When reading this section, you should take into account the fact that we are talking about the possibility of restoring sensitivity, and not about its normalization. For anatomical damage spinal cord restoration of sensitivity occurs in a certain sequence.

Superficial skin sensitivity is restored first. Gradually, the emerging areas of skin sensitivity expand and merge. Usually, by the end of the 2nd week during an intensive rehabilitation process, superficial skin sensitivity is noted on the entire surface of the skin below the site of injury. The rate of restoration of skin sensitivity is shown in photos 10.7 and 10.8 and indicates that compensatory mechanisms are activated - collateral pathways for conducting information, and not regenerative processes in the spinal cord. Subsequently, skin sensitivity increases, but will always be less than skin sensitivity above the level of injury. In some areas, restoration of discrete types of sensitivity is observed. At the same time, the hypersensitivity of the skin above the lesion site is reduced. The hyperesthesia streak is not diagnosed at the end of the first stage of rehabilitation. Restoration of skin sensitivity is possible due to intersecting receptor zones of segmental innervation (A.V. Triumphov) and other mechanisms described in Chapter 2 of this book.

Photo 10.7 Photo 10.8

Restoration of deep sensitivity begins at the end of the second week. Initially, the patient can distinguish a strong stimulus - a blow to the sole, but cannot determine from which side he receives the signal. Then the perception threshold decreases, and the patient gradually more and more confidently determines which side the signal came from. By the end of the first month of intensive rehabilitation, deep sensitivity increases, although it may not reach normal.

Restoration of deep sensitivity is associated with improved circulation cerebrospinal fluid, improvement of metabolism in the reception zones of the dura mater, forming intersecting fields and restoration of conductivity along r. meningeus. Surface sensitivity is also involved in signal differentiation. Pain sensitivity is not always restored in such patients, but its restoration has the following patterns.

Zones of pain sensitivity during intensive rehabilitation fall 5-10 cm below the level determined for segmental lesions. In case of damage to C V - C VI, pain sensitivity after 2 months is determined throughout the entire upper limb and in the hands. Restoration of pain sensitivity begins with a feeling of “pins and needles”, which then turns into a burning sensation, then into a hyperpathic type of sensitivity, then pain sensitivity is clearly defined. The restoration of pain sensitivity is initially also diffuse in nature, then the localization zones merge. Pain sensitivity is a differentiated type of sensitivity and with massive lesions of the spinal cord substance, full recovery it doesn't happen.

Described phenomena of functional recovery in patients with tetraplegia due to trauma cervical spine are also characteristic of patients with other levels of spinal cord damage and obey a certain pattern, which is outlined in this chapter. This pattern lies in the fact that, first of all, structures that are less differentiated, phylogenetically more ancient, will be restored, and then phylogenetically younger ones, which will manifest themselves in the form of corresponding functions.

Annex 1

CRITERIA FOR INTENSIVE REHABILITATION
PROCESS

ACOUSTIC PHENOMENON

With a spinal injury, all joints, as well as articulations, undergo dystrophic changes. High water content and loose collagen structure in pathological processes reduce the elastic properties of the periarticular bursa and make the surfaces of the joints loose. The elastic properties of the tissues surrounding the joint depend on the endogenous water content. Changes in the water content of tissues entail changes in sound effects.

In clinical practice, several types of sound effects are observed during manipulations.

1. "Clicks"(as with traction of the digital phalanges) at the time of manipulation - a characteristic sign of normal tendon tone in unaffected joints, is regarded as a variant of the norm if there is no pain. The clearer the click, the closer it is to normal.

2. "Crunch of dry wood" at the time of manipulation indicates dystrophic lesions in the ligamentous-muscular apparatus of the joint, loss of fluid by these tissues and, as a consequence, impaired elasticity of the joint capsule. It is more often observed in older people and in some chronic patients in the first days of rehabilitation. There is no pain during manipulation. Subsequently, this sound becomes clear and rich, as in the first version.

3. "The crunch of wet rice" resembling the crunch of snow, indicates the involvement of the cartilaginous surfaces of the joint in the pathological process, their hyperhydration (corresponds to the exudation phase during the inflammatory process), loss of elasticity of collagen fibers and their swelling. This reduces the space between the congruent surfaces of the joint. These surfaces and surrounding tissues, when rubbed, reproduce this acoustic phenomenon, which can be compared to crepitus that occurs during palpation of inflamed joints. Pain during manipulation of these segments can range from moderate to severe. If the segments and intervertebral joints are located below the site of damage to the spinal cord, then pain may be absent.

4. Rough sound during manipulation, it indicates pathology in this segment and in the vertebrobostal joints. It can be compared to the sound produced when wooden sticks hit each other. This acoustic phenomenon occurs in the affected segments and joints outside the acute stage and characterizes a lack of fluid in articular capsule. Pain during manipulation is moderate.

5. No acoustic phenomenon. Sometimes during manipulation there is no acoustic phenomenon, despite the mobility of the spinal column. Its absence indicates paresis of the ligamentous-muscular apparatus that forms the corset of this segment or segments of the spine. Most often, the absence of an acoustic phenomenon is observed in spinal injuries, paresis and paralysis below the site of spinal injury.

6. Clicking of costosternal joints with some manipulations. The clicking of the costosternal joints on both sides of the sternum during manipulation indicates good unblocking, that is, the appearance of movements in these semi-joints. In patients after manipulation, light clicks are heard in well-unblocked costosternal joints when taking a deep breath.

7. "The creaking of sand." A characteristic sound, reminiscent of the creaking of sand, is sometimes heard by the patient or doctor in silence after manipulation, most often in the cervical spine. This indicates the removal of the block in the pathologically changed segment and the beginning of active movements in it. In the future, the creaking should disappear with continued slight mobility of the spine segment under study. As a rule, this phenomenon is not accompanied by pain.

OTHER REHABILITATION CRITERIA ESTABLISHED
AUSCULTATIVE

Hoarseness of voice. Hoarseness of the voice or a change in its timbre indicates a decrease in the tone of the vocal cords, a change in the configuration and volume of the larynx due to a decrease in the length of the neck, due to a decrease in the tone of the muscles of the neck muscles. Restoring the sonority of the voice and its timbre is a mandatory criterion for rehabilitation, since restoring the tone of the neck muscles will lead to some lengthening of the neck and restoration of the physiological configuration of the larynx. At the same time, the tone of the vocal cords is restored.

Nasal breathing disorder(nasal congestion - pronunciation). During a conversation with a patient, disturbances in nasal breathing, nasal sounds, and pronunciation may be noted. An obligatory criterion for rehabilitation is the restoration of free nasal breathing, the elimination of nasal sounds, regardless of the reasons cited by the patient.

Wheezing, cough. Wheezing or coughing that occurs during manipulation indicates the presence of bronchospasm in the lungs. Experienced doctor over time can clearly establish by this characteristic which lung segment amazed. The affected segment of the lung is connected to a certain segment of the spinal column by autonomic nerve fibers innervating this segment of the lung. The criterion for rehabilitation is the elimination of bronchospasm and restoration of free exhalation without wheezing and coughing during manipulation.

VISUAL CRITERIA

Persistent, uniform red dermographism is a positive criterion if it appears after manipulations in those places where it was not there before, and if it is not accompanied by maceration of the skin.

The appearance of a clear “furrow” at the site of projection of the spine, when the patient stands or lies on his stomach after treatment, is a positive criterion, indicating restoration of the tone of the back muscles and elimination of excessive kyphosis.

The appearance of clearly defined tubercles at the site of the spinous processes and pits at the sites of the interspinous ligaments along the entire length of the spine is a positive criterion for rehabilitation.

Pinpoint hemorrhages under the skin, reaching the “butterfly” syndrome. After manipulation, visible radiating subcutaneous hemorrhages may appear on the back, sometimes even from the shoulder blades to the lower back, resembling the contours of a butterfly (hence the name). In these places, moderate pain on palpation is determined. Previously, patients here noted a feeling of numbness, coldness, etc. The appearance of such hemorrhages is not accompanied by a deterioration in organ function and does not limit the patient’s mobility. They indicate an increase in blood flow in dystrophically changed layers of the skin, which is accompanied by rupture of fragile capillaries.

Sometimes spontaneous subcutaneous hemorrhages are observed on the upper and lower extremities, although neither the doctor nor the patient touched these areas. All these phenomena indicate a positive result of rehabilitation. Subcutaneous hemorrhages are a consequence of increased blood flow in the affected areas. In these same places, moderate pain is noted, which decreases before the hemorrhages disappear. The appearance of these signs is not a contraindication for continued manipulation. Hemorrhages during manipulations disappear approximately on the third to fifth day after their appearance.

Please note that traumatic hemorrhages in pathological processes, resulting in loss of tissue specificity and cessation of blood flow to the affected tissue, are observed for 7-14 days. With correctly performed manipulations, on the contrary, blood flow to the affected tissues is restored and their trophism is restored, so hemorrhages go away faster during rehabilitation.

Porous skin pattern. An experienced doctor should pay attention to the fact that the affected areas of the skin have narrowed pores. Against the background of the treatment in these places, there is first an expansion of the pores, and then the restoration of an adequate skin reaction in the form of expansion and narrowing of the pores in response to changes in temperature and blood flow in this area.

Sweating. In the affected areas of the skin, sweating is reduced or absent, especially in severe pathological processes.

Restoration of sweating, red persistent dermographism and porous skin pattern indicate optimal rehabilitation.

If sweating is increased, it should also return to normal.

Relief pattern of the surface layer of muscles. The absence of contours of muscle groups under the skin is mistakenly associated with obesity. More often, the reason is a decrease in the tone of the striated muscles. The appearance of clear contours of the muscle groups of the back, abdomen, clear facial expressions, clear intercostal spaces and intercostal muscles during forced inspiration is a positive criterion for the treatment.

