Carpal Tunnel Syndrome
What is carpal tunnel syndrome?
腕管综合征是指正中神经在穿过腕管时受到压迫. 腕管是手腕上的一个开口,由手腕底部的腕骨和横跨手腕顶部的腕横韧带组成. 正中神经为拇指和三个中指提供感觉和运动功能. If it gets compressed or irritated, you may have symptoms.
What You Need to Know
- 腕管松解是最常见的需要手术治疗的手部疾病之一.
- Symptoms may include tingling, pain, numbness or weakness in the thumb through ring fingers of the affected hand.
- Women get carpal tunnel syndrome three times more often than men.
- 腕管综合征是一种进行性疾病,如果没有适当的治疗,可能会恶化.
- 腕管综合征的症状经常发生在怀孕期间,可以通过非手术治疗来缓解. Symptoms often improve after delivery, 但这些患者在以后的生活中患腕管综合征的风险更高.
Carpal Tunnel Syndrome Causes and Risk Factors
腕管综合征是由腕管内压力增加引起的, 当正中神经穿过腕管进入手掌时是什么导致了它的压迫.
In most cases, 腕管内压力的增加很难归因于一个原因. 通常,有多种因素导致神经受压:
- Anatomical changes and differences: The carpal tunnel opening is too narrow
- 有些人的腕管尺寸可能小于平均水平,这可能会在家族中遗传
- Women, on average, 腕管尺寸比男性小,更容易患上腕管综合征
- 由于骨关节炎或手腕创伤等疾病,骨骼和关节可能会随着时间的推移而改变形状
- Swelling and inflammation当腕管内部和周围的组织肿胀时,它们会压迫正中神经. Swelling and inflammation could result from:
- Frequent, repetitive movements with the hands
- Extending or flexing the wrist for long periods of time
- 类风湿关节炎和其他引起关节炎症的疾病
- 激素或代谢变化(例如,更年期、怀孕或甲状腺失衡)
- Other contributing factors:
- Changes in blood sugar levels (may be seen with type 2 diabetes)
- 手腕的其他情况或损伤(例如,拉伤、扭伤、脱臼或骨折)
- Obesity
What are the symptoms of carpal tunnel syndrome?
These are the most common symptoms:
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Weakness when gripping objects with one or both hands
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Pain or numbness in one or both hands
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"Pins and needles" feeling in the fingers
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Swollen feeling in the fingers
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刺痛手指,尤指拇指、食指和中指有灼烧感或刺痛感
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Pain or numbness that is worse at night, interrupting sleep
腕管综合征的症状可能与其他疾病或问题相似. Always see your health care provider for a diagnosis.
Carpal Tunnel Syndrome | FAQ with Dr. Sophia Strike
(music) >> My name is Sophie Strike and I'm one of the hand and upper extremities surgeon at Johns Hopkins. 我治疗过手部和上肢有问题的推荐十大正规网赌平台,也治疗过有肿瘤的推荐十大正规网赌平台,因为我的专业是骨科肿瘤学.
(音乐)腕管综合症实际上是手腕处的一条大神经受到压迫,这会导致麻木, tingling, 当这种神经控制手的某些运动时,手指的灼痛或无力.
(音乐)通常,腕管综合征可以通过我们的临床检查来诊断. 如果诊断不明确,我们也可以建议患者做神经传导检查.
(音乐)腕管综合症的治疗方法包括非侵入性治疗,如夹板或手部治疗,人体工程学和神经滑翔练习,以及注射,注射也可以提供诊断信息或, for persistent or severe cases, patients may require surgery.
(music) (muffled speaking) For patients who have long-term symptoms, 麻木不会消失或者手部开始出现运动无力, those are patients that we are more aggressive with pursuing surgery.
(music) Often, 该过程可以在轻度镇静和局部麻醉下完成,因此患者通常不需要全身麻醉. 手术后,他们会有一个柔软的敷料,当天就可以回家了. 你的手指可以自由活动手腕可能会有些酸痛,但是, generally, patients get back to regular activities after about two to four weeks.
(音乐)轻微病例的长期预后通常是在头六个月内几乎完全康复. 有长期或严重症状的患者可能需要更长的时间,可能无法完全恢复以前的功能. It can recur although we often see this 10, 15 years down the line and that can be treated if it comes up.
(music)
How is carpal tunnel syndrome diagnosed?
Your provider will check your medical history and give you a physical exam. 他或她可能会建议你对你的神经进行电诊断测试. These tests are the best way to diagnose carpal tunnel syndrome. 电诊断测试刺激你手上的肌肉和神经,看看它们的工作情况如何.
Treatment of carpal tunnel syndrome
你的医疗保健提供者会根据以下因素为你找出最好的治疗方法:
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Your age
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Your overall health and medical history
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How bad your wrist is right now
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How well you tolerate specific medications, procedures, or therapies
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How bad the disease is expected to get
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Your opinion or preference
Treatment may include:
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Splinting your hand. This helps keep your wrist from moving. It also eases the compression of the nerves inside the tunnel.
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Anti-inflammatory medication. These may be oral or injected into the carpal tunnel space. These reduce the swelling.
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Surgery. This eases compression on the nerves in the carpal tunnel.
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Worksite changes. 改变电脑键盘的位置或做其他符合人体工程学的改变可以帮助缓解症状.
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Exercise. 伸展和强化运动对症状好转的人有帮助. These exercises may be supervised by a physical or occupational therapist.
Surgery for carpal tunnel syndrome
Surgery for carpal tunnel syndrome is usually done as an outpatient. 有两种类型的腕管手术:开放手术和内窥镜手术. You may have local or general anesthesia, or both, for either surgery.
During open surgery, the surgeon cuts open your wrist. The tissue that is pressing on the nerves is cut. This relieves the pressure on the nerve.
在内窥镜手术中,外科医生将一根又长又细的杆子穿过手腕上的一个小切口. The rod, or scope, contains a camera and a light. The scope lets the surgeon to see inside your wrist. He or she cuts the tissue using tiny surgical tools.
After the surgery, your hand and wrist are wrapped and put into a splint. This will help to keep you from moving your wrist during your recovery. You will need to wear the splint for a week or two. You will probably have some pain after your surgery. It's usually controlled with pain medication taken by mouth. You may also be told to sleep with your hand elevated to help ease swelling.
Recovery from carpal tunnel surgery is different for each person. If your nerve has been compressed for a long time, recovery may take longer. 手术后几天,医生会鼓励你活动手指和手腕,以防止僵硬.
You may need to adjust your work or home activities while you recover. Talk with your health care provider about what you need to change.