手根管症候群

carpal tunnel syndrome

整形外科を受診して、手根管症候群の診断を受け、手術は希望しないとのことで、こちらに来院されました。手のしびれ感と、痛み、さらには指の動きが悪く、母指球筋のやせ（萎縮）がみられました。患者さんには、他の更年期障害（骨粗鬆症の治療中）もありました。手根管症候群の初期の症状は、手首や中指のしびれ感です。これは、手根管の中を、正中神経が通っているためです。痛みは夜間や明け方に強く、痛みのため目が醒めることもあるとのこと。症状が進行していて、母指球筋（母指の付け根の筋肉）の筋力低下と筋の痩せ（萎縮）が認められました。手首の手根管部を軽く叩くと（チネル徴候）、指先の方まで放散痛もでて、ファーレン徴候テスト、手関節を曲げるとしびれ感が増悪しました。コップやティーカップをよく落としてしまうなど、日常生活にも影響がでているとのことでした。保存療法としての鍼灸治療は、神経、筋、腱に鍼を刺すことで、患部の疼痛緩和と、血行を促進して、萎縮した筋に栄養を与えて症状の改善を目指します。

He came to us after seeing an orthopedic surgeon who diagnosed him with carpal tunnel syndrome and did not wish to perform surgery. The patient had a numb feeling in her hand, pain, as well as poor finger movement and emaciation (atrophy) of the ball of the thumb muscle. The patient also had other menopausal symptoms (osteoporosis being treated). An early symptom of carpal tunnel syndrome is a tingling sensation in the wrist and middle finger. This is due to the median nerve passing through the carpal tunnel. The pain is more intense at night and at dawn, and the patient sometimes wakes up because of the pain. The patient's symptoms were progressive, with weakness of the ball of the thumb (the muscle at the base of the thumb) and thinning (atrophy) of the muscle. When lightly tapping the carpal tunnel at the wrist (tinel's sign), radiating pain was also felt toward the tips of the fingers, and the Fahlen's sign test and numbness sensation was exacerbated when the wrist joint was bent. He often dropped cups and teacups, which affected his daily life. Acupuncture treatment as a conservative therapy aims to relieve pain in the affected area by inserting needles into nerves, muscles, and tendons, and to improve symptoms by promoting blood circulation and nourishing the atrophied muscles.