Carpal tunnel syndrome - causes, symptoms, diagnosis, treatment & pathology
Summary
TLDRالسندروم ال Carpal tunne العصبي هو حالة تسبب الضغط على العصب المتوسط الذي ي穿過 القناة ال Carpal، مما يسبب آلام، شلل، و麻麻 في أصابع الإبهام وال食指 والوسط والربع ال食指 الجانب من الإبهام، التي هي المناطق التي تغذيها العصب المتوسط. يمكن أن يؤدي الضغط إلى ألم وضعف في العضلات، وأحيانا يمكن أن يؤدي إلى تساقط العضلات في قاعدة الإبهام. يمكن أن يحدث بسبب التهاب في الأنسجة وال Ligaments المجاورة، ويتم التشخيص من خلال اختبارات الكهربائية والجسدية، والعلاج يتضمن تغيير السلوكيات والعلاج الجسدي وأحيانا العمليات الجراحية.
Takeaways
- 📜 Carpal tunnel syndrome is a nerve entrapment disorder caused by compression of the median nerve.
- 🖐️ Symptoms include pain, numbness, and tingling in the thumb, index finger, middle finger, and thumb side of the ring finger.
- 🦴 The carpal tunnel is formed by a bony arch on the dorsal side and the flexor retinaculum on the palmar side.
- 🧠 The median nerve and nine flexor tendons pass through the carpal tunnel.
- 💡 The median nerve innervates the thumb, index finger, middle finger, and half of the ring finger.
- 🌟 Carpal tunnel syndrome results from inflammation of nearby tendons and tissues, causing compression of the median nerve.
- 😖 Initial symptoms include dull ache or discomfort, progressing to sharp, pins-and-needles-like pain and muscle weakness.
- 🧩 Severe cases can lead to wasting of the thenar muscles at the base of the thumb.
- 🔬 The palmar branch of the median nerve is not affected, so there's no loss of sensation in the central palm.
- ⚠️ Risk factors include repetitive stress, obesity, pregnancy, and conditions like rheumatoid arthritis.
- 📝 Diagnosis can be made through electrophysiological testing, physical tests like Phalen's maneuver, Tinel's sign, and Durkan's test.
- 💪 Treatment includes behavior modification, physical therapy, splinting, corticosteroid injection, and possibly surgery.
Q & A
ما هي مرض تنفس ال Carpal Tunnel Syndrome؟
-ال Carpal Tunnel Syndrome هو مرض تلقيع العصب يحدث بسبب ضغط العصب الوسطي الذي ي穿過 القناة ال Carpal، مما يسبب آلام، أحساس بالضعف، و麻麻ting في الإصبع الأكبر، وال食指، والوسط، والنصف من الإصبع الرابع على الجانب من الإصبع الأكبر.
ما هي القناة ال Carpal وكيف تشكل؟
-القناة ال Carpal هي ممر ضيق يحتوي على عضلة الخماسي السعة التي تذهب إلى الإصبع وال拇指، بالإضافة إلى العصب الوسطي الذي ي穿過ها من قبل الforearm.
ما هي العوامل التي تؤدي إلى ضغط العصب الوسطي في ال Carpal Tunnel؟
-الضغط على العصب الوسطي يحدث عادةً بسبب التورم الذاتي للعضلات والأنسجة المجاورة، مما يزيد من كمية السائل في مساحة ضيقة ويضغط على العصب الوسطي.
ما هي العلامات التشخيصية لل Carpal Tunnel Syndrome؟
-العلامات التشخيصية يمكن أن تشمل ألم، ضعف العضلات، و麻麻ting، ويمكن أن تظهر في أي منطقة من اليد التي ت受影响 من العصب الوسطي.
ما هي أعراض ال Carpal Tunnel Syndrome التي يمكن أن تظهر في الforearm؟
-قد يتطور الألم من ال Carpal Tunnel Syndrome إلى ألم حاد، شعور بال麻麻ting، ويمتد حتى الforearm.
كيف يمكن أن تؤثر ال Carpal Tunnel Syndrome على القوة العضلة؟
-قد تؤدي ال Carpal Tunnel Syndrome إلى ضعف العضلات مما يسبب صعوبة في التعامل مع الأشياء الصغيرة وفتح الأبواب والمفتاح، أو المهام الدقيقة مثل زب الملابس.
ما هي العوامل المحتملة التي تزيد من خطر الإصابة بـ Carpal Tunnel Syndrome؟
-العوامل المحتملة تشمل الوزن الزائد أو الحمل، وكذلك وجود أمراض مثل الالتهاب العضلي الذاتي، حيث الالتهاب في الarticulations يؤدي إلى ضغط العصب الوسطي.
