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Monday, December 24, 2012

Tingling or numbness in HANDS (MAINLY THE NIGHT)



Tingling in the hands

  • You wake up with a hand tingling at night?
  • It has the feeling of numbness in the fingertips?
  • He feels a pain that goes up the arm?
  • Enough to let objects fall from your hand?
If you answered yes to any of the questions above, you can be with Carpal Tunnel Syndrome.
It is caused by compression of a nerve in the wrist.


IMPACT 
It is estimated that the incidence in the general population ranges from 3-10%, being more common in women aged between 40 and 60 years. However, with the widespread use of computers began to be found in young adults of both sexes. 

ANATOMIC EXPLANATION

In the region of the wrist (carpus also called) is a real tunnel through which pass from the forearm into the hand, the Median nerve along with nine tendons. The floor of the tunnel is formed by small bones and the roof consists of a fibrous tissue.
Median nerve controls the sensitivity of the palm of the fingers (excluding the little finger) and also sends impulses to the muscles that move the thumb. 

CAUSES 

The Carpal Tunnel Syndrome occurs when the median nerve is compressed within the tunnel, and this can occur in any situation that reduces the size of the tunnel or increase the volume of tissue that pass inside. 
When we long with the handle folded reduced the space for the nerve, such as in situations such as reading the newspaper, go and sleep with flexed wrist. 

FACTORS ASSOCIATED

• Menopause (due to hormonal changes) • Pregnancy (fluid retention in the tendons) 
Polycystic Ovary • / Endometriosis 
• Poor posture • Diabetes • Osteoarthritis • Rheumatoid Arthritis • Hypothyroidism. • Post-wrist fracture 
• repetitive movements / computer use

SYMPTOMS 
The patient may experience pain, tingling sensation, shock, fatigue or weight forearm numbness in fingers innervated by the Median nerve and in more severe cases, atrophy of muscles, causing weakness and falling objects hand. In about 50% of cases can affect both sides.

The early diagnosis and treatment are important to prevent permanent nerve damage and consequent anesthesia and atrophy of the hand, which can make the affected person dependent on others.

You need a medical evaluation to rule out other problems that can mimic these symptoms, 
As nerve compression elsewhere since their departure from neck (herniated disc), and passing by the shoulder and elbow. 



TREATMENT 


Treatment varies from the use of medications for the temporary wrist splints, combined with physiotherapy to correct postural and muscle stretching.

In resistant cases the surgical treatment is necessary to prevent progression of the disease.

The surgery is to "open" the roof of the tunnel, releasing the pinched nerve. This can be achieved through a mini-incision in the palm of the hand.

The patient receives sedation (sleep and do not see or feel anything) and the surgery is performed under local anesthesia at the handle.

A few hours later the patient returns home with a splint immobilizing the wrist, using a sling to prevent swelling of the hand and fingers moving.

The tingling sensation usually disappears already in the immediate postoperative period.

And VITE sweeteners with exception of STEVITA (some sweeteners stamp THAT THE NAME "STEVIA" CONTAINS ONLY A PERCENTAGE OF STEVIA) They can cause tingling in the legs.Feet and Hands

Aspartame

An expert on the 
Dr. Nanci MARCKLE has the word:

'I spent several days lecturing at the WORLD ENVIRONMENTAL CONFERENCE about aspartame, known as NutraSweet, Equal, Zerocal, Finn and Spoonful'

They announced that there was an epidemic of multiple sclerosis and systemic lupus, and they did not understand what toxin was causing these diseases assolassem the United States so quickly.


I explained that I was there to lecture on exactly that subject.

When the temperature of Aspartame exceeds 30 ° C, the alcohol contained in the aspartame becomes formaldehyde and then to formic acid, which causes metabolic acidosis (formic acid is the ant venom).

The methanol toxicity mimics multiple sclerosis and people receive the wrong diagnosis of multiple sclerosis.