Pastiness and swelling on the legs, arms, face. As a result of the treatment, swelling decreases. This is a criterion for restoring the tone of the striated muscles and its pumping function, as well as restoring the functions of internal organs. Normally, swelling on the face and limbs should disappear completely.

"Circles on the water ". When the tone of the muscles of the chest, neck, face, and head is restored, a transition of skin folds from the neck to the shoulder girdles and lower to the chest, reminiscent of circles on water, is noted. Ideally, they should disappear when muscle tone is restored.

Contouring of the neck organs and sternocleidomastoid muscles is a mandatory criterion for rehabilitation. Sometimes, a conglomerate of inert soft tissue emerges from under the sternum. This phenomenon is more often observed in overweight women with a kyphotic deformed chest. This conglomerate consists of adipose tissue and tissues that have lost their specificity. On palpation, it resembles a subcutaneous lipoma measuring 3x3 cm. Subsequently, it resolves and is replaced by specific tissues.

Double chin reduction. This is a mandatory criterion for rehabilitation. It indicates restoration of the tone of the neck muscles, muscles of the floor of the mouth, “platism”, reduction of kyphosis and scoliosis.

Some cosmetic effects, as criteria for positive rehabilitation.

1. The appearance of a normal autonomic reaction on the face. The face goes from pasty and pale to non-puffy and pink.

2. Elimination of all types of paresis of facial muscles.

3. Restoration of the physiological pattern of the lips and nose.

4. Expansion of the palpebral fissure and elimination of Horner's syndrome.

6. “Climacteric mound (tubercle).” This term was introduced by gynecologists who described its appearance in those women who come to them with complaints related to hormonal changes during menopause. This “tubercle” forms in the area of ​​the VII cervical and I-II thoracic vertebrae and is observed not only in women, but also in men. It is a kyphotic deformity of this part of the spine, surrounded by adjacent soft tissues.

Changes are also noted on the side of the sternum. The manubrium of the sternum is deflected backward, indicating the presence of traction of the first ribs in the dorsal direction. In this case, palpation of the sternoclavicular joints is painful. Against the background of these changes, the arch formed by the articulation of the second ribs with the sternum is moved forward with a ledge, which is easily determined by inspection or palpation.

Elimination of all these defects as a result of the use of traction and manipulation methods is a mandatory criterion for rehabilitation. In this case, the manubrium of the sternum together with the first ribs will move forward, kyphotic deformity will decrease cervicothoracic region and the so-called “menopausal tubercle” will disappear.

SUBJECTIVE CRITERIA FOR REHABILITATION
(according to the patient)

The effect of wave-like flow of the rehabilitation process.

During rehabilitation in patients in the first stages (weeks 1-4), an improvement in general well-being may be replaced by a deterioration. Pains reappear, reminiscent of those that occurred immediately after the injury. Sometimes sleep and appetite worsen. In the morning there is some increased stiffness. The condition of patients and the totality of complaints differ from relapse of the disease the following signs:

a) the feeling of stiffness that arises in the morning disappears in the evening;

b) pain is stronger in the morning than in the evening;

c) the emotional tone of these patients is increased;

d) the range of movements does not decrease, although they cause some pain;

e) all these phenomena pass quickly, within 3-5 weeks, decreasing every day.

The doctor, correctly analyzing the processes occurring in the patient’s body, will warn him in advance about these effects. Knowing that such manifestations are possible, patients usually calmly talk about their feelings. The dynamics of the rehabilitation process can be compared to a video film viewed in accelerated mode in the opposite direction. The patient experiences all his sensations that he experienced during the illness, but in reverse order.

The concept of disease includes dysfunction of organs, determined by the patient’s own sensations. Based on this, an important (but not the main) criterion for rehabilitation will be the disappearance of discomfort, pain and other unpleasant sensations.

A. When conducting intensive rehabilitation, the physician must be aware that after pain has subsided with ongoing treatment, pain may occur again. It is not accompanied by dysfunction and indicates the restoration of sensitivity in the area of ​​previously inactive nerve endings in the ligamentous apparatus and skin. IN in this case pain is considered as a “post-manipulation exacerbation” and means the restoration of blood flow to the receptors of the muscles and skin, which signal this. The appearance of these pains is only an indication for reducing the intensity of manipulation, which must not be stopped under any circumstances.

B. During treatment, patients often experience "broken rib" symptom. This feeling is characterized by intermittent local pain in the area of ​​the X-XI ribs during inhalation, movement, and palpation and indicates successful treatment and reversal of the rib that fixed the scoliotic deformity. In this case, there is no crepitus, a characteristic sign of fractures. Rib pain occurs the morning after the procedure and sometimes lasts from 3 days to a week. After its cessation, moderate pain occurs on the contralateral side, which also lasts 3-7 days.

B. The emergence of various forms of sensitivity from paresthesia and burning to normal in areas where there was no sensitivity before indicates the positive dynamics of the rehabilitation process. The restoration of this type of sensitivity, such as the “sensation of volume,” that is, the appearance of a sense of the length and width of the body and limbs in paralyzed patients, is associated with the restoration of proprioception and superficial sensitivity.

D. During the rehabilitation process, pain sensitivity appears in areas where there was no local sensitivity, but due to their small area the patient did not pay attention to them. The pain increases with palpation of these areas and disappears with continued treatment. This indicates the restoration of normal sensitivity in the affected areas.

D. The feeling of drowsiness and relaxation that occurs after a set of manipulations is a positive criterion, indicating a decrease in muscle hypertonicity and restoration of the sleep rhythm. The patient begins to “get enough sleep for the entire duration of his illness,” noting that he is dreaming.

SOME PHENOMENA, EFFECTS OBSERVED WHEN
REHABILITATION

The effects that occur during intensive rehabilitation of spinal patients are briefly noted here.

1. Muscle sensitivity. When muscle tone is restored, a feeling of your own muscles appears, every muscle hurts, this condition lasts 3-7 days. The phenomenon is reminiscent of muscle pain in athletes after training.

2. At the same time, a feeling of chills and an increase in body temperature appear, associated with an increase in intense muscle metabolism and the entry into the blood of metabolic products from paralyzed muscles.

3. Restoration of “thermal sensitivity” (the term is in quotation marks, since the generally accepted term does not correspond to the patient’s real sensations). Patients note that their hands and feet, which were previously cold, become warm. In this case, the reaction of temperature receptors and analysis in the cerebral cortex may not correspond to real temperature stimuli. For example, a hot object applied to an area of ​​skin may be perceived as cold and vice versa. As rehabilitation continues, temperature sensations become more and more adequate.

4. Restoring sensitivity of the pelvic organs:

a) increased intestinal motility leads to the restoration of the feeling of “abdominal fullness” and the appearance of the urge to defecate; at first, the urge does not correspond to the real act, but then this process normalizes (although it may not reach the previous sensations in patients with an anatomical break of the spinal cord);

b) sensitivity when urinating in men occurs faster than in women, which is due to the large number of receptors along the way urethra in men than in women;

c) sexual sensitivity in men (erection in the morning and erection in response to sexual fantasies) indicates a progressive restoration of pelvic functions and functions of the genital organs in spinal patients. The author does not have more detailed information, since the main goals of rehabilitation of paralyzed patients were different, but the fact deserves attention and may be of interest to urologists and sex therapists.

5. Paresthesia - a feeling of “pins and needles”, hyperpathia, hyperesthesia and even the appearance of phantom pain in places where no types of sensitivity were previously identified in paralyzed patients, indicate a positive dynamics in the restoration of sensitivity.

6. Reverse development of the clinical picture of Brown-Séquard syndrome. The author has repeatedly observed an interesting phenomenon in patients with spinal cord injury and complete transverse conduction block, which the patients described as follows: “1-2 months after the start of intensive rehabilitation procedures, there was a feeling as if I was lying divided by thin glass into two halves (left and right) from the head to the crotch." At the same time, consciousness suggested that this could not happen. The sensation persisted for 2-4 hours and then disappeared. The next day, in such patients, the symptoms of Brown-Séquard syndrome were sharply erased, that is, skin sensitivity and muscle tone on the contralateral sides were “balanced.” The disappearance of Brown-Séquard syndrome is not observed in all patients. The author associates this phenomenon with the restoration of collateral conduction pathways during transverse blockade of the spinal cord conduction pathways.

Appendix 2

SOME PRINCIPLES OF DEONTOLOGY
IN REHABILITOLOGY

In ordinary clinical practice, without thinking about the consequences, doctors tell the patient: “You need to come to terms with, get used to the fact that this disease is steadily progressing... The function of an organ lost during injury or illness is not restored,” etc. These and other statements of this type sound like a sentence. It is not for nothing that the issue of iatrogenic diseases and the consequences of medical statements is so pressing.

The patient believes the doctor, and this makes him give up searching for an opportunity to rehabilitate himself and restore the lost function. He moves from a state of actively searching for methods of rehabilitation to a state of passive adaptive life activity, which decreases every day due to subsequent dysfunction of certain organs.

Adaptive reactions are a different qualitative state. It lowers the patient one step to a state of vegetative existence.

The volitional component during rehabilitation is an important qualitative criterion for prognosis rehabilitation treatment. You can give here examples of the restoration of such famous personalities, like the athlete Yuri Vlasov, the famous artist Vladimir Vinokur and many others. All these patients were driven by one thing - the need to restore reduced and lost functions for survival, that is, to increase their vitality. These people took the path of abandoning adaptive rehabilitation methods. The main thing that helped them recover was the presence of an anatomical substrate that must perform its specific function, awareness of the need to restore function, and willpower!

