Disease of office workers: Does tunnel syndrome threaten us all?
Many of us work at the computer every day for hours., resulting in tired eyes, aching neck, and sometimes there are strange sensations in the hand and wrist - from tingling and goosebumps to pain. If you share feelings, you can get a lot of dubious recommendations from friends in return - from the council to tie a woolen thread on your wrist to a “direction” on an MRI of the spine. In fact, such discomfort is usually caused by tunnel syndrome. Why he is called so, where it comes from and what to do with it, we found out from a neurologist, Candidate of Medical Sciences Alexandra Platonova.
What does the tunnel
Tunnel syndromes, or compression neuropathies, occur when a nerve is compressed in a narrow anatomical space - the so-called tunnel formed by bones, tendons and muscles. At the same time there are concerns that are associated with different functions of the nerve: sensitive, motor or trophic (feeding). Tunnel syndrome may occur in different parts of the body, and about fifty of its types are described in the literature. Some variants have unusual names: “tennis elbow” (compression of the radial nerve in the elbow area), “park bench syndrome” (nerve compression in the middle third of the shoulder) or “crutch paralysis” (in the armpit) - so they are called, guess not difficult. But most often affected is the median nerve, which is compressed in the wrist area - this type is also called carpal, or carpal, canal syndrome.
With such compression of the median nerve, so-called paresthesias most often disturb, that is, unusual sensations: tingling, burning, and crawling. Most often, these sensations are clearly localized and cover the large, index, middle and half of the ring finger - just the area of innervation of the median nerve. Sometimes it’s impossible to pinpoint the location, or the whole brush is numb. There may be pain - during exercise or at rest. It can be associated with inflammation in the area of compression, muscle spasm, or even damage to the nerve itself - in the latter case, it is burning or similar to the impulses of an electric current. In advanced cases, there is weakness of the fingers, the muscles of the eminence in the area of the thumb can atrophy, sometimes there is increased sweating or the hand seems cold. Complaints often arise when the palm is held in a certain position for a long time - for example, when reading a book, driving, playing a musical instrument, pushing a pram.
Why not treat for
Unfortunately, tunneling syndrome is rarely paid attention to, and it happens that people are treated for years for osteochondrosis, prescribing endless physiotherapy and massages of the cervical-collar area. Such methods would be good, only in this case they are used to the wrong address: the level of damage is much lower. Moreover, the patients themselves, having discovered the numbness of the fingers and not seeking qualified medical assistance, independently assign themselves a back massage - and he has no relation to the causes of numbness. Even worse, now almost all examination methods are available without the recommendation of a specialist, and patients, for example, do an MRI on their own, and not with targeted (in the area of nerve compression), but different or even all parts of the spine. There, of course, they find a number of ordinary age-related changes in the spine, and everything becomes “clear” - phrases like “what do you want, do you have osteochondrosis, and therefore it goes numb”.
In February 2016, the American Academy of Orthopedic Surgeons released official recommendations for the diagnosis and treatment of carpal syndrome. It says that to establish the diagnosis should not rely on only one method, and the results of different tests should be correlated with complaints. First, the neurologist must question the patient and examine it. Then special tests are carried out using a hammer or checking how the brush is bent and unbent. Electroneuromyography is also used - it is a method to determine how fast the impulses travel along the nerve. Sometimes, of course, you need an ultrasound, MRI or x-ray to determine the condition of the bones of the wrist, or tests to identify other causes of nerve damage.
To whom it threatens
At the end of the twentieth century, it was believed that the prevalence of carpal tunnel syndrome was about 3% among women and 2% among men. Now this figure has risen to 5-7% (and continues to increase), and the syndrome is still more common in women. Causes are local swelling and stretching of the tendons as a result of constant repetitive movements. Therefore, they suffer from people who work at the computer for a long time. Other "dangerous" activities are gardening, work on assembly lines and vibrating mechanisms.
It has been found to increase the risk and smoking. Of course, among the influencing factors there are diseases associated with metabolic disorders, edema, deformity of the joints, tendons, bones, such as arthritis, diabetes and others. Syndrome often occurs during pregnancy. Yet the main in the first place - overweight and high frequency and speed of repetitive movements in the wrist. This is followed by premenopause, anatomically narrow wrist, rheumatoid arthritis, tendon inflammation, and also psychosocial factors: depressed mood and depressive disorders.
What to do
In light cases, reducing the load and applying local compresses can help. Sometimes you have to immobilize your wrist and prescribe anti-inflammatory drugs. It happens that a local blockade is required, that is, an injection of a hormonal anti-inflammatory agent with an analgesic directly into the wrist area. According to Alexandra Platonova, folk methods like wearing a woolen thread on the wrist are useless - but if the patient wants it, you can tie the thread and drink the vitamins, the main thing is not to refuse adequate treatment.
Physical therapy also helps - for example, phonophoresis, in which a medicine is applied to the wrist (usually it is an anesthetic and an anti-inflammatory agent) and is exposed to ultrasound. It is believed that ultrasound can promote the penetration of drugs into the tissue. In the most severe cases, an operation is performed to relieve a squeezed nerve.
How to prevent
The most important thing to avoid situations that provoke nerve compression. If you work at a computer, then you need to properly organize the workplace. Hands should lie on the table, preferably away from the edge, and elbows - bent at a right angle. Mouse pads with pads and an ergonomic keyboard are not a marketing move, they really help your hands to be in a more healthy position. Do not forget to take breaks and give your hands a rest - and it would be good to do special exercises. They are very simple and each takes 10-15 seconds: relax your hands and shake them in the air; place the palms in the center of the chest and press with the palm on the palm, then tilt the hands to the right and left; stretching the arms, rotate the hands in different directions; squeeze and unclench your fingers; connect fingertips and take turns fingers backward.
If the symptoms have already occurred and continue for some time, you should consult with your doctor. This will help, firstly, to clarify the diagnosis, and secondly, to determine the treatment. To defeat the disease is much easier in the early stages, and even better to try to prevent it.
Photo:Africa Studio - stock.adobe.com (1, 2, 3)
