The deepening of the wrist is lined with a wide palmar ligament, and a transverse ligament is stretched between the elbow and radial elevation. The median nerve passes through the carpal tunnel formed by these ligaments. Under the conditions of macro- and microtraumatization of the ligament, for example, in masons , movers, milkmaids or polishers, a thickening of the transverse ligament and swelling of its fibers occur, which leads to the infringement of the median nerve. More often, women over the age of 40 get sick. Patients are concerned about paresthesia and pain in I-III, and sometimes in all fingers. These sensations are amplified in the horizontal position of the patient, especially at night and when raising the arm up (postural provocation). They decrease in the upright position and with the arm lowered, when the hydrostatic pressure in the capillaries of the nerve increases. The pain intensifies with percussion of the transverse ligament ( Tinel’s symptom ) or with intense palpation. Often identified hypalgesia leather palm, fingers and sluggish paresis of the muscles of the thenar .
Nocturnal paresthesias of the hands (static paresthetic brachialgia ) in some cases are caused by this syndrome, in others by syndromes of the anterior scalene or pectoralis minor muscle, and in some cases by general disorders (endocrine and other effects on the vasomotor systems of the hands).
Ulnar Nerve Infringement Syndrome
Syndrome of the ulnar nerve infringement in Guillain’s bed develops due to compression of the deep palmar branch of the ulnar nerve in the carpal canal between the pea and hook-shaped bones. Hypotrophy and weakness of the muscles (flexors and adductors of the little finger, ulnar interosseous and vermiform) innervated by this branch of the ulnar nerve may give rise to the false anthrax lesion. Injury of the nerve is also possible in the area of the altered meniscus in contact with the mentioned bones of the wrist.
Carpal tunnel syndrome
Carpal syndrome of infringement of the posterior interosseous nerve develops due to infringement of this branch of the radial nerve under the aponeurotic edge of the short wrist extensor distal to the elbow. Injury of the nerve is possible and even more distal – in the crevice of the arch support. It is characterized by pain in the extensors of the hand, hypalgesia along the radial edge of the forearm. Often, the syndrome accompanies epicondylitis of the shoulder joint.
Elbow Compression Syndrome
Elbow compression syndrome develops due to the infringement of the ulnar nerve under the thickened triangular ligament, stretched between olecranone and the internal epicondyle of the shoulder. It is characterized by paresthesia and pain in the ulnar parts of the hand.
Excavation Syndrome
The suprascapular notch syndrome develops due to the infringement of the suprascapular nerve under the transverse upper ligament of the scapula in the notch of the scapula. Since the nerve innervates the capsule of the shoulder joint, supra- and infraspinatus muscle, the corresponding syndrome is characterized by hypotrophy of these muscles, dystrophic and pain manifestations in the area of the capsule of the shoulder joint.