The need for a particular function for survival is determined by consciousness. Consciousness is a thought process formed under the influence of information coming from the external environment. Naturally, only the awareness of the need for the function of a particular organ for survival is the driving reason for the restoration, formation and development of lost (reduced) function in sick and disabled people.

The rehabilitation doctor must clearly understand the above, and through his actions and words create in the patient the consciousness of the need to restore lost functions. He must prohibit others from helping the patient in cases where the latter can handle it himself. It is necessary to encourage any patient’s aspirations for independence and, if necessary, to be tough and demanding of the patient, to suppress laziness and hysterics. A rehabilitator must clearly understand the psychology of disabled people who, before meeting him, led a secluded life and were surrounded by excessive care. Often patients are spoiled by their own exclusivity and the sympathy of others. They are accustomed, more often subconsciously than consciously, to using their inferiority for survival. They are jealous and require increased attention. Patients who are not familiar with rapid rehabilitation methods are usually in a depressed state.

Patients with tetraplegia often experience suicidal thoughts. Some accept their disability status and even derive some benefit from it. With each year of disability, their faith in recovery fades. Some patients have an inadequately euphoric assessment of their condition and are ready to be treated anywhere, anyhow, and with anything. For such patients, disability is a way of life, and treatment is its variety. During their disability, many patients visited various rehabilitation centers and saw similar patients without signs of rehabilitation progress. Their pessimism is understandable. Severe physical and psychological trauma makes them withdrawn, hysterical and, as a rule, very suggestible. All patients in this group, when asked “Do you want to recover?” They will answer positively and will assure you that this is all they dream of. In reality many of them only dream, but they will not help the doctor or fulfill his demands. They proceed from a false attitude of their own exclusivity: the whole world revolves around them, everyone is obliged to help them, they are the ones who made the doctor happy by allowing themselves to be treated. An experienced rehabilitation doctor must first of all find out who needs rehabilitation: patients or relatives who are tired of these patients. From the first day of his appearance, a doctor must break the existing stereotype of thinking and behavior not only of the patient, but also of the people around him.

A doctor who knows the methods of high-speed rehabilitation must be confident in himself, in his knowledge and in a one hundred percent positive effect. During a conversation with patients and their relatives, the doctor’s voice should be confident and firm. Any attempts to evade the doctor’s demands must be stopped even in small things.

A rehabilitation therapist must be a subtle psychologist and be flexible in his statements, otherwise the opposite result can be achieved - the patient may become depressed and lose the will to win.

The doctor should sincerely rejoice together with the patient in any small victories over disability. Remember! A big victory is made up of small victories. It is necessary to encourage the patient not to stop there.

And it is also important to note: if the doctor does not know how to restore function in the presence of an anatomical substrate, this does not mean the outcome is fatal. This only indicates the level of competence of a particular doctor. But statements about the fatality of the outcome are a sign of the doctor’s incompetence!

Of course, to help a patient restore lost functions, you need to be competent. And competence and professionalism are knowledge of the laws of the processes of restoration of impaired functions, the ability and desire to put your knowledge into practice in order to see the result that you predict.

The doctor must find a common language not only with the patient, but also with the patient’s relatives, friends and medical specialists to whom he will have to turn for help. The behavior and speech of the rehabilitation therapist should strengthen the patient’s faith in the positive outcome of rehabilitation. Without the faith of the patient and his environment in the rehabilitator, all attempts at rehabilitation are doomed to failure.

Against the background of rehabilitation measures, patients who immediately notice progress - healing of bedsores, the appearance of muscle tone, new movements, at first rejoice at these changes, and then begin to assure that they have always been like this. Don't be surprised, this phenomenon has a simple explanation. Every disabled person dreams in his sleep and in reality: to be independent and mobile. Changes in the psyche during a long stay in a motionless state lead to an inversion of temporary perception in consciousness. In other words, what the patient once saw in a dream is layered onto current events. This is an elementary defensive reaction of the psyche. We all don’t like to remember bad things, and what could be worse than helplessness and disability.

Record video before and during treatment. It will help analyze the dynamics of the rehabilitation process. Showing the patient footage where he cannot make any movements has a sobering effect on euphoric patients and will help avoid arguing with them. Video footage shown to patients when controversial issues arise (and they will inevitably arise) will strengthen the authority of the rehabilitation therapist. We also recommend taking photographs of interesting moments of rehabilitation. As soon as the patient’s fingers begin to obey and he can write, let him keep a short diary, where he briefly notes the positive aspects of rehabilitation. In addition to the ability to analyze changes during the rehabilitation process, changes in handwriting will also indicate progress during rehabilitation.

Correct psychological tactics will consolidate the positive dynamics of intensive rehabilitation.

LITERATURE

1. Badmaev B.Ts. Psychology: how to study and master it. - M.: Educational literature, 1997.

2. Buhl P.I. Psychotherapy, hypnosis and suggestion in modern medicine. - L.: Knowledge, 1985.

3. Group psychotherapy / Ed. B.D. Karvasarsky, S. Leder. - M.: Medicine, 1990.

4. Platonov K.I. The word as a physiological and healing factor. - M.: Medgiz, 1957.

5. Topolyansky V.D., Strukovskaya M.V. Psychosomatic disorders. - M.: Medicine, 1986,

6. Freud Z. About psychoanalysis. - St. Petersburg: "Alletheia", 1997.

7. Haley J. Extraordinary psychotherapy. - London, 1986.

8. Shertok L. Hypnosis / Trans. from French - M.: Medicine, 1992.

CONCLUSION

Finishing this book, the author understands that the reader may have many questions, especially about further tactics management of such patients. The conversation about this will be continued on the pages of the following books. The possibilities for rehabilitation of such patients increase every year thanks to medical advances. The selfless work of doctors who save the lives of victims of car accidents, military conflicts and natural disasters allows patients to survive in cases that were previously considered hopeless. The author hopes that the use of intensive rehabilitation methods will help many patients who have suffered a spinal injury to restore seemingly irretrievably lost functions. If this book helps rehabilitation doctors, at least in some cases, help seriously ill patients, then the author will consider the task for which the book was written completed.

Types of sensory disturbances when pathways are damaged at various levels.

11783 0

Particularly difficult problems in hand nerve surgery include plastic surgery of nerves in a scar-modified tissue bed, as well as irreparable lesions of the central and/or peripheral ends of the nerve. Depending on the characteristics of the damage and the condition of the tissues in the defect area, two main situations can be distinguished: 1) when nerve repair is possible and 2) when the problem of restoring sensitivity in the fingers should be solved in other ways (Diagram 27.3.1).

Scheme 27.3.1. The choice of method for restoring the sensitivity of the skin of the finger, depending on the condition of the ends of the nerves and tissues of the hand.

Nerve grafting is possible. If a previously performed operation on the nerves did not lead to the restoration of skin sensitivity on the fingers, then in most cases the surgeon chooses one of four options for nerve plastic surgery: 1) repeated conventional plastic surgery; 2) plastic surgery of the nerve with non-blood-supplied neural grafts with their placement outside the scarred tissue area; 3) plastic surgery with blood-supplied neural grafts and 4) placement of non-blood-supplied neural grafts in a flap specially transplanted into the defect area, which plays the role of a full-fledged biological environment.

Repeated nerve repair is performed when the condition of the soft tissues is satisfactory, there are no significant scars in the area of ​​the tissue defect and a relatively small amount of diastasis between its ends. The chances of good results are maximized if the extent of the damage allows excision of scarred tissue in the area of ​​the nerve defect.

Nerve plastic surgery with transposition of neural grafts. With a significant size of the nerve defect (several centimeters) and pronounced scar tissue changes, the real danger becomes blockage of axon growth through the grafts by the resulting scars. If the scar cuff around the area of ​​nerve damage cannot be excised, then the chances of success increase significantly when longer neural grafts are used for repair of the nerve, laid to bypass the scarred area.

Transplantation of blood-supplied neural grafts is indicated in cases where simple plastic surgery options are not applicable due to the high probability of scar blockage of the grafts. Most often, this situation occurs with defects of the median nerve at the level of the carpal tunnel and proximal hand.

Technique of operation. A radial vascular bundle from the contralateral forearm is used as a blood-supplied neural graft, if necessary including a muscle fragment and/or a piece of skin.

The graft is transferred to the defect area and placed so that the length of the intermediate sections of the donor nerve corresponds to the size of the diastasis between the refreshed ends of the median nerve (Fig. 27.3.16, b). Then the neural graft is divided into sections, keeping the adjacent vessels intact (Fig. 27.3.16, c). After connecting the ends of the neural grafts with the ends of the median nerve, the artery and one of the veins of the transplanted tissue complex are connected to the corresponding elements of the vessels of the receptive bed (radial or ulnar vascular bundle - Fig. 27.3.16, d).

Rice. 27.3.16. Scheme of plastic surgery of a median nerve (MN) defect using a blood-supplied neural graft from the radial neurovascular bundle.
a — location of the ends of the median nerve before surgery; b, c — laying and formation of fragments of the neural part of the graft; d - after surgery. A, V - artery and vein; N - nerve (explanation in the text).

Creation of a complete biological environment around neural grafts. With widespread scar tissue changes in the area of ​​the nerve defect, the surgeon often has to solve the problem of not only nerve plastic surgery, but also restoration of damaged tendons and skin. A radical solution to this set of problems can be transplantation of a complex of tissues into the defect and the placement of both neural grafts (non-blood-supplied) and tendon grafts.

When the defect is located in the area of ​​the carpal canal and base of the hand, radial or ulnar flaps (muscle or musculocutaneous) can be used as a donor source. However, the least complicated and traumatic is the transplantation of a muscle flap from the flexor carpi ulnaris on a peripheral pedicle.

