Partial symptoms of carpal tunnel syndrome only manifest as sensory nerve disorders. In the initial stage, numbness or pain may occur on the palm surface of the radial three and a half fingers, which can also be burning pain. The pain can radiate to the elbow and shoulder, and is easily mistaken for neck and shoulder pain. The symptoms are most severe at night or in the morning, and patients often wake up in pain at night and need to get up, move around or shake their hands to alleviate the pain.

Symptoms of movement disorders, such as weakness of the thumb and inflexibility in movement. When there are obvious movement disorders, hand grasping, writing and other movements will be affected.

Both sensory disorders and motor disorders are present; The condition worsens, and numbness, stabbing pain, and sensory loss can affect the entire palm surface. There may be atrophy of the greater interosseous muscle, thumb abduction, and weakness in the opposite palm. Proper shaking of the wrist can alleviate the symptoms. Thumb, index finger, and middle finger may feel allergic or sluggish.

Primary carpal tunnel syndrome is caused by lesions such as synovium, tendon, tenosynovitis, or wrist joint inflammation at the transverse carpal ligament, leading to increased pressure in the carpal tunnel and compression of the median nerve.

Traumatic carpal tunnel syndrome is a condition where the median nerve is compressed due to wrist fractures, dislocations, or traumatic tenosynovitis caused by trauma.

Secondary carpal tunnel syndrome refers to inflammatory diseases secondary to connective tissue, diabetes, myxedema, acromegaly, women in pregnancy, peripheral neuropathy or local benign tumors.

The carpal tunnel is composed of the base and lateral walls of the wrist bone, and is covered by the transverse carpal ligament to form a bone fiber tunnel. There are flexor pollicis longus tendons, 2-4 deep and superficial flexor tendons, and median nerve passing through the tube. The median nerve is most superficially located between the transverse carpal ligament and other tendons. When the wrist joint is flexed, the median nerve is compressed and the fist is clenched forcefully, resulting in more severe compression.

Repetitive and excessive wrist flexion and extension exercises such as using a computer, typing, weaving, twisting objects with the thumb, and prolonged wrist flexion can easily cause this disease. In addition, wrist fractures, sprains, and other external injuries can also cause this disease.

Pain, numbness, and weakness in the hands can be caused by problems with the hands themselves or other parts of the body. Below are several diseases that are easily confused with carpal tunnel syndrome.

Cervical spondylotic radiculopathy is a series of clinical manifestations caused by degenerative changes and protrusion of cervical intervertebral discs, thickening and calcification of ligaments, and stimulation or compression of cervical nerve roots. Clinical symptoms may include hand sensation and motor dysfunction similar to carpal tunnel syndrome, as well as neck and upper limb sensation. However, carpal tunnel syndrome does not have symptoms of cervical spine and upper limbs.

Skin sensory disorders are generally limited to the ulnar side of the hand, with the little finger often located on the outer side and unable to be close to the ring finger. The metacarpophalangeal joint is over extended, the interphalangeal joint is flexed, and the "claw shaped hand" is deformed.

Radial nerve injury:

Skin sensory disorders are generally limited to abnormal sensations in the radial half of the back of the hand (tiger mouth area), as well as functional impairments in wrist and thumb extension.

Chronic aseptic inflammatory changes in the tendon sheath caused by mechanical friction. Narrow tenosynovitis of the hands and wrists is the most common, which is more common in middle-aged and elderly women, light industry workers, and orchestral musicians who use their fingers and wrist joints for a long time, quickly, and excessively. Finger flexion tenosynovitis, thumb flexion tenosynovitis, radial styloid stenosis tenosynovitis.

Positive wrist flexion test: If the elbow is bent and the forearm is raised, and both wrists are flexed 90 degrees at the same time, the affected side will experience median nerve stimulation symptoms within 1 minute.

Neutral braking and fixation of wrist joint. Use wrist braces.

Oral mecobalamin nutrition nerve, celecoxib and other non steroidal anti-inflammatory drugs to relieve pain, external ointment such as flurbiprofen gel ointment. Severe pain can be treated with intravenous injection of prednisolone acetate into the wrist canal.

Physical factor therapy, such as ultrasound, low-frequency pulses, ultra short waves, percutaneous nerve electrical stimulation, laser therapy, etc., can improve local microcirculation, promote the resolution of inflammation and edema, and alleviate pain. Passive wrist range of motion training and local massage can improve wrist range of motion. After the symptoms of wrist pain improve, corresponding muscle and strength hand function exercise training (such as thumb to palm, abduction, etc.) should be developed for the existing muscle atrophy.

Massage and acupuncture and moxibustion.

If non-surgical rehabilitation treatment is ineffective for 2-3 months, surgical release treatment should be considered. Rehabilitation treatment is still necessary after surgery.