Tunnel syndrome : carpal tunnel .Neuropathy of the femoral nerve .Neuropathy tibial and peroneal nerve - Causes, Symptoms and Treatment .MF .
- carpal tunnel syndrome (carpal tunnel syndrome)
- neuropathy femoral nerve
- neuropathy of the tibial and peroneal nerves
pridavlivaniya nerve to bone protrusions or impairment in narrow channels with solid walls leads to the development of tunnel neuropathy.
carpal tunnel syndrome.
The most common neuropathies tunnel syndrome refers to compression of the median nerve in the carpal canal.Carpal tunnel syndrome (carpal tunnel syndrome) is caused by compression of the median nerve at the point where it passes through the carpal tunnel at the wrist transverse ligament.The syndrome usually develops in people whose activities require repetitive flexion and extension movements in the brush or long bending it (work with the mouse at the computer, typing, playing the piano or cello, working with a jackhammer, and others.).The tendency to develop tunnel neuropathy of the median nerve is seen in persons suffering from medical conditions that manifest metabolic neuropathies (diabetes, uremi
Symptoms tunnel syndrome carpal tunnel.
Typical symptoms of carpal tunnel syndrome: pain and tingling in the hands, which are more pronounced at night, feeling of swelling of the hand and wrist, numbness in the thumb, index and middle fingers.Initially, the numbness is transient in nature, and later becomes permanent.Often marked nocturnal pain extending from the wrist to the forearm, sometimes up to the elbow.When lifting your hands up in pain and numbness reinforced.At a percussion of the median nerve in the carpal tunnel area there is paresthesia in the hand (positive Tinel symptom).Bending the hand for 2 minutes (Falena sign) increases the symptoms.There have been a moderate reduction of pain and temperature sensitivity in the first three fingers of the hand, muscle weakness, opposes the first finger, sometimes it atrophy.There have electromyographic signs of denervation of varying severity in the muscles innervated by the median nerve, reducing the speed of the pulse at its branches to the brush.
In the long such a state as the tunnel carpal tunnel syndrome in a patient may develop osteoporosis phalanges of fingers, combined with a spasm of blood vessels and persistent burning pain.
Diagnostics tunnel syndrome carpal tunnel
The cause of this condition is established as a result of examination of the patient, the study of the characteristics of his way of life.Are revealed typical symptoms of musculo-tonic at the level of the forearm of the same hand.Often the diagnosis tunnel syndrome at carpal tunnel and neurological examination is limited.
Tunnel Syndrome Treatment carpal tunnel.
The first step is to treat the disease that underlies the development of carpal tunnel syndrome.So, conducted replacement therapy in hypothyroidism.In these cases, there is a rapid restoration of the disturbed functions.To improve
regional circulation administered vasoactive drugs (Trental, xantinol, nicotinic acid) in combination with anti-inflammatory and diuretic agents (diakarb, triampur).Patients with severe paresthesias at night shows prescriptions karbamazepinovogo series (Tegretol 200 mg 2-3 times a day).
the early stages can be achieved by improving the administration of novocaine and steroid drugs in the channel region - blockade.In drug therapy using NSAIDs, analgesics, hormones.
Eliminating pain, tingling and restoration of sensitivity in the fingers in the treatment of neuritis of the median nerve in the case of carpal tunnel syndrome channel is accelerating the use of physiotherapy (UHF, SMC, etc.), manual therapy (muscle, joint and radicular technique), acupuncture,LFK.
In the absence of effect of conservative therapy there are indications for surgery: dissection of the transverse carpal ligament.Operation is generally open manner, but can also be accomplished using an endoscope.
Prevention tunnel syndrome carpal tunnel
uses a special lock and wrist pad with roll as a preventive measure relieves the load on the median nerve and tendons in the wrist joint.
TO tunnel syndrome also applies compression of the ulnar nerve in the fascial channel between the heads of the ulnar flexor carpi.
neuropathy femoral nerve.
may be due to its compression at the exit site in the inguinal ligament.Patients complain of pain in the groin, which irradiate the surface at the anterior-thigh and lower leg.Over time, there are sensory and motor disturbances, numbness of the skin occur in the innervated area and malnutrition, and later atrophy of the quadriceps femoris.
Neuralgia external femoral cutaneous nerve.Neuralgia appears excruciatingly painful sensations on perednenaruzhnoy thigh (Roth's disease).The reason is the compression of a nerve in the channel formed by the inguinal crease.
piriformis syndrome.The sciatic nerve is squeezed piriformis muscle spasm.Pain, burning, strong, accompanied by paresthesias, spread over the outer surface of the leg and foot.Characteristically increased pain with internal rotation of the hip, with leg, bent at the hip and knee joints.Palpation of the piriformis muscle and the pain intensifies.
neuropathy of the tibial and peroneal nerves.
Common peroneal nerve and its branches, the tibial nerve may be affected at the level of the head of the fibula.Compression occurs when the wrong limb position, in particular, the streets who love to sit with his legs crossed.Pathogenetic factors are diabetes, Dysproteinemia, vasculitis, and others.
Clinically defeat the common peroneal nerve manifested weakness of the rear flexor foot outward rotation of the foot is weakened.There numbness of the outer surface of the leg and foot.Patients go, slapping foot.Reduced sensitivity in the outer surface of the leg and foot.The defeat of the anterior branches of the tibial nerve leads to weakness of flexion of the foot and toes.This nerve can be diminished at the point of passage for the inner ankle and tarsal on the foot in the channel region.There are pain, tingling sensation along the base and the base of the toes, numbness in the area.The process may be involved the medial or lateral plantar nerve branch.With the defeat of the first marked discomfort in the medial part of the foot, with the defeat of the second - on the side of the foot.There are also disorders of sensation in the medial or the outer surface of the foot.
Surgical Treatment of tunnel syndrome.
In the absence of the effect of physical therapy, blockades, topical hormones appear indications for surgical decompression of nerve compression.