Technique of operation. A flexor carpi ulnaris flap is formed from the center to the periphery, separating the muscle tissue from the tendon so as to preserve the anatomically constant and fairly large branches of the ulnar vascular bundle entering the peripheral part of the muscle (Fig. 27.3.17, a). The length of the flap is determined taking into account the size of the defect between the refreshed ends of the nerve and the arc of rotation of the tissue complex.

The muscle flap is moved into the carpal tunnel and sutured to the surrounding tissues. Neural grafts are passed through the transplanted muscle, and their ends are anastomosed with the ends of the median nerve (Fig. 27.3.17, b).

Rice. 27.3.17. Scheme of plastic surgery of the median nerve using a flexor carpi ulnaris flap on a peripheral pedicle as a complete biological medium.
CH - median nerve; LSK - flexor carpi ulnaris; L - muscle flap from the ulnar flexor of the hand; Tr - neural grafts passed through a mixed muscle flap; LA - ulnar vascular bundle (explanation in the text).

Use of sensory branches of intact nerves for plastic surgery. In rare cases, as a result of injury, the central end of the nerve trunk is affected over a significant extent. Most often, the median nerve at the level of the forearm is affected by ischemic necrosis of the tissues of the anterior surface of the segment. In this case peripheral section nerve can be used for reinnervation, and the dorsal cutaneous branch of the ulnar nerve or the superficial branch is used as the central end radial nerve.

Nerve plastic surgery is not possible. Implant plastic surgery of nerves. A special situation arises in cases where the peripheral ends of the median and/or ulnar nerves are excised. This may be the result of an improperly performed operation for Dupuytren's contracture, a consequence of injury, or the result of transplantation of a denervated flap with a significant thickness of tissue onto the hand.

If the condition of the skin of the finger is satisfactory, then reinnervation of the working surfaces of the hand can be achieved by implantation nerve plasty.

Technique of operation. The central end of the median (ulnar) nerve is isolated and refreshed. A neural graft (usually the sural nerve) is passed under the skin in the direction of the denervated zone so that the end of the donor nerve comes out into the smallest incision in the functionally significant area of ​​the finger (hand) (Fig. 27.3.18, a). Then the central end of the neural graft is sutured to the central end of the main nerve, and the distal end is divided into separate bundles (Fig. 27.3.18, b). Each bundle is brought out using a thin thread and a needle to a separate point, and after removing the excess bundle with scissors, its end is immersed with microtweezers at the subdermal level (Fig. 27.3.18, c). This method allows us to obtain a fairly high level of reinnervation of complex flaps transplanted onto the fingers.

Rice. 27.3.18. Scheme of the stages of implantation plastic surgery of the native palmar digital nerve (SPN) for reinnervation of the palmar surface of the distal phalanx.
a — neural graft (Tr) is brought into the wound of the distal phalanx; b — the end of the graft is divided into separate bundles; c — implantation with a neural graft bundle is completed (explanation in the text).
Sensitive flap transplantation. Transplantation of sensitive flaps onto the denervated surface of the fingers is possible in various variations and in many cases is an alternative to complex options for plastic surgery of nerves and tissue defects. The following methods of transferring sensitivity to the hand can be used.

S-shaped plastic surgery with opposing flaps. Indicated for moving sensitive skin from the secondary to the dominant surface of the finger in elderly patients or after unsuccessful plastic surgery nerves.

Technique of operation. The operation is performed in two stages (Fig. 27.3.19). During the first stage, two flaps are formed on the proximal pedicle (sensitive) and on the distal pedicle (denervated - Fig. 27.3.19, b, c). The flaps are swapped and sutured to the edges of the defect (Fig. 27.3.19, d). In this case, excess skin occurs and both flaps protrude somewhat. After 6-8 weeks, the swelling subsides and the flaps take root.

During the second stage of the operation, the superficial layer of skin along approximately two-thirds of the insensitive flap is excised. When determining the size of the excised area, it is advisable to first remove about half of the skin of the flap, then try to move the distal edge of the proximal flap and, only after assessing this distance, finally determine the boundaries of the excision. In this case, the contours of the distal phalanx change only slightly (Fig. 27.3.19, e, f). This method allows one to obtain close to normal sensitivity of the distal phalanx, despite a 2-month period of flap hyperesthesia.

Rice. 27.3.19. Stages of reconstruction of the soft tissues of the distal phalanx of the finger to improve the sensitivity of its denervated surface (according to I. Niechajev, 1987).
a - d - 1st operation; d - f - 2nd operation. Points - denervated half of the finger; dark shading - sensitive half of the finger (explanation in the text).

Transfer of an island flap from the non-dominant surface of the finger. This operation can be carried out in two ways. In the first option, a flap is cut out on a wide base, into which the neurovascular bundle is included (Fig. 27.3.20, a). After transposition of the flap onto the dominant surface of the finger, the donor defect is covered with a skin graft. The method was proposed by J.Littler in 1964.

In the second option, proposed by BJoshi in 1974, a flap from the non-dominant surface of the finger is isolated and transplanted onto the denervated surface of the finger as an island flap (Fig. 27.3.20, b).

Rice. 27.3.20. The use of flaps to restore the sensitivity of the working surface of the finger at the expense of the skin of the sensitive non-dominant surface.
1 — transposition of the flap from the opposite surface of the finger (according to JXittler, 1964); 2 - island flap transplantation (according to BJoshi. 1974) (explanation in the text).

Transplantation of a flap from the dorsal radial surface of the second finger of the hand is advisable for tissue defects of the first finger. The broad-based flap includes the terminal branches of the 1st dorsal carpal artery, as well as the superficial branch of the radial nerve (Fig. 27.3.21). The donor defect is covered with a dermatotomy flap.

Rice. 27.3.21. Scheme of transplanting a flap from the dorsal radial surface of the second finger to the palmar surface of the first finger: before (a) and after (b) surgery.

Transfer of an island flap from the fourth finger to the first finger. Irreversible damage to the branches of the median nerve with impaired sensitivity of the palmar surface of the first finger became the basis for the development of an operation to transfer sensitive skin from the zone of innervation of the ulnar nerve.

Technique of operation. An island flap is cut out on the ulnar surface of the fourth finger of the hand and isolated on the palmar digital neurovascular bundle in the proximal direction to the level of the departure of the common palmar digital artery from the superficial palmar arch (Fig. 27.3.22, a, b). The vascular pedicle is isolated with a layer of loose fatty tissue, preserving the thin veins accompanying the arteries. If necessary, the radial portion of the palmar arch can be divided and mobilized. The common palmar digital nerve is divided to the point of flap rotation using a microsurgical technique. The flap is carried out in the subcutaneous canal, making additional access if necessary, and sutured into the tissue defect of the first finger (27.3.22, c). For the success of the operation, it is important to prevent torsion and compression of the vascular pedicle.

Rice. 27.3.22. Stages of transplantation (a, b, c) of an island flap from the ulnar surface of the fourth finger to the palmar surface of the first finger (explanation in the text).

Engraftment of the flap leads to the restoration of sensitivity on the working surface of the first finger. At the same time, many authors note hyperesthesia of the transplanted tissues, sometimes reaching hyperpathy, which reduces the value of this method.

Sensitive islet radial cuta transplantation. A radial fasciocutaneous flap on a peripheral vascular pedicle can be transplanted to the area of ​​the eminence of the first finger and reinnervated (Fig. 27.3.23).

Rice. 27.3.23. Scheme of transplantation of a radial flap on a peripheral vascular pedicle and its reinnervation through the palmar cutaneous branch of the median nerve.
LuA - radial artery; LoA - ulnar artery; LCN—lateral cutaneous nerve of the forearm; LVSN - palmar branch of the median nerve; KT - skin graft covering the donor defect, a - before surgery; b - after surgery.

Free transplantation of tissue complexes. To restore the full sensitive skin of the hand, various donor sources can be used, most often the basin of the first dorsal metatarsal artery. The advantages of flaps taken from the area of ​​the first interdigital space of the foot include the possibility of transplanting flaps of various shapes and relatively large ones, which can be placed on the working surface of the hand. Reinnervation of transplanted tissues can be achieved through the deep branch peroneal nerve(nerve flap), which is sutured to one of the sensory nerves of the bone (Fig. 27.3.24).

Rice. 27.3.24. Scheme of isolation and transplantation of a flap, including tissues of the first interdigital space of the foot (a), onto the denervated surface of the stump of the fingers (b).
Ta - dorsal artery of the foot; B - accompanying arteries and veins; N - deep branch of the peroneal nerve; T - graft, NA - zone of neural anastomosis; SA - zone of vascular anastomosis.

IN AND. Arkhangelsky, V.F. Kirillov

Most often, we first notice numbness when waking up in the morning or at night, and at first we do not attach any importance to it, because the cause may be an uncomfortable posture.

If numbness in your fingers becomes regular, then you should hurry to see a doctor, because any treatment is more successful in the early stages of the disease, and this symptom is a cause for alarm.

Why do my fingers go numb?

With various problems, we may feel numbness in different parts of the hand. Numbness of the little finger is quite common, but discomfort in the thumb area is less common.

The causes of numbness in the hands or fingers can be different.

Most often this condition is associated with osteochondrosis, but this is not the only cause.

Causes of numbness

• Osteochondrosis;
• Carpal tunnel syndrome;
• Endocrine disorders;
• Inflammatory processes in the joints;
• Polyneuropathy;
• Raynaud's disease;
• Injuries;
• Violation of vascular patency;
• Overstrain of muscle fibers;
• Severe stress.

The most harmless reason that causes numbness in the hands is muscle strain. If your head lies uncomfortably on the pillow while sleeping, or if your posture is incorrect when working at a desk or computer, then severe tension in the neck muscles occurs. Muscle spasm compresses nearby nerve fibers.

Unpleasant sensations can occur in different fingers of the upper extremities, from the little finger to the big, depending on which nerve and in which area is pinched.