Multiple sclerosis is not a death sentence, but methanol toxicity is .. In the case of systemic lupus, we are finding that it is almost as rampant as multiple sclerosis, especially with Diet Coke and Diet Pepsi by reason of methanoltoxicity.  
(The victims usually drink 3 the 4 cans of soft drinks per day or more).

In cases of systemic lupus caused by Aspartame, the victim usually does not know that the aspartame is the cause of his illness and continues its use, aggravating the lupus to such a degree, that sometimes it becomes life threatening.

When off of aspartame, the people who had lupus usually become asymptomatic.

Unfortunately, we can not reverse this disease. On the other hand, in cases diagnosed as Multiple Sclerosis (when, in reality, the disease is methanol toxicity) most of the symptoms disappear. We have seen cases where their vision has returned and even their hearing has returned.

This also applies to cases of tinnitus (ringing in the ear).

In a Conference I said, 'If you are using Aspartame (NutraSweet, Equal, Spoonful, etc.) and suffers from fibromyalgia symptoms, spasms, shooting pains, numbness in hands and legs, cramps, vertigo, dizziness, headache, tinnitus , joint pain, depression, anxiety attacks, slurred speech, blurred vision, or memory loss - you probably have ASPARTAME DISEASE! "


It should therefore prevent aspartame (sweetener) preventively, as well as soft drinks, especially diet, and zero light.

Carpal Tunnel Syndrome
Dr. Kouyoumdjian JoãoAris


Síndrome carpal tunnel is the name referred to a disease that occurs when the nerve that passes in the wrist (median nerve) is subjected to compression, leading to characteristic symptoms which are described below. 


Disease is very common among women aged 35 to 60 years; may occur less frequently outside of these age ranges and also occasionally in men.


Typical symptoms are represented by numbness and tingling in the hands, especially at the ends of the index finger, middle and ring; almost 2/3 of cases are bilateral

Characteristically these symptoms occur at night, causing people to have to get up, move your hands or even put them in hot water immersion, sometimes pain can arise throughout the upper limb (hand, forearm and arm) are also frequent feelings of shock in certain hand positions like holding an object with force, hold steering wheel or peel fruits and vegetables.


Too often people think they are having "stroke" or "circulation problems" seeking specialized medical care in this area. These symptoms of numbness and tingling may improve and worsen over months or even years, making the correct and accurate diagnosis is delayed.


In most cases this nerve compression in the wrist ("trapped nerve") is due to the narrowing your channel crossing by chronic inflammation unspecified tendons also pass through this channel.

In other cases less frequently associated diseases may exister compressing the nerve.


It is important to note that pregnant women may have symptoms of the disease caused by edema ("swelling") own pregnancy, in most cases the symptoms disappear after delivery can reappear many years later. Some professional activities involving continuous flexing of the fingers (eg milking milk) can trigger symptoms of nerve compression.
The diagnosis of carpal tunnel syndrome is based on typical symptoms and evidence of nerve compression by a test called electromyography; exam nerves in the forearm, wrist and fingers are stimulated by shocks of low intensity and the measured result on the screen apparatus.


The treatment for cases of mild compression (criterion based on Electrodiagnostic examination) can be done initially immobilizing the wrist for "splints"; never be bandaged wrist as it may worsen the compression, should also be avoided as this phase physiotherapy . The "splints" are small splints hard yet flexible material that are placed from hand to the forearm and secured with velcro and can be easily removed and replaced. Remedies or infiltration at the site may be used, but are always palliative ie not solve the problem permanently.


In cases where the treatment by immobilization failure or those in which the examination reveals Electrodiagnostic more severe nerve compression should undergo surgery. The goal of surgery is to open the channel through which the nerve passes, finally solving the problem in most cases. When the nerve is too long can be compressed final atrophy ("nerve atrophy or dry") with little recovery even after surgery. Dr. JoãoAris Kouyoumdjian
Professor Neurology and Assistentede
Chief Setorde Electroneuromyography
Medicinade School of São José do Rio Preto.
Av Bady Bassitt, 3896.
15025-000 - SãoJosé do Rio Preto, SP.

