Hands are an important organ that distinguishes humans from other animals. If our hands become disabled due to pain, numbness, trembling, loss of control, etc., it will not only cause inconvenience to work and life, but also bring huge mental pressure to the patient. The vast maj

Hands are an important organ that distinguishes humans from other animals. If our hands become disabled due to pain, numbness, trembling, loss of control, etc., it will not only cause inconvenience to work and life, but also bring huge mental pressure to the patient.
The vast majority of hand dysfunction can be treated. As long as the crux of the problem can be found, through appropriate treatment and active rehabilitation training, the vitality of the hands can be restored.

All sensations such as pain and numbness are sensed, transmitted and recognized by the nervous system. nervous system consists of the central nervous system (such as the brain) and peripheral nerves (such as the median nerve of the hand, peripheral nerves ). The peripheral nerves are responsible for collecting sensations, and the central nervous system and are responsible for distinguishing sensations.
All motor functions of the human body are also controlled by the nervous system. Whether it is heartbeat, vasomotion, gastrointestinal motility, running, arm swinging, or flexing fingers, instructions are issued by the central nervous system and transmitted to the muscles through peripheral nerves. Specific movements are accomplished through muscle contraction.
As far as numbness, pain, trembling, uncontrollable and other sensory and motor function abnormalities in the hands are concerned, the first cause lies in the nervous system. Clinically, the three most common causes are listed below.

One of the common causes: Carpal tunnel syndrome
As shown in the figure below, Carpal tunnel is a lumen in the wrist enclosed by the transverse carpal ligament, through which multiple finger tendons and the median nerve pass. The median nerve passing through it is very important. It controls the sensory and motor functions of the thumb, index finger, middle finger and half of the ring finger. The carpal tunnel is relatively tough and the internal space is small. If there are frequent hand labor, carpal fractures and other inducements, the tissues in the carpal tunnel will rub against each other and cause edema, and the median nerve in the carpal tunnel will be compressed.

. Symptom characteristics. The most typical symptoms are numbness, tingling, limited function, and abnormal sensation in three and a half fingers on one side of the thumb. If you tap on the transverse carpal ligament with your fingers, it can cause a significant tingling sensation in the above-mentioned parts. If symptoms persist for a long time, there may also be atrophy of the thenar muscle (big thumb belly) and atrophy of part of the flexor muscles. Workers who work frequently with their fingers and wrists (e.g. typists, quality inspectors who need to turn switches, etc.) are at high risk for carpal tunnel syndrome. It is worth noting that if pain, numbness and other abnormal sensations occur in the arm, there may be nerve entrapment in the elbow, shoulder, thorax and cervical spine, and differential diagnosis should be made.

. Coping methods.
(1) rest, the focus is to rest the fingers and wrists. If necessary, the brace can be used to brake the hand. The goal is to eliminate acute edema in the carpal tunnel.
(2) Physical therapy, ice compress can quickly improve edema, ultrasound, , electrical stimulation, manual loosening, etc. can help improve local circulation; if conditions permit, the above methods can be used for auxiliary treatment.
(3) Tendon gliding and strength training. Tendon sliding is actually a full range of hand activities. The movements should be slow and not too frequent. The main purpose is to prevent adhesion and promote recovery. For specific methods, please refer to the figure below:

The purpose of strength training is to improve function and prevent muscle atrophy. The movements should be Slowly and gradually, once a day (several groups at a time) is enough. But do not overdo it, otherwise it may cause unnecessary compression of the median nerve. Training can be carried out with the help of small tools such as rubber bands. The specific method is as shown in the figure below:

(4) Nerve loosening. The so-called nerve loosening refers to the movement of nerve tissue relative to the limbs, including sliding, peristalsis, twisting, etc. of nerve tissue. Nerve loosening can effectively expand the activity space of nerve tissue and improve adhesions and edema. The main way to loosen nerves is to make the limbs do some "extreme" movements.As far as the median nerve is concerned, it can be like this: Lie on your back on the bed, adduct the affected shoulder, flex the elbow, wrist, and fingers, and tilt the head and neck to the affected side to relax and retract the entire nerve; then perform shoulder abduction at the same time , elbow extension, wrist extension, finger extension, and movements of the head and neck to the opposite side (all movements in the opposite direction to the initial movement), so that the median nerve can be tightened and stretched under the drive of the proximal and terminal parts, so as to obtain the maximum activities; the movements should be slow, just a few times.