Pinched nerves also occur with constant tension in the hands, when a person works with his hands for a long time. Today this is most often associated with working at a computer, because actively using the keyboard is an unnatural activity for our hands. Monotonous work impairs blood circulation, swelling develops, and tendons or joints may become inflamed.

As a result, the nerves become pinched. The most commonly affected nerve is the median nerve, which passes through the carpal tunnel. At first, numbness in the hands is felt only in the morning, and later pain occurs.

If you do not pay attention to the symptoms, the condition will worsen, and your hands will hurt day and night. This disease is called carpal tunnel syndrome; it can manifest itself on only one side; numbness in the right hand is more common, because it usually bears more load.

Inflammatory processes in the joints lead to approximately the same consequences. More often this is arthrosis. It affects one joint first, but can spread to others.

If, for example, you notice numbness in your left hand and do not take action for a long time, then after a while the symmetrical joint on the right may become inflamed.

The causes of numbness will also be a pinched nerve.

Numbness in the hands may be due to Raynaud's disease. In this case, microcirculation is disrupted and discomfort spreads to both hands. Already at the initial stage of the disease, the fingers freeze, turn pale and hurt in the cold. The nerves responsible for the functioning of the fingers and hands are affected by polyneuropathy. In turn, the causes of this disease can also be different.

Causes of polyneuropathy

• Diabetes;
• Hypovitaminosis;
• Anemia;
• Infectious diseases.

Similar processes, accompanied by compression of nerves, occur with some endocrine diseases, during nervous overload, for example, when in a state of chronic stress or after severe emotional shock.

Injuries can damage nerve tissue and lead to irreversible consequences, in which case numbness in the hands will remain forever.

An alarming symptom may be one-sided sensations.

This may be due to narrowing of the lumen of blood vessels due to various diseases. Atherosclerotic plaque or a blood clot in the blood vessels means a threat of ischemic stroke.

The fact is that numbness in the fingers of one hand occurs when the vertebral artery is compressed or blocked on one side. The vertebral arteries supply blood to the brain, and narrowing of their lumen, and even more so, blocking can be catastrophic for the brain.

Thus, even slight numbness in the fingers of the left hand (as well as the right) can be a symptom warning of an impending stroke, and therefore requires attention.

Osteochondrosis as a cause of hand numbness

The most common cause of numbness in the limbs is osteochondrosis. This disease is so widespread that it is rare that an adult does not experience its symptoms. With significant damage to the spine by the pathological process, numbness of the arms and legs is possible, but this degree of the disease is not very common.

Numbness of the fingers causes osteochondrosis of the cervical spine. Degenerative-dystrophic changes in this disease lead to damage to the intervertebral discs and the vertebrae themselves.

For this reason, compression of the nerve endings occurs and the functions of the vertebral arteries are disrupted, in particular, they become less blood-permeable. These pathological processes and cause numbness in the upper extremities.

Damage to the intervertebral discs leads to the formation of protrusions and hernias, which put pressure on the nerve roots and on the vessels passing nearby. Degeneration of the vertebral bodies can be manifested by the formation of osteophytes (bone growths), which also compress the nerves.

Thus, numbness in the fingers can be a sign of cervical osteochondrosis, and you can even determine which vertebrae are affected, because compression at certain levels is reflected by numbness in the corresponding areas of our body.

For example, numbness in the little and ring fingers indicates damage 8 cervical vertebra. If the numbness extends to the innominate and middle fingers, then the 7th vertebra was damaged. With such sensations at the level of the thumb, index and middle fingers, the cause is usually a problem in the 6th vertebra.

Diagnosis of the problem

It is very important to make a correct diagnosis. The most alarming signal is numbness in the fingers of the left hand. First you need to exclude pre-infarction and pre-stroke conditions.

Numbness in the fingers of the right hand can also be a signal of an impending stroke. Severe violations cerebral circulation can be prevented if this pathology is diagnosed in time. Next, you need to find out the condition of the spine for osteochondrosis. Its treatment depends on the stage, so the examination must be thorough, you need to do all the procedures that the doctor prescribes.

Further diagnosis of numbness in the upper extremities is associated with the identification of inflammatory processes, compression or damage to the nerve endings responsible for the functioning of the hand and fingers.

Diagnostic procedures

• X-ray of the cervical spine in different projections;
• Dopplerography and angiography of blood vessels;
• Magnetic resonance imaging of the spine;
• Computed tomography of the brain;
• Electroencephalography.

Treatment

If you wake up in the morning or at night and feel numbness in your fingers, then do not ignore this manifestation. Perhaps something needs to be done, because this could be a signal from the body about trouble.

First of all, of course, we think that the reasons are simple: an uncomfortable pillow, a sleeping position. Most often in this case we feel numbness in the little finger; if you stay in an uncomfortable position for a long time, the unpleasant sensations can spread to the entire hand, but, as a rule, this only happens on one side.

To exclude this option and not bother the doctor in vain, try changing the bed; it may be worth purchasing an orthopedic pillow so that at night when you change position you will not find yourself in an uncomfortable position again.

If this is the problem, then it will literally immediately positive result, and nothing else needs to be done.

If simple measures do not help, you need to consult a doctor to get adequate treatment.

Pinched nerve endings in the hand are treated by a neurologist using medications, vitamins and physiotherapy. If the cause is excessive physical exertion or incorrect body position during work, then these causes need to be eliminated and a short course of treatment restored to restore balance in the body and the functioning of nerve endings.

Specific treatment is prescribed for inflammatory diseases or osteochondrosis.

Possible treatments for numb fingers

• Medication. Relieves inflammatory swelling, reduces pain, improves the functioning of blood vessels and nerves. Vitamins and chondroprotectors help restore tissue functions.
• Local treatment involves manual therapy and massage.
• Physiotherapeutic procedures stimulate blood circulation and tissue regeneration. The most commonly used are laser, ultrasound, and magnetic therapy.
• In many cases, therapeutic exercises can completely relieve numbness in the hands or significantly alleviate the condition.

Prevention of hand numbness

It is always much easier to prevent a disease than to treat it. Disturbances in the functioning of blood vessels and nerves can cause numbness in the upper extremities. To preserve blood vessels, you need to adhere to a healthy lifestyle, that is, do not abuse alcohol, stop smoking, limit salty, spicy foods.

The diet must include meat, fish, seafood, a lot of vegetables and fruits, and herbs.

If you work with your hands, be sure to take breaks every few minutes for small exercises so that normal blood flow in the extremities has time to restore. If you suspect more serious problems, contact a specialist immediately.

I read the article, everything is probably correct. I have cervicothoracic and lumbar osteochondrosis, diabetes, high blood pressure - I have all this. On top of everything else, my fingers are becoming numb more and more often. I carry out treatment with all available means, follow the recommendations of doctors, and use traditional medicine.

I live in the Petrovsky district, my husband is a disabled person of the first group. The only son serves. I am a caregiver. On June 7, from hard work or something else, the little finger and half of the ring finger on the left hand were lost in the morning, the whole hand became weak. I went to Stavropol. Doctors without money won’t even let you come to me. How to be? As long as the other hand is intact, should I be buried alive? What to do? There is nothing to take out loans and debts for. The husband is a labor veteran, he earned the Gorbachov Order. How to treat? Or write Malakhov on television?

Since when did the 8th vertebra appear in the cervical spine?

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Causes of numbness in fingers. What to do if your fingers go numb

Unpleasant sensations in the fingers - tingling, numbness - are familiar to many. More often than not, this is not given importance. But if symptoms appear constantly, you need to find out what is the cause of numbness in your fingers. Sometimes discomfort is easily eliminated by changing the position of the limb, with a few active movements.

Causes of paresthesia

There are many nerve endings concentrated in the fingertips. In an uncomfortable position, the blood vessels are compressed, blood circulation is disrupted, which entails unpleasant painful sensations. They target women more often than men. At any age, numbness in the fingers and toes can occur. Reasons not related to the disease are the following:

1. Sleeping in an awkward position.
2. Local or general hypothermia of the body.
3. In case of poisoning with chemicals, alcohol, drugs.
4. Consequences of limb injuries.
5. Prolonged position of the fingers during certain types of activities (working at the computer, knitting, etc.)
6. The presence of tightly fitting accessories (bracelets, rings).

Paresthesia often plagues pregnant women due to increasing stress and hormonal changes. You should think about the seriousness of the disorders if only one limb or finger is numb. Frequently recurring symptoms may indicate the presence of dangerous diseases such as:

1. Brain disorders and hemorrhages.
2. Disturbances in the functioning of the cardiovascular system.
3. Osteochondrosis and intervertebral hernia.
4. Carpal tunnel syndrome is a disease of the carpal tunnel.
5. Blood circulation disorders in diabetes mellitus.
6. Fungal diseases of nails.

Sometimes impaired sensitivity of the limbs is associated with an incorrect lifestyle. In any case, consultation with a specialized specialist is essential.

Symptoms and manifestations of the disease

With diseases of the cardiovascular system, numbness occurs in the little finger, and sometimes in all the fingers of the left hand. Impaired sense of touch may worsen at night. Gradually they turn into tingling, spreading to the entire surface of the left hand. Accompanied by pain behind the sternum and under the shoulder blade.

Numbness and muscle weakness in only one arm, lower limbs may indicate a stroke. This adds severe headaches and poor coordination when moving.

Compression of the nerve endings in the intervertebral discs of the cervical spine is accompanied by numbness and weakness of the first three fingers. There is pain in the shoulder, elbow, hand, and a feeling of crawling. Numbness of the index finger is present with arthritis or arthrosis elbow joint.