ما هي الاختبارات الطبية التي يمكن استخدامها لتشخيص ال Carpal Tunnel Syndrome؟
-يمكن التشخيص من خلال اختبارات إلكترونية، وصف الأعراض، واختبارات فيزيائية مثل Phalen’s maneuver و Tinel’s sign و Durkan’s test.
ما هي الطريقة الطبية الأكثر شيوعًا لعلاج ال Carpal Tunnel Syndrome؟
-قد يشمل العلاج تغيير السلوكيات، مثل الحفاظ على مسار اليدين موازٍ للبعض والمكتب، استخدام الفأرة الكمبيوتر بدلاً من اللوحة المتحركة، وارتداء الدعم العظمي والsplints أثناء الكتابة.
ما هي العمليات الطبية التي يمكن استخدامها في حالات مGravity ال Carpal Tunnel Syndrome؟
-في الحالات الأكثر خطورة قد يتم المعالجة من غير الجراحية من خلال الsplinting أو حقن الكورتيكوستيرويدات، لكن الإدارة النهائية عادة تتطلب تقسيم ال Ligament ال Carpal لفتح القناة ال Carpal وتخفيف الضغط.
لماذا لا تظهر أعراض ال Carpal Tunnel Syndrome في الجزء الوسط من الكف؟
-العصب السطحي للعصب الوسطي، يسمى فرع ال Carpal، يوفر الشعور بال麻麻ting للجزء الوسط من الكف، لأن هذا العصب يفرع قبل أن ي穿過 القناة ال Carpal ويسافر على سطحها، لذا لا يتأثر بال Carpal Tunnel Syndrome.
Outlines
🤕 Carpal Tunnel Syndrome Overview
Carpal tunnel syndrome is a condition caused by the compression of the median nerve within the wrist's carpal tunnel. This leads to symptoms such as pain, numbness, and tingling in specific fingers. The carpal arch and flexor retinaculum form the tunnel's structure, housing the median nerve and flexor tendons. Inflammation from nearby tendons causes the nerve compression. Symptoms can escalate from discomfort to sharp pain and muscle weakness, affecting fine motor skills. Severe cases may result in muscle atrophy. A unique aspect is the palmar branch of the median nerve, which remains unaffected, explaining the lack of sensation loss in the central palm. Common causes include repetitive stress injuries, and risk factors encompass obesity, pregnancy, and conditions like rheumatoid arthritis. Diagnosis involves electrophysiological testing and physical tests such as Phalen’s and Tinel’s maneuvers. Treatment ranges from behavior modification and physical therapy to surgical intervention if necessary.
Mindmap
Keywords
💡سندروم القناة ال Carpal tunnel
💡العصب الوسطي
💡القناة ال Carpal
💡الضغط العصبي
💡الألم
💡麻麻
💡الضعف العضلاتي
💡التشخيص
💡العلاج
💡ال Ligaments ال Carpal
💡العمليات الجراحية
Highlights
Carpal tunnel syndrome is a nerve entrapment disorder caused by compression of the median nerve in the wrist.
The median nerve is responsible for sensations in the thumb, index, middle fingers, and half of the ring finger.
The carpal tunnel is formed by the carpal arch and the flexor retinaculum, housing the median nerve and flexor tendons.
Compression of the median nerve can lead to pain, numbness, and tingling in the affected areas.
Inflammation of tendons and tissues can cause edema, increasing pressure on the median nerve.
Early symptoms may include dull ache or discomfort in the hand areas innervated by the median nerve.
Advanced symptoms can manifest as sharp, pins-and-needles-like pain called paresthesia.
Muscle weakness may affect fine motor skills and tasks requiring dexterity.
In severe cases, the thenar muscles at the base of the thumb can waste away due to nerve compression.
The palmar branch of the median nerve provides sensation to the central palm and is unaffected by the syndrome.
Typically, both hands are affected due to repetitive stress injuries like typing.
Symptoms often worsen at night after a day of activity.
Risk factors include obesity, pregnancy, and underlying conditions like rheumatoid arthritis.
Diagnosis can involve electrophysiological testing, symptom description, and physical tests.
Physical tests like Phalen’s maneuver and Tinel’s sign can help diagnose the syndrome.
Behavior modification, such as changes in hand positions while typing, can alleviate symptoms.
Physical therapy with stretching and isometric exercises may help relieve symptoms.
