Carpal Tunnel Injection - Everything You Need To Know - Dr. Nabil Ebraheim
Dr. Ebraheim’s educational animated video describes injection of the carpal tunnel - median nerve compression.
As the median nerve travels through the carpal tunnel, it may become compressed. Carpal tunnel syndrome is the condition of pressure being placed on the median nerve. The transverse carpal ligament is usually thickened at the wrist which causes compression of the nerve, the condition usually occurs due to overuse injury such as repetitive handgrip movements.
Carpal tunnel syndrome predisposing factors:
•Trauma
•Fractures
•Pregnancy
•Diabetes
•Rheumatoid arthritis
•Ganglion cyst.
As a result of this compression, the patient may experience pain and paresthesia in the median nerve distribution, as well as weakness in the hand.
Steroid injection is often used and may be successful to treat some patients who suffer from carpal tunnel syndrome. The median nerve is located between the palmaris longus and the flexor carpi radialis tendons.
Surface anatomy for injection
The course of the flexor carpi radialis, palmaris longus and the distal palmar crease should be identified and marked. The injection can be given either blind or with ultrasound guidance. The blind injection can be performed by the usual approach or by the proximal approach.
Usual approach:
•Mark the intersection of the palmaris longus tendon and the distal palmar crease.
•Next go 1 cm proximal and 1 cm ulnar to that site, this will then be the point of injection.
•Use a 25 gauge needle with desired steroid and 1 ml of 1 % lidocaine.
•Warn the patient before injection that if any feeling of numbness, paresthesia or severe pain exists, to let the physician know about it. If these symptoms exist, the doctor should withdraw the needle or adjust it before injection.
•May use local anesthesia or spray.
•Use a sterile field.
•Put the needle at a 45-degree angle to the skin of the wrist.
•Direct the needle towards the base of the thumb and advance the needle distally and slowly.
Proximal approach:
•Mark the site 4-5 cm proximal to the distal palmar crease and between the palmaris longus and the flexor carpi radialis tendons.
•Advance the needle distally towards the wrist at about a 20-degree angle from the skin.
•Keep the needle between the two tendons.
•Be aware that the nerve is in between the two tendons and adjust the needle as needed.
•Inject the desired fluid.
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Пікірлер: 43
I'm a PA student learning how to do these injections, and this really helped. Many thanks!
Respected sir your all educational videos are very easy impressive and useful for all newcomers who is struggling in orthopaedic practice .....thanks a lot .....keep going.... namaste
Very useful video! Thanks!
When an injection given into the nerve and when it is given into the muscles???
Thx for the knowledge dr. Nabil
i thought it was fabulous, and very informative. and for that i thank you hun...i really do. i now know a lot more s to why i feel the pains i feel. Thank you sweetie.
thanks for video.
Hello doctor , are these shots hurts ?? Please can u tell me and is there any exercices to be treated without injections ??
Hello doctor , is the shots painful in the carpal tunnel syndrome , and is there any exercice to avoid injections ? Thank you
Excellent!!
Great Video
Thanks
see another doctor or go back to your original one if you are having those symptoms
Hi everyone just wanted to ask you all i have a ultrasound appointment soon for my left wrist i just want to know what will happen on your first appointment and will there be injection involved let me know thanks its my first time for this appointment
Hi sir .mujhe c.t.s howa tha maine ek injection lagaliye .ab mujhe aram hai kabhi kabhi thoda pain hota hai zyda km kare toh.kya mujhe phir se toh nai aajaega.... Please reply me thanks for this helpful information
Мышечное воспаление или защемление нерва дает вопаление лимфоузла ,или наоборот воспаленный узел отдает боль окружающим тканям.Как понять связь.
How to find out this
My reaction to your videos was THAT'S IT, THAT'S IT...there's my freakin' problem!! My quality of life has suffered due to severe pain in/around my thumb/wrist area. My GP simply gave me Naproxen which didn't even begin to mitigate the terrible pain. I couldn't button my shirts, I'd drop things. However, after watching some of your excellent videos, I feel that I can elevate the discussion to more than just "Hey doc, my wrist is sore...the info is great and I appreciate it.
Can 22 weeks pregnant women take this injection please advise
nice video,,,,,,just awesome,,,keep doing in same rhythem...
@bentong3046
8 жыл бұрын
+arif razu cure for carpal tunnel visit here => www.thecarpaltunnelmaster.tumblr.com
For the usual approach, do you mean 1 cm proximal to the wrist crease, not distal palmar crease?
@Dr-789
5 жыл бұрын
There are 2 palmer crease ...... Proximal and Distal palmer crease....u shoud go 1cm proximal to distal palmer crease....
@Dr-789
5 жыл бұрын
Shamful.......First u read the bounderies of carpel tunnel.and entry points then u will know what i mean
@santosmoises3035
4 жыл бұрын
It has anesthesia?
I will try to get an injection from Australian Dr. Wish me luck. It will be very telling time to locate problem and diagnose well. Thank you for video.
Had this treatment yesterday but thus far doesn’t seem to have made a difference. No pain in the injection process.
@marylu5164
3 жыл бұрын
I have carpal tunnel on both hands, I woke up two weeks ago with arms and hands swollen went to walk in hospital the dr gave me prednisone tablets 5mg first day taking it help a LOT
@starscream5813
3 жыл бұрын
Exsctly like me, 3 days in and nothing:( have it in both hands and they could only inject one at a time due to covid wirh a 8 week gap
@Salomaeful
Жыл бұрын
This has been working for me for 10 years, I get 3 months relief from each injection. My doctor slowly probes until he his the nerve then pulls back a hint before injecting - unpleasant and painful for about 12 hrs but worth it for 3 months of relief
Local anaesthetic not needed Can give the patient a numb hand for several hours for which they won’t thank you A lot of people don’t have palmaris longus but injecting in midline if wrist in distal palmar crease works well
I heard these shots hurt SOOO bad, is it true?
@aviewisaview
6 жыл бұрын
I just came back from the doctor. I got this shot and it didn't hurt much. I thought it was going to be painful. Nope. It only hurts for seconds then the hand goes numb.
@p0ck3tp3ar
6 жыл бұрын
How did it work out for you?
@angelenevazquez9641
6 жыл бұрын
Moonie C it did not for me..i have been soar for 2 weeks now but it's not like it felt before..i can sleep now
@bigaaliyahlittleaaliyah1561
5 жыл бұрын
Yessssssss!
@filip6472
5 жыл бұрын
Mate my wrist hurt for like 3 weeks....Anatetic wears off quick and you need endome after...If the doc does it right with a big fit like their ment to its going to hurt a lot.