Carpal tunnel syndrome often plagues office workers who long time spent at the computer, musicians, drivers. It occurs when performing the same type of repetitive movements over a long period of time. Manifested by numbness of the thumb and index finger. There is pain and discomfort in the wrist joint, when bending the hand. Pain can equally affect people of different professions, both painters and seamstresses.

In diabetics, blood vessels suffer due to high sugar levels. Poor blood circulation leads to numbness in the hands and feet. The same symptoms can be observed in inflammatory processes associated with fungal infections in the root area of ​​the nail plate.

Treatment of loss of sensation

Violation of tactile sensations is only a symptom of a particular disease. Correct qualified diagnosis is necessary. The fight should be aimed at treating the underlying disease. If the cause lies in heart problems, consultation and treatment with a cardiologist is necessary. Numbness of the fingers - the little and ring fingers - may indicate a heart attack or stroke. In this case it is necessary urgent help and hospitalization.

In case of polyneuropathy, you should consult a neurologist. After diagnosis and tests, the doctor will prescribe individual treatment. The complex includes the use of medications, manual therapy, and physiotherapy.

Cervical osteochondrosis or glenohumeral periarthritis often causes numbness in the fingers of the right hand. The reasons, as well as the treatment, may vary. You will need to consult several specialists - a neurologist, vertebrologist, rheumatologist, orthopedist. In addition to the use of drugs aimed at eliminating inflammatory processes, vitamins, painkillers, ointments, compresses, physiotherapy, massage and gymnastics are prescribed.

Physiotherapy and gymnastics

For certain diseases, drug treatment is aimed at relieving swelling, eliminating pain, improving the functioning of the bloodstream and nerve endings. A significant role Physiotherapeutic procedures play a role in treatment. They improve blood circulation and promote the restoration of affected tissues. Electrophoresis with hydrocortisone and lidase will help relieve pain and inflammation in the joints and soft tissues for arthritis and arthrosis. Magnetic therapy sessions, ultrasound and laser effects, and amplipulse are useful.

The set of measures may include impact on active points– acupuncture. Osteopathy is used to reduce spasms in muscles and ligaments. This is a technique and techniques for gentle effects on certain muscle groups. The action of manual therapy is aimed at both relaxation and stimulation of soft tissues.

A healthy, active lifestyle will help get rid of the problem. Gymnastics and massage are essential to restore sensitivity in the fingers. Many similar complexes have been developed that can give good results.

Traditional medicine

To get rid of numbness in the fingers at night, if the cause is numbness of the limb, then special treatment will not need. It is enough to complete a few simple exercises consisting of opening and closing the hands. If numbness is accompanied by pain, you can use the following: folk remedies.

• To increase blood circulation in the extremities, rub an oil-pepper mixture. To do this, boil 50g of ground black pepper in 0.5 liters of vegetable oil for 30 minutes.
• Warm pumpkin porridge is applied to the entire limb. Cover with polyethylene or compress paper, with a warm scarf on top.
• A vodka tincture of marsh cinquefoil, nettle and wormwood in a ratio of 1:2:2, relieves inflammation and stimulates blood circulation. Plant materials are infused with vodka for 20 days in a dark place. Used as a rub.
• Contrast baths will help improve sensitivity. Hands are alternately lowered into hot and cold water. The procedure can be performed several times a day.
• For numbness of the fingertips associated with arthrosis of the elbow or shoulder joint make a compress with “talk”. The ingredients can be purchased at the pharmacy: saline. solution (150 ml), dimexide (50 ml), hydrocortisone (2 ampoules), lidocaine (5 ampoules).

When using traditional medicine, you should consult your doctor. Use with caution in people prone to allergic reactions.

Preventive actions

The main goal is to notice in time the onset of the disease, which causes paresthesia of the fingers. Monitor the condition of the cardiovascular system, joints and spine. Avoid hypothermia of hands and feet, excessive physical exertion, and injuries.

No matter how trivial it may be, you should lead a healthy lifestyle. Healthy food, a minimum of fat and salt - this is dangerous for blood vessels. Regular physical activity appropriate to your condition and age is required. Proper alternation of work and rest, especially with monotonous and monotonous work. Mandatory cessation of smoking and alcoholic beverages.

To avoid the unpleasant sensations associated with paresthesia, take care of your health. Contact your doctor promptly. An adequate diagnosis can guarantee recovery.

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Numbness of fingers - causes. What causes numbness in the fingers and what is the most effective treatment.

Reasons: why there is numbness in the fingers on the right and left hand

Many people experience numbness in their hands while sleeping. It is often expressed by tingling, numbness and even the inability to raise the arm or turn it along with the body to the other side. The hand can hang like a lifeless whip, which undoubtedly frightens a person who has not yet woken up. Agree, this situation confuses many, but is it worth panicking because of the symptoms? What should you pay attention to?

1. When our hands go numb at night, we often realize that our limbs have simply “rested.” Due to unconscious movements during sleep, a person can roll over from side to side many times, sometimes not noticing that he is not lying down quite comfortably. And the hand can be under the body. This causes a slight circulatory disorder due to squeezing of blood vessels and the hand goes numb for a short time. Usually, if nothing else bothers you and the paresthesia disappears within just a few minutes, there is no need to call an ambulance.

2. A more threatening cause of numbness in the fingers is osteochondrosis or intervertebral hernia in the cervical region. With this diagnosis, paresthesias are constant companions of patients’ night sleep, which causes considerable discomfort. Since osteochondrosis is the scourge of our century, it affects more than 75% of the population, it is extremely important to treat such a disease. Otherwise, lack of therapy can lead to disability, constant pain in the spine and impaired blood supply to the spinal cord and brain.

3. Numbness of the hands also indicates a serious illness - Raynaud's syndrome. In rare cases, the disease is acquired, but usually it is a genetic disorder. It can occur in workers of industrial factories, where microdamage to the fingers has become the norm. Raynaud's disease also appears in people with frequent hypothermia and emotional stress.

4. Carpal tunnel syndrome is a disease of office workers. It appears in almost everyone who sits day and night at the computer or performs the same type of movements: writes a lot, knits, stitches on a sewing machine or paints the walls. Each profession can trigger the occurrence of carpal tunnel syndrome. It is manifested by pain in the wrist joint, numbness of the fingers, most often the thumb and index, as well as unpleasant sensations when bending the hand. If such an ailment is not treated, it can lead to muscle dystrophy, compression of blood vessels and serious circulatory problems. This can be treated surgically, as it turns into gangrene.

5. For people suffering from diabetes, numbness in the fingers is not uncommon. Due to increased sugar, blood vessels invariably suffer, which leads to blood circulation disorders.

6. Fingertips may go numb due to nail fungus - onychomycosis. Due to the inflammatory process that develops in the area of ​​the nail root, you may feel numbness at the ends of your fingers.

7. Pregnant women often feel paresthesia. This happens because the body is under constant increasing stress. Hormonal changes within it are also an important factor.

You may notice that only certain fingers on your hands are numb, for example, the little finger and ring finger on the left hand, or the index and thumb on the right. Here's what this may indicate:

About the development of myocardial infarction. The left hand often signals problems in the cardiovascular system. Pain radiating to the left hand with numbness in the fingers is a threatening symptom of a heart attack. If these sensations are accompanied by tingling and pain attacks behind the sternum and under the shoulder blade, as well as a feeling of shortness of breath and dizziness, immediately call an ambulance.

About cerebral stroke. Whether your right or left hand goes numb – it doesn’t matter at all. A sudden sharp headache, loss of coordination of movements and severe muscle weakness in the arms or legs may indicate a cerebral hemorrhage.

Alcohol abuse causes a disease called polyneuropathy. It is characterized by pain in the hands, weakness, massive swelling and loss of sensitivity in the fingers.

Any neurological diseases or pathological formations in the body that manifest as paresthesia should alert patients and prompt them to immediately visit a doctor.

Diagnostics: how to determine the causes of hand numbness and what to do about it

Primary self-diagnosis consists only of analyzing one’s own feelings. Before coming to the doctor, it is worth recording any symptoms, you can even write them down. For example, note the duration and nature of numbness in your hands. When exactly does this happen: at night, in the morning, during the day or in the evening. How long does paresthesia last and which fingers are involved in the process. All this will help the doctor make the correct diagnosis and subsequently prescribe treatment.

The first place to start is to visit your regular therapist. He will assess the situation and may send you to specialists. Numbness of the fingers is also treated:

Each of the doctors will prescribe a treatment that will relieve you of the feeling of numbness at night or during the day.

In addition to self-diagnosis and an in-person examination with a doctor, you can also undergo:

X-ray of the spinal column;

MRI or CT scan of the spinal cord or brain, as well as blood vessels and the cervical spine;

Electrocardiogram and ultrasound of the heart;

Take a general and detailed blood test;

ENMG, that is, electroneuromyography. This study is aimed at determining muscle mobility and excitability, assessing the condition of peripheral nerve fibers and their sensitivity. It allows you to accurately determine the nature of the disease, whether it is a neurological disorder or a primary muscular disease.

Treatment of numbness in fingers - what procedures a specialist can prescribe

Immediately after diagnosis, a qualified doctor will prescribe a course of procedures for you. Often this list includes:

A lack of vitamins can greatly affect the condition of the muscular and nervous systems, resulting in many problems, including numbness in the fingers, hands, and feet. Vitamins B, E and A will help replenish the balance. They can be taken in tablets or by injection if the situation is advanced. In milder cases, diet will help normalize the level of vitamins in the body. For example, a lack of vitamin B12 can be eliminated by eating eggs, fish and meat, as well as liver, cheese, seafood and sour cream.

You can replenish the level of vitamins A and E by eating butter, seaweed, cheese, cottage cheese, garlic, broccoli, as well as nuts, dried fruits, spinach and oatmeal.