Where to Find More About the Subject.
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome. Defines carpal tunnel syndrome (CTS), its causes, and treatments.This illustrated brochure addressesmany common questions about ..
http://www.apta.org/resource/pr39.html

Biomet ®, Inc.: Carpal Tunnel Menu
presented by the James W. Strickland, MD and the IndianaHand Center. Pictured Above: The Indiana Tome. Carpal tunnel syndromeis one of the most common ..
http://www.biomet.com/carpal-tunnel/carmenu.html

Carpal Tunnel Syndrome - Introduction
Carpal Tunnel Syndrome - Introduction. "The new power wheelchairuser developed carpal tunnel syndrome soon after purchasing herwheelchair. Her power ...
http://www.ccsd.k12.wy.us/cchs_web/sptmed/cts1.htm

CyberHealth 2000: Carpal Tunnel Syndrome Prevention Video
Carpal Tunnel Syndrome, Will You Be Affected? Welcome to CyberHealth2000's Carpal Tunnel Syndrome / Repetitive Strain Disorder informationcenter. We offer.
http://onestop.directory.com/video/

Overview of Carpal Tunnel Syndrome
Overview of Carpal Tunnel Syndrome. Anatomy. The carpal canal osteoligamentous tunnelis the rigid beneath the proximal one-thirdof the palm and the wrist ..
http://www.biomet.com/carpal-tunnel/carpal.html

Classification of carpal tunnel syndrome cases.
Classification of carpal tunnel syndrome cases. Record Type: Interpretation. Standard Number: 1904. Subject: Classificationof carpal tunnel syndrome ...
http://gabby.osha-slc.gov/OshDoc/Interp_data/INTERP_19930621.html

Conditions Which Contribute to Carpal Tunnel Syndrome
Conditions Which Contribute to Carpal Tunnel Syndrome. Also thereare many conditions cause Carpal That Will Eventually TunnelSyndrome If They are not ...
http://www.ccsd.k12.wy.us/cchs_web/sptmed/cts2.htm

What is Carpal Tunnel Syndrome?

You usually feel a numbness or tingling in your hand, especially at night? You may experience difficulties in handling objects and sometimes you feel a pain that goes up the arm to shoulder height.
    These may be symptoms of Carpal Tunnel Syndrome. 
    The median nerve travels from the forearm into your hand through a tunnel in your wrist. The bottom and sides of this tunnel are formed by wrist bones and the top of the tunnel is covered by a mass of strong connective tissue called ligament. 
     
      
    This tunnel also contains nine tendons that connect muscles to bones and move your fingers and thumb. These tendons are covered by a membrane lubricant called synovium, which can increase and decrease depending on circumstances. 
     
      
    If the swelling is enough, can cause the median nerve becomes pressed against this strong ligament. This can result in numbness, tingling in your hand and difficulty in handling objects or pain, as described above.

    Initiation

    What causes this?

    Anything that causes swelling, or irritation expeçamento Synovial membrane surrounding the tendons in the carpal tunnel can result in pressure on the median nerve.

    Some of the common cases and associated conditions are:

    * Repetitive rubbing with hands and forced 
    * Displaced or broken bones in the wrist, which cause swelling. 
    * Arthritis, especially rheumatoid. 
    * Thyroid imbalance 
    * Hormonal changes associated with menopause 
    * Diabetes and Pregnancy

    Although any one of these conditions may be present, most cases do not have defined causes.

    Initiation

    How is it Diagnosed?

