What medicine should I take for carpal tunnel syndrome?

People who work on computers and those who like to play games are at high risk of carpal tunnel syndrome. A major symptom of carpal tunnel syndrome is wrist pain and numbness. This disease is often easily ignored. If the condition worsens, it will affect people's normal life and work. Therefore, we must pay attention to carpal tunnel syndrome and seek timely treatment. What medicine should we take for carpal tunnel syndrome?

What medications are available to treat carpal tunnel syndrome? What are the medical treatments for carpal tunnel syndrome?

1. For patients in the early stages of the disease and with mild symptoms, non-surgical treatment can use a small splint to fix the wrist joint in a neutral position for 1 to 2 weeks, which is effective for most patients. In addition, intracarpal tunnel corticosteroid blockade may be used. Usually, 0.5 g of triamcinolone acetonide (triamcinolone, triamcinolone A) plus 1 ml of 2% lidocaine are used for local blockade once a week for 3 to 4 weeks. The closure method is: insert the needle on the ulnar side of the distal wrist crease close to the palmaris longus tendon (if the palmaris longus tendon is absent, it is on the extension line of the ring finger), with the needle tip pointing to the middle finger, the needle tube forming a 30° angle with the skin, and slowly enter the carpal tunnel about 2.5 cm. If paresthesias are induced, the needle needs to be withdrawn and repositioned. A survey showed that after three blockades, 81% of patients experienced relief, lasting from 1 day to 40 months, but usually relapsed after 2 to 4 months. If the first closure is invalid, it cannot be closed again. Others have found that the effect of local blockade is closely related to the efficacy of surgery. If the local blockade is effective, the effect of surgical treatment will definitely be good. It must be noted that if the patient suffers from rheumatoid arthritis, diabetes, or hypothyroidism, the primary disease must be actively treated first.

2. Surgical treatment should be performed as soon as possible for patients with severe symptoms and who have not responded to conservative treatment for 2 months. Usually the transverse carpal ligament is cut open to decompress the carpal tunnel. The surgical incision is generally an arc-shaped incision that bulges toward the ulnar side at the radial edge of the hypothenar eminence and extends toward the wrist to avoid damaging the palmar cutaneous branch of the median nerve. The median nerve and transverse carpal ligament can be exposed by pulling the palmaris longus tendon and radial flexor carpi tendon to both sides respectively. The transverse carpal ligament should be cut along the ulnar side of the median nerve from near to far to avoid damaging the recurrent branch of the median nerve. Because in about 23% of people, the recurrent branch of the median nerve passes through the transverse carpal ligament to the thenar muscle. After cutting the transverse carpal ligament, explore the situation inside the carpal tunnel. If the median nerve is adhered to the surrounding tendon bursa, carefully release it. If there is a neoplasm in the carpal tunnel, remove it surgically. The transverse carpal ligament does not need to be reconstructed after incision, and the wound is sutured after complete hemostasis. After surgery, the hand is immobilized in an extended wrist cast for 7 to 9 days to prevent herniation of the flexor tendons, and then the cast is removed to begin active movement.

What causes carpal tunnel syndrome?

1. Local factors

(1) Factors that cause carpal tunnel volume reduction: such as Colles fracture, Smith fracture, scaphoid fracture, malformation healing after lunate dislocation, and acromegaly.

(2) Factors that cause the increase of carpal tunnel contents: such as lipoma, fibroma, ganglion cyst, abnormal position of muscles in the carpal tunnel (the belly of the superficial flexor muscle is too low, the belly of the lumbrical muscle is too high), nonspecific synovitis, and hematoma.

2. Systemic factors

(1) Factors that cause neurodegeneration: such as diabetes, alcoholism, infection, gout, etc.

(2 ) Factors that change fluid balance: such as pregnancy, oral contraceptives, long-term hemodialysis, and hypothyroidism.

3. Postural factors: People who overuse their wrists, such as computer operators and disabled people who walk with crutches, have their fingers and wrists flexed and extended repeatedly. Gellman et al. investigated 77 patients with paraplegia and found that 38 of them (49%) suffered from carpal tunnel syndrome.

However, it should be pointed out that for some patients with carpal tunnel syndrome, the cause of the disease is unclear.