2. Physiotherapy and massage.

Gives good results for numbness of fingers and hands Physical Culture under the supervision of a specialist. Some exercises can be done at home, especially since they are not complicated. For example, if your fingers are often numb, you can perform a flexion-extension exercise in different positions: with arms raised up, at an angle and when lowering down.

A massage performed by a professional helps to normalize blood circulation. In addition to kneading the fingers, palms and hands, it will be useful to undergo a course of massages of the cervical-collar area, for the prevention of osteochondrosis, flexor-extensor muscles of the forearm, elbow joint, or a general strengthening tonic massage. There are also certain types of massages to solve problems of the nervous and cardiovascular systems.

3. Treatment with medications and ointments.

In this case, only a doctor can select therapy. You should not self-medicate, because you must understand that numbness in your fingers can cause dangerous character and be a symptom of a serious pathology that can lead to disability and even death (stroke or heart attack).

Therapy in tablets is aimed at relieving the inflammatory process in tissues, removing excess fluid if swelling occurs, reducing pain and relieving the feeling of numbness.

Exposure to physiotherapeutic devices solves many problems. Magnetic therapy will help relieve joint pain, improve blood circulation and remove swelling. Heat therapy (paraffin or ozokerite compresses) is prescribed for diseases of the spine and osteochondrosis; it helps to warm up sore spot, relieve spasms and speed up blood circulation. And electrophoresis makes it possible to deliver medications to the deep layers of the skin, directly to focal inflammation, providing a quick treatment effect.

Folk remedies: how to treat numbness in fingers using a home first aid kit

At home, some remedies can also help relieve numbness in your hands. For example, simple contrast baths or douses will perfectly restore blood microcirculation, and with regular use they will also relieve paresthesia. For this procedure you need to take two containers with hot and cold water. Lower your hands into them one by one, holding them for literally seconds. Repeat this exercise about 10 times.

A massage with essential oils will be an excellent help not only in treating numbness, but also in preserving the youth and beauty of your hands. Only for this you will need someone close to you, because an independent massage may be inconvenient. To cope with frequent numbness in your fingers, you need to take:

You can also use pumpkin or potato wraps to combat paresthesia. You need to boil the pumpkin or potatoes, mash them and apply them to the sore spots, first wrapping them in film and then in a towel or foil.

Another recipe: to relieve numbness, mix olive oil with black pepper, simmer on the stove for about half an hour and spread this mixture 2-3 times a day on the area of ​​the hands and fingers.

Preventive measures for numbness in fingers

Remember: in order not to reap the fruits of your carelessness, you need to take care of your health.

Don't freeze. This is very important, since hypothermia negatively affects the entire body and the condition of the joints in particular.

Let's give your hands a rest. Especially if you work at a computer or make a lot of monotonous movements throughout the day. Do a little gymnastics after every hour of work.

Take comfortable positions while sleeping. Do not forget that the normal state of the spine is its linearity. If your pillow is too high and the spine in the cervical region is bent, it cannot fully rest. Due to constant compression of small vessels, paresthesia may occur.

Take care of your body, otherwise it may respond to acquired diseases with very unpleasant sensations.

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8 reasons for numb hands

Most often, hand numbness occurs due to the following diseases:

1. Cervical osteochondrosis. Characterized by dystrophic changes in the tissue of the vertebrae and intervertebral discs. As a result, disc herniations occur. Cervical osteochondrosis is characterized by shooting pains during exacerbation, numbness of the neck and shoulder girdle, forced position of the head and neck.

2. Cervical spondylosis. Occurs due to pathological growth bone tissue vertebrae, which causes compression of nerves and deformation of ligaments. Characterized by pain in the back of the head and neck, which intensifies with movement.

3. Scalenus syndrome. The scalene muscle is located under the shoulder joint in front; it often suffers from injuries and sprains, and can also be compressed when the spine is curvature. Often the arm above this muscle loses sensitivity and becomes weaker.

4. Neuralgia of the shoulder joint. May appear due to infection. Subsequently, inflammation of the nervous tissue occurs. This is often observed during an exacerbation of herpes zoster.

5. The baby’s arm falls out during childbirth. In the future, such a birth injury can lead to delayed development of the shoulder joint and loss of sensitivity due to chronic compression of the inferior subclavian artery.

6. Injuries to the elbow and shoulder joint.

7. Tunnel syndrome. With this disease, the nerve in the wrist joint is compressed, resulting in pain and numbness when moving the hand.

8. Ulnar nerve syndrome. It is a complication after injury and occurs as a result of compression of the peripheral nerve in the ulnar groove.

Most of these diseases are successfully treated with osteopathy. If numbness in the hands is not associated with cancer or systemic diseases, then it is eliminated after several sessions with an osteopath.

How to quickly relieve numbness in your hands?

To restore blood supply, you need to shake your hands and vigorously clench and unclench your fists several times. Then stretch your fingers. If numbness occurs in bed, you need to roll over onto your back, raise your arms up and vigorously clench and unclench your fists several times. Then lower your arms along your body and repeat clenching your fists. It is useful to stretch your hands and roll balls in your palms throughout the day. If the symptom recurs frequently, consult a doctor immediately and get treatment.

Why do my fingers go numb - what to do?

Loss of sensation in the fingers of the upper extremities often indicates the development of a serious illness. Both specific phalanges and the entire hand can be removed. If numbness in your fingers occurs regularly, you need to find out the source of the unpleasant symptom.

Numb fingers are a sign of illness

Causes of numbness in fingers

Most often, fingers go numb during sleep or in the morning when a person wakes up. What does it mean? The cause of this condition is incorrect body position during sleep, which impairs blood circulation in the limbs and causes temporary discomfort. If this condition occurs infrequently, there is no reason to worry.

When the fingers of one or both hands tingle constantly, the following conditions may be the provoking factors:

• pathologies of the heart and blood vessels (atherosclerosis, angina pectoris, multiple sclerosis, blockage of cerebral vessels);
• endocrine diseases (diabetes mellitus, thyroid problems);
• poor patency in the vessels of the upper extremities (thrombosis) or impaired blood circulation in the capillaries and veins of the fingers (Raynaud's syndrome);
• injuries or bruises of the shoulder, elbow, fingers, hands;
• pressure on the nerve roots due to swelling of the hands during pregnancy;
• pinched nerve in the carpal tunnel (a disease of people who work at the computer for a long time).

Thrombosis is a common cause of numbness in the limbs

Often fingers become numb due to illness internal organs(liver, kidneys, lungs) or as a result of severe stress, nervous strain.

Based on the unpleasant sensations in one or another phalanx, a specific disease can be identified.

Numbness of the thumb and index finger

If a large or forefinger after monotonous long work (knitting, printing, embroidery), we are talking about overload of the neuromuscular system. At this time, loss of sensation may be accompanied by seizures and impaired motor ability. This condition does not last long and is not a pathological deviation.

After knitting for a long time, your thumbs and index fingers may go numb.

Basically, the index finger and thumb often numb when there is inflammation in the intervertebral discs, which occurs due to pinched nerve endings in the cervical region. Another cause of this condition may be an intervertebral hernia.

Will tolerate the middle, ring and little fingers

Numbness of the little finger along with the middle and ring fingers may indicate problems with the heart and blood vessels. Usually the phalanges on the left hand swell heavily at night, and during the day the patient feels a barely noticeable tingling sensation that spreads over the entire surface of the arm to the shoulder.

Inflammation of the elbow joint or pinched nerve endings in the brachial plexus is indicated by poor sensitivity of the ring and middle fingers with back side palms, which is accompanied by pain from the hand to the elbow.

Fingers often go numb due to inflammation of the elbow joint

Often, severe poisoning of the entire body can cause numbness in the middle finger. To accurately determine the source of discomfort, it is better to consult a doctor.

Tingling of the tips of any finger in adolescence often occurs due to a lack of vitamin A and group B. After 45 years, a deficiency of such substances provokes not only a temporary loss of sensitivity in a specific phalanx, but also numbness of the hands in general.

Which doctor should I contact?

If your fingers are constantly moving away, you should consult a therapist. During the examination, the doctor collects anamnesis and determines which specialist doctor to refer the patient to.

Depending on the clinical manifestations, these may be:

• cardiologist;
• orthopedist;
• surgeon;
• neurologist.

Only a specialist can determine why sensitivity in the fingers has disappeared. To do this, he prescribes diagnostic measures.

Diagnostics

To exclude severe abnormalities in cerebral circulation and prevent their development, the doctor prescribes a series of medical tests for the patient.

1. Dopplerography of the vessels of the neck - allows you to assess the degree of patency of the arteries and veins.
2. Tomography (computer and magnetic resonance) of the head and neck - identification of degenerative processes in the vertebrae, nerves and soft tissues.
3. Electroencephalography – diagnostics of brain activity and assessment of oxygen saturation of the main vessels.
4. Echoencephalography is the study of structural changes in the brain.
5. X-ray of the cervical spine - assessing the condition of the intervertebral discs and identifying compression of blood vessels and nerves.

Dopplerography will show the condition of the arteries and veins

If necessary, a cardiogram or ultrasound of the heart may be prescribed. Such studies are needed when there is a suspicion of a pre-infarction condition or other cardiac diseases.

Treatment of hand numbness

After diagnosing and identifying a specific disease, the doctor decides how to treat the patient.

Complex therapy combines the use of:

Medicines

Medications for numbness in the fingers are prescribed in accordance with the identified disease.

1. Disruptions in the cardiovascular system - vasodilator tablets (Corinfar, Cordafen, Nifedipine), drugs to reduce blood viscosity, improve microcirculation and oxygen saturation (Pentoxifylline, Vazonit, Trenpental). These medications are also used for Raynaud's syndrome.
2. Pinched nerve roots as a result of osteochondrosis or intervertebral hernia, as well as with carpal inflammation - anti-inflammatory tablets (Ibuprofen, diclofenac, Indomethacin), analgesics (Amidopyrine) and muscle relaxants (Mydocalm).