In serious cases, non-surgical treatments like splinting or corticosteroid injections may be used.
Definitive treatment often requires surgical division of the transverse carpal ligament to relieve pressure.
A quick recap summarizes the condition, its symptoms, and potential surgical treatment.
Transcripts
Carpal tunnel syndrome is a nerve entrapment disorder that results from compression of
the median nerve which winds its way through the wrist through a narrow passageway called
the carpal tunnel.
This compression typically causes pain, numbness, and tingling in the thumb, index finger, middle
finger, and the thumb side of the ring finger, which are the areas of skin innervated by
the median nerve.
Now taking a cross section of the wrist, we’ll see a bony arch known as a carpal arch on
the dorsal side of the hand which forms the floor of the carpal tunnel, and a sheath of
connective tissue called the flexor retinaculum or transverse carpal ligament, which is on
the palmar side of the hand forms the roof of the carpal tunnel.
Also there are nine flexor tendons, which go to the fingers and thumb, as well as one
nerve—the median nerve—which travels down the forearm and go through the carpal tunnel.
The skin of the hand served by the median nerve includes the thumb, the index finger,
and middle finger, as well as half of the ring finger that’s on the thumb side.
The other side of the ring finger and pinky are served by the ulnar nerve, and the back
of the hand’s served by the radial nerve, only the median nerve goes through the carpal
tunnel.
Carpal tunnel syndrome is caused by compression of the median nerve, and that typically happens
as a result of inflammation of the nearby tendons and tissues, which creates local edema
or swelling which increases the amount of fluid in a very tight space, and essentially
puts pressure on the median nerve.
Initially that pressure can cause a dull ache or discomfort in any of the areas of the hand
that are innervated by the median nerve.
Eventually this discomfort can lead to sharp, pins-and-needles-like pain, called paresthesia,
which can extend up the forearm.
People might also have muscle weakness which can cause clumsiness with tasks like holding
small objects, turning doorknobs and keys, or fine motor tasks like buttoning up a shirt.
In severe situations, the thenar muscles at the base of the thumb can start to waste away.
This happens because those muscles are innervated by the recurrent branch of the median nerve
which arises from the median nerve after it passes through the carpal tunnel.
Basically, in a nutshell, any structure innervated by the median nerve downstream of the point
of compression can be affected.
Interestingly, a superficial sensory branch of the median nerve, called the palmar branch,
provides sensation to the central base of the palm.
Because this nerve branches upstream or proximal to the carpal tunnel and travels superficial
to it, this nerve is not affected by carpal tunnel syndrome, and this is also why there
is no loss of sensation in the central palm of the hand.
Typically in carpal tunnel syndrome, both hands are affected because usually there is
a repetitive stress injury like typing which causes inflammation in both wrists.
This also explains why symptoms of carpal tunnel syndrome tend to be worse at night,
after a day of use.
Other risk factors of carpal tunnel syndrome include obesity or pregnancy, as well as having
underlying conditions like rheumatoid arthritis, where there’s joint inflammation from an
autoimmune process leads to the compression of the median nerve.
Diagnosis of carpal tunnel syndrome can be made based on electrophysiological testing,
description or symptoms, as well as physical tests.
For example, Phalen’s maneuver, where you flex the wrists are far as possible and then
hold that position for a minute, results in numbness in the areas of the hand innervated
by the median nerve in people with carpal tunnel syndrome.
Another physical test, Tinel’s sign, is performed by tapping the transverse carpal
ligament which reproduces the symptoms of tingling or feelings of pins and needles in
areas of the hand served by the median nerve.
Finally there’s Durkan’s test, which is another way to elicit carpal tunnel symptoms,
but this time by manually compressing the carpal tunnel with the thumb for 30 seconds.
One major form of treatment is behavior modification, many of which are associated with hand positions
while typing which is a common cause of the problem.
Changes like keeping the axis of the hands parallel to each other and the table, using
a computer mouse instead of a track pad, and wearing wrist supports and splints while typing,
can all be super helpful.
Physical therapy in the form of stretching and isometric exercises can also help relieve
symptoms.
In more serious cases it might be treated non-surgically by splinting or corticosteroid
injection, but the definitive management often requires surgical division of the transverse
carpal ligament to help open up the carpal tunnel and relieve the pressure.
Alright as a quick recap: carpal tunnel syndrome is a condition most often characterized by
a numbness and tingling in the hand caused by a compressed median nerve in the wrist,
and if necessary can be surgically treated by release of the transverse carpal ligament
which forms the roof of the carpal tunnel.
5.0 / 5 (0 votes)