    Your doctor can diagnose this condition through the following signs and symptoms:

    * Numbness and tingling in the hands, especially when these symptoms occur at night and after using the hand. 
    * Diminished sense in your thumb, index finger and ring finger. 
    * The presence of an electric shock type or tingling (like when hitting up the "bone-law"), when the doctor touches the median nerve in your wrist. 
    * Playback of these symptoms by holding the wrist flexed down for 1 minute.

    In some cases your doctor may recommend a special test called "Study Conductor Nerve." This test, done by a specialist determines the safety of the pressure of the median nerve and can help your orthopedic surgeon to make a diagnosis and outline a treatment plan.

    Initiation

    How is it treated?

    Simple cases should be treated by placing a splint or brace, which is usually used at night and keep your wrist firm without letting it bend. Resting your wrist that allows the swollen and inflamed synovial membranes decreases, it relieves pressure on the nerve.

    These swollen membranes can also be reduced in size through medicines oraischamados of anti-inflammatory steroids. This drug spreads over the surrounding synovial membranes swollen tendons and reducing the swelling, and thus, relieving pressure on the median nerve.


    The dosage of cortisone is small and when used in this way often has no side effect.

    The efficiency of non-surgical treatment is often dependent on diagnoses and treatments

    Of these patients, those who do not get relief from these non-surgical measures may be necessary to perform a surgery.

    The local operation is numbed with local anesthetic injected into the wrist, hand or higher up on the arm.

    This can be done by your orthopedic surgeon or an anesthetist. The surgery is called "Liberation" - cutting the ligament that forms the top of the Carpal Tunnel to relieve the pressure of the median nerve.

    The surgery is usually done on an outpatient basis and the patient does not need to spend the night.

    Your doctor can explain to you the need for a non-surgical treatment, or surgical treatment, based on their individual circumstances.

    Initiation

    After Surgery

    After the surgery, their symptoms may be relieved immediately or within a short period of time.

    The sensitivity at the point of incision may persist until healing is completed.


    The numbness may remain for a certain period of time, particularly in older people or in more severe cases.

    May be several weeks before you are able to return to their normal level of physical activity.

    Probably you will be given exercises to reactivate the movement to rebuild muscle strength and joint flexibility in your hand and wrist.

    Dr.Paulo David Gusmao
    Medical Director of Orthopaedic and Physiotherapy Inst.Ortopedia


    IN PREGNANCY 
    When carpal tunnel syndrome appears?
    Symptoms can appear at any time during pregnancy, but usually present at the beginning of the fifth or sixth month, along with mild swelling of the ankles and feet.
    What can I do to ease the pain?
    Symptoms may worsen at night. Whenever you feel the twinges, change position in bed - that alone relieves much of the hassle.  
    Try not to sleep on the hands. 
    Another trick is to shake hands until the pain and numbness subside.



    Flex your fingers and hands several times during the day is also positive. If you are in pain, avoid repetitive motions like typing and doing crafts, which can worsen symptoms. Keep your hands high when seated, for example on the back of the couch while you watch TV, can also help.



    If you work with computers, adjust the height of your chair so that the wrists are not bent down when you type.Ergonomic keyboards can also help. Remember to take breaks to stretch your hands and fingers.



    Symptoms of carpal tunnel syndrome usually disappear shortly after the baby is born, along with the swelling. The disappearance of pain, however, is not immediate - you will still be swelled to some days after delivery.



    If the pain persists long after delivery, you may need a special treatment to relieve pressure on the median nerve, first with anti-inflammatory medications, cortisone injections later with or, in very severe cases, even surgery, all depending on the medical recommendation.

    The procedure is done through a small incision in the palm, so that the doctor can make a cut on the transverse carpal ligament, one of the walls of the carpal tunnel, thus freeing the nerve. With the incision, the median nerve function normally again.

IN THAT SITUATION NEED TO TALK TO THE DOCTOR?



Talk to your doctor if the pain and tingling are interfering with your sleep and your routine. Do not take any painkiller without the permission of her obstetrician. The use of wrist splints removable, for periods of rest, can also be beneficial.


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