Corinfar - a vasodilator

External remedies (Voltaren ointment, Fastum gel, Diclofenac cream) can also relieve unpleasant tingling in the fingers. The main thing is to use all medications (systemic and local) only after a doctor’s prescription.

Vitamins A, PP, group B (B1, B6, B12), as well as minerals (magnesium and nicotinic acid) have a positive effect on melting fingers.

How to treat with folk remedies

Loss of sensitivity in the fingers can be treated with folk remedies. Some effective recipes will help relieve numbness and unpleasant tingling in a short time.

Milk and honey baths

Mix 2 liters of milk and 1 liter boiled water, add 5 tbsp. l. honey and 0.5 kg of salt. Mix everything thoroughly and heat over low heat until hot (do not boil). Soak your hands in the solution for 15–20 minutes. The course of treatment is 12–17 procedures.

Ingredients for milk and honey bath

Eggshell

Grind the shells of 10 chicken eggs to a powder consistency. Every morning eat 1 tsp. healthy potion with a glass of warm water. The product quickly restores numb fingers and prevents further discomfort.

Eggshells help with numbness in fingers

Wild rosemary and apple cider vinegar

Grind the dry wild rosemary herb and add apple cider vinegar in a ratio of 1 to 3. Leave the liquid for at least a week, then strain and rub into the affected areas 3-4 times a day. Duration of therapy is 2–3 weeks.

You need to infuse wild rosemary for at least a week.

Black pepper and sunflower oil

Stir 60 g of ground black pepper into 700 ml of vegetable oil. Place the liquid over low heat and cook for about 45 minutes. After the remedy has cooled, it can be rubbed into the fingers 2-3 times a day for 2 weeks. The folk medicine helps thin the blood and improve its circulation in the extremities.

Sunflower oil improves blood circulation

Exercises for numb fingers

Morning exercises will help restore finger mobility and eliminate numbness. It consists of simple exercises.

1. Without getting out of bed, you need to raise your arms above your head, and then clench and unclench your fists 50–60 times.
2. The body position is the same, the arms are pressed tightly along the body. Simultaneously clench and unclench your fists 60–70 times.
3. Stand facing the wall, raise your arms above your head, and rise on your toes. Spend 30–50 seconds in this position, then return to the starting position. Do several approaches.
4. Stand on your full foot, place your hands behind your back and clasp them together for a minute. Return to normal position and repeat the exercise 3-5 times.
5. In a standing position, relax and smoothly turn your head, first to the left (hold for 20–30 seconds), then to the right. Do not make circular movements.

Properly performed gymnastics improves blood circulation in the upper extremities and promotes quick relief with numbness in the fingers.

Prevention

To prevent diseases that lead to numbness in the fingers, you need to take some preventive measures.

1. Choose the right clothes. Avoid wearing jackets and sweaters with tight cuffs. Gloves should be made only from natural materials and not squeeze your fingers.
2. Pay attention to your hands at work. Try to do health exercises for your fingers every 1–2 hours (especially if your main activity takes place at the computer).
3. Monitor heavy lifting and physical activity.
4. Give up bad habits (alcohol, nicotine).
5. Eat right. The diet should always contain foods with vitamin B12 (fermented milk products, fish dishes, liver, eggs, seaweed).

Eat more foods with vitamin B12

A healthy lifestyle, long walks in the fresh air, limiting stress and normalizing sleep - all this helps strengthen the body as a whole and prevent discomfort in the upper extremities.

Poor sensitivity in the fingers, numbness and tingling often indicate pathological changes in the blood vessels, heart, endocrine and nervous systems, and are also a consequence of deformation of the vertebrae during osteochondrosis, hernias or injuries. It is important not to ignore regular bouts of numbness in your fingers, but to immediately seek help. medical care. This will help to avoid negative consequences and identify the cause of unpleasant sensations in time.

Treatment of hand numbness

Treatment of hand numbness is a set of techniques aimed at eliminating this problem. Let's look at the main causes of numbness in the limbs and the diseases that lead to this symptom. As well as effective treatment methods for numbness in fingers, hands, and toes.

The problem of numbness in the hands occurs at any age; sometimes loss of sensitivity occurs due to a compressed or pinched nerve, but in some cases the cause is more serious. Numbness is a pathological condition that occurs due to prolonged compression of the vascular trunk that supplies the limb. As a rule, it causes concern when it becomes systematic and is accompanied by other pathological symptoms.

It is worth noting that numbness is not a disease, but just a symptom caused by more serious problems in the body. So, if numbness in the limbs appears after sleep or prolonged work in an uncomfortable position, this indicates that the hands are simply numb and light exercises will restore their sensitivity. But if it occurs spontaneously, then it is necessary to find out the cause of this pathology.

Causes of hand numbness:

• Diseases endocrine system.
• Injuries and inflammatory processes in the joints.
• Carpal tunnel syndrome - occurs when regularly performing monotonous work in which the limbs are in the same position. This is often observed among musicians, drivers, and during prolonged work at the computer. The pathology occurs due to compression of the median nerve, which innervates the limb. The leakage may be accompanied by burning and tingling.
• Raynaud's disease – pathological disorder the work of small arterial vessels that are responsible for the blood supply to the upper extremities. The disease causes prolonged spastic contraction of the arteries, which causes numbness and coldness in the hands.
• Polyneuropathy is damage to peripheral nerves that impair sensitivity.
• Osteochondrosis of the cervical spine and limbs - numbness occurs due to impaired compression of the roots of the spinal nerves responsible for the innervation of the limbs.
• Uncomfortable body position causes mechanical compression of the arterial vessels of the extremities. Numbness occurs due to tissue hypoxia, and if the compression is prolonged, this can lead to irreversible damage.

That is, the loss of sensitivity in the hands is caused by a pathological effect on the nerves and blood vessels, which is associated with a violation of tissue trophism. For successful treatment, diagnosis is very important. Doctors examine the patient to identify the true causes of leakage; the examination is carried out by a vertebroneurologist. The doctor must identify factors of a domestic and professional nature that could contribute to the development of numbness due to carpal tunnel syndrome, and also exclude systematic mechanical compression of blood vessels. Special attention During the diagnostic process, attention is paid to the signs of spinal osteochondrosis. The patient undergoes radiography and nuclear magnetic resonance scanning.

Treatment of numbness in fingers

Treatment of numbness in the fingers is aimed at eliminating the causes that disrupt the normal functioning of the limbs. As a rule, numbness occurs in the morning, when the body has not yet fully woken up. Many people are dismissive of such symptoms, mistakenly believing that the hand is numb due to an awkward position, but this is not always the case. After some time, morning stiffness will occur more and more often and it will take more time for the fingers to gain sensitivity. In this case, it would be a good idea to consult a specialist in order to prevent the further development of the disease, which causes numbness in the fingers.

• Sticky fingers can be a psychosomatic disorder or occur for more serious reasons. One of the reasons for numbness is poor circulation. In this case, it is worth paying attention to how often numbness occurs and whether it occurs only on the fingers of one hand or on both. This may indicate poor circulation in the brain and cervical spine. In turn, poor circulation can lead to a stroke.
• Numbness of the fingers also occurs in patients with high blood pressure and increased level cholesterol in the blood. Dreading can appear due to disturbances in the functioning of the endocrine system, injuries and inflammations, and not only the fingers, but also the hands become numb.
• To treat numbness, you need to contact a neurologist who will diagnose and prescribe tests. The effectiveness of treatment depends on the correctness of the diagnosis. It is strictly forbidden to self-medicate, as this can cause paralysis of the fingers and the entire hand. Treatment depends on the cause of the symptom.
• If numbness in the fingers is caused by osteochondrosis, then special ointments and tablets are prescribed for treatment, which stop the inflammatory process and relieve swelling. In particularly advanced cases, surgery may be performed.
• For numbness caused by polyneuropathy, that is, a disease of the peripheral nervous system, treatment consists of drug therapy and physiotherapy. The patient must perform therapeutic exercises, which will help restore normal functioning of the fingers.
• If numbness in your fingers occurs after a night's sleep, the best treatment is to perform simple exercises. The most basic: clasping your hands together, clenching and unclenching your fingers.

Traditional medicine methods can be used to treat numbness in the fingers, but only after the approval of a doctor. Basic medicinal recipes consist of food. Thus, warm pumpkin porridge, used as a compress for the hands, significantly improves blood circulation and eliminates numbness in the fingers. Therapeutic warm baths have also proven themselves well, helping to relax tired muscles of the fingers and restore their normal functioning.

Treatment of numbness in hands and feet

Treatment of numbness in the arms and legs is a problem that Lately More and more people are turning to a neurologist. Typically, an uncomfortable posture or prolonged stay in one position causes loss of sensitivity. In this case, the wicking is completely normal phenomenon, as it will disappear without a trace after a short period of time. But if it occurs frequently and for no apparent reason, then it is a pathology.

Numbness may occur due to damage to blood vessels and nerves distant from the body. Long-term numbness occurs when there are disturbances in nerve conduction in the limb and obstructed blood flow in it. Stiffening of the arms and legs occurs when nerve pathways are pinched due to diseases of the spine, joint diseases and central circulatory disorders. Pathological changes in cartilage tissue and the appearance of bone outgrowths are another cause of temporary loss of sensation in the arms and legs. Particularly dangerous is numbness, accompanied by pain in the muscles and weakness in the limbs, which lead to impaired coordination of movements.

Treatment for numbness in the arms and legs is mandatory if symptoms occur frequently and last for a long period of time. There are a number of therapeutic techniques that will improve innervation and can be used at home:

• To minimize