Carpal Tunnel Syndrome

Carpal tunnel syndrome is a condition caused by compression of the median nerve in the carpal tunnel. The carpal tunnel is a tube consisting of the transverse ligament of the wrist and the carpal bone. The tube contains the median nerve line and nine tendons. Early symptoms include numbness in the thumb, index finger, middle finger and half ring finger, and the situation is poor at night. Patients often have to wave their palms to relieve symptoms. In severe cases, there will be atrophy of the thumb muscles.

The causes of increased pressure in the carpal tunnel include:
Hormonal disorders – edema – common in women during menstruation, pregnancy or hypothyroidism
‧ Wrist fracture or dislocation
‧ rheumatoid arthritis and gout
‧ strain causes flexor tenosynovitis
‧ Infection (such as tuberculosis infection) or tumor (such as ganglion cyst) can also cause compression of the median nerve line in the carpal tunnel

The sides of the thumb, index finger, middle finger and ring finger felt paralyzed and stinging, and the situation was even worse at night. Hands sometimes feel weak and clenched, affecting everyday life. Patients tend to wave their palms to alleviate symptoms. Late stages can also cause the thumb of the thumb to shrink and affect thumb function.
High-risk profile:
ousewives and long-term use of computer mice and keyboards in the office are considered high risk. Women, pregnant women, rheumatoid or diabetic patients are also at high risk.

If the condition is mild:
‧ Rest to avoid overwork on the palms and wrists
‧ Hold the wrist joint in the center position with the hand rest
‧ Inject steroid into the carpal tunnel
If the above treatment fails, surgery is generally recommended. If necessary, a nerve line conduction test will be arranged before the operation. Surgery usually requires local anesthesia, direct carpal tunnel release or endoscopic carpal tunnel release.

What should I do with my thumb?
Ms. Xu is over forty years old. She needs to wear sorghum shoes for a long time because of work. She recently found that the medial joint of the big toe is painful, and is deformed outwards. It is difficult to get a diagnosis, but the result comes back to be toe valgus.

Most patients with thumb valgus are women. It is generally associated with heredity, and factors include wearing inappropriate shoes (such as stiletto shoes and pointed shoes), rheumatoid arthritis, etc. Patients feel pain in the initial part of the humerus, and the big toe will gradually turn outwards, and the soles of the feet are thickened due to uneven force. In the case of severe conditions, the second toe will be pressed due to the outward push of the big toe, causing it to flex, deform then overlap with the big toe, resulting in difficulty and pain in wearing shoes.

Early treatment of hallux valgus includes:
1. Shoes that are wide and deep
2. Use the insole to decompress the sole
3. Take painkillers

If the above methods fail to improve the condition, surgery may be considered. The purpose is to correct the deformation of the big toe and the two toes, so that the soles of the feet can exert an average force and relieve pain.

As there are various types of orthopedic surgery, depending on the condition of the surgery; patients with severe conditions may need to undergo surgery or arthrodesis to correct the situation of thumb valgus.