the hand, when working with such a stylus, just repeats the free state of the hand and palm - not parallel and not perpendicular to the body, but about 45 degrees to the table surface. In addition, our fingers holding the stylus are not fully extended, as when working with a normal or vertical mouse, but are in a half-bent state and therefore apply efforts to acquire in a less tense position.

It is useful to add that the most frequent action of the left "click" is replaced when working with the stylus by pressing on its virtual rod (pressing with the whole hand towards the tablet), bringing additional relief to our long-suffering hands. The right click is made by pressing the stylus button located under the thumb, thus relieving the middle finger from the load.

Returning again and again to bitter personal experience, I can see that working with such a device, you can stop pain in the wrist and fingers almost instantly.

Semi-medical solutions: elastic bandages

If you do not have the opportunity to change your mouse / keyboard to one of the ergonomic solutions described above, then you can use a half-hearted approach - try to save correct position hands when working with the wrong device. Correct hand position can be achieved with a medical elastic bandage that supports the hand and wrist. Not every bandage will be useful to us, but only one containing a rigid or springy metal element.

Rigid headband

Headband with a springy element

From experience, it is quite convenient to work with both types of dressings, except that the first option provides less freedom of the hand, which, however, for our case is hardly a drawback. An example of such firm dressings can be seen and.

Touchped as another solution

Another solution for replacing the mouse is an external touchpad (usually USB). Such a device, although it may to some extent be an alternative solution, but according to the experience of working on a laptop, is not effective enough. Although hand movement will be limited, the position of the wrist on the table will still be problematic and the fingers will be tense for tracking.

Conclusion

In conclusion, there is only one very simple truth to say - take care of yourself. No one will ever know and feel what exactly is happening to you from day to day. If you feel that a problem arises while working, do not ignore it. The sooner you deal with it, the less blood you will cost, since I tried to describe most of the possible solutions and procedures in sufficient detail, but simply and without unnecessarily tiring details.

I don’t know how to finish such a long story correctly, so I just hope that everything described above will help you one way or another. Bye.

The first symptoms of tunnel syndrome are pain, tingling and numbness in the hands, an unpleasant sensation when bending the hand, thumb and index finger.

p.s. Long, interesting story. Now we understand that a very long stay of the hand / wrist in one position pinches the nerve, which is why all these troubles occur. I will add a couple of lines from myself.

1. Hand grips help. But - often you are lazy and forget.

2. Rugs with cushions help, but not much.

3. Tablets - well, this is not an option. I had three of them. From Wacom Intuos to small ones. Yes, drawing is convenient, but constantly working is still a hassle.

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