(5) Surgical means. If the symptoms never improve, or relapse after improvement, there may be fibrosis in the carpal tunnel, and surgical release can be performed under the advice of the surgeon.

The second common cause: Cervical spondylosis
1. Symptom characteristics. The nerves that control the sensation and movement of the hand are not only the median nerve introduced above, but also the ulnar nerve and radial nerve (the median nerve mainly innervates the palmar surface of the three fingers on the radial side, and the remaining parts are innervated by the ulnar nerve and radial nerve ). These three nerves are branched from a group of large nerves called " brachial plexus ", and the brachial plexus is branched from the nerve root in the neck and chest. We can simply think that the hand nerve is a branch of the cervical nerve and is its "subordinate unit". When cervical spondylosis causes damage to the nerve roots in the neck, it may also cause abnormal sensory and motor functions of the hands.

Cervical spondylosis usually causes a wider range of sensory and motor function abnormalities: in addition to the three fingers on the radial side, it may also be the two fingers on the ulnar side; it may be on the palm surface or the back of the hand; it may be located on the forearm or the back of the hand. It may affect the shoulders and upper arms; it may be an abnormality in the same area or a combination of symptoms in multiple areas.
If the hand symptoms are caused by cervical spondylosis, when we press the carpal tunnel, cubital tunnel and other areas where nerves are easily compressed, it will not aggravate the hand symptoms. This is an important method to distinguish cervical spondylosis from distal nerve entrapment.

. Coping methods.
(1) Treatment of cervical spondylosis itself. The neck is an important gathering area for the central nervous system. The terrible thing about cervical spondylosis is its compression and damage to the large nerves. If cervical spondylosis causes abnormal sensory and motor functions of the hand, the cervical spondylosis itself should be treated first. The treatment of cervical spondylosis is mainly conservative treatment. Commonly used treatment methods include: using anti-swelling drugs, traction, intervention, cervical spine exercises , adjusting pillows, etc., which are usually effective.
(2) hand function training. In addition to the treatment of cervical spondylosis itself, it is also necessary to train hand functions by referring to the "tendon sliding and strength training" introduced above to prevent hand function degradation and muscle atrophy.

The third common cause: stroke
Stroke, also known as " stroke ", is a brain injury caused by cerebrovascular abnormalities. It can be divided into two types: cerebral hemorrhage and cerebral infarction . Both types can be Causes ischemia and necrosis.
The brain is the "command" of the nervous system. Brain lesions can cause any physical abnormalities, including abnormal sensory and motor functions of the hands.
1, symptom characteristics. In general, abnormal hand sensory and motor functions are only part of many stroke symptoms. Related symptoms may also include paralysis, abnormal thinking and consciousness, abnormal language function, abnormal walking function, and abnormal function of the entire upper limb, etc. In extremely coincidental cases, only hand symptoms may occur, but generally it does not only cause symptoms on the radial three and a half fingers like carpal tunnel syndrome. Of course, accurate diagnosis of stroke still relies on sophisticated brain imaging.

. Coping methods.
(1) Active treatment for stroke.
(2) When the hand function is acceptable, try to train the hand function by referring to the "tendon sliding and strength training" introduced above as much as possible to prevent hand function degradation and muscle atrophy until the stroke is fully recovered.
(3) If the hand function is seriously missing, PNF training and other methods should be used for more active hand rehabilitation training, and electrical stimulation and other means should be used to activate the neuromuscular muscles of the hand to prevent functional degradation and muscle atrophy to the greatest extent.