Tunnel neuropathy
All tunnel neuropathies represent a fairly serious lesion of typical peripheral nerves, which occurs due to their strong compression in typical anatomical constrictions. These include ligament holes, aponeurotic fissures, fibromuscular canals, and rigid fibrous bone tunnels. The main predisposing reason for the development of this ailment is considered a certain narrowness of any ordinary anatomical tunnel where the nerves pass.
It has been proven that rather narrow anatomical canals can often be the main genetically determined factor, which is often passed from generation to generation. However, another reason for the development of tunnel neuropathy is specific congenital malformations. These include additional fibrotic problems of tendons and muscles, as well as rudimentary bone spurs.
The presented disorder often manifests itself when these contributing factors begin to act, when there is acromegaly, diabetes mellitus or hypothyroidism, as well as various professional, sports and household loads on only one muscle group.
For example, constant microtraumatization of the neurovascular bundle occurring in a narrow canal often contributes to the inevitable development of typical aseptic inflammation. They lead to severe local edema of specific fatty tissue. Such edema provokes a more dangerous compression of the anatomical structures. From which it can be seen that the vicious circle is closed, and there is a progression and chronization of the process.
Pain is the main symptom of tunnel neuropathy. The pains can often be paroxysmal or aching in nature, be shooting, take on a burning hue, and in many cases they are accompanied by serious disturbances in sensitivity at the site of the direct innervation of the affected nerve.
It should be mentioned that with significant infringement of the nerves that take part in the specific innervation of the muscles, sometimes rapid fatigue, decreased strength and muscle atrophy are possible. The development of vascular disorders is possible with compression of veins and arteries. This is manifested by a decrease in local temperature with pallor or noticeable cyanosis of the skin. Puffiness is also observed.
How to get rid of tunnel neuropathy?
The main modern treatment for typical tunnel neuropathies is pressure reduction, in other words, decompression of the contents of a particular anatomical canal. This helps to improve blood circulation, which entails the regeneration of the immediate myelin sheath of a particular damaged nerve.
Only with proper and timely treatment can one hope for a complete and quick recovery. This therapy usually consists in a certain protective mode, the necessary introduction of a modern suspension of steroids precisely into the desired anatomically narrowed canal. In other more severe cases, surgery will be required to decompress specific nerve structures. In this case, an important fibrous canal is dissected, and the necessary revision of the nerve is performed.
With tunnel neuropathy, the operation is quite effective and not dangerous. In most cases, it leads to the complete restoration of all functions of the damaged nerve itself, as well as to the rapid relief of severe pain syndrome.
Dangerous carpal tunnel syndrome is considered one of the most common forms of tunnel neuropathy. The development of this disorder is usually due to some compression on the medial surface of the wrist of the median nerve, exactly where there is a narrow rigid tunnel, which is formed by the transverse ligament and the bones of the wrist.
In this channel, along with the median nerve itself, those tendons pass that are directly involved in the mandatory flexion of all fingers of the hand. Moreover, in most cases of this syndrome, there is an accumulation of fluid and a significant increase in the volume of typical synovial sheaths. They are the ones that surround these tendons.
Such severity of symptoms of tunnel neuropathy can often range from almost imperceptible to very severe. Without timely correct treatment, the course of this disease always tends to a dangerous progression. Most often it is diagnosed in women over 30-35 years old. One of the most common causes is considered to be non-specific inflammation of typical synovial bursae, in other words, tendovaginitis.
Regular flexion of the fingers, which is a professional feature of milkmaids, for example, also provokes carpal tunnel syndrome. Certain medications, injury, and even pregnancy can lead to increased fluid in these synovial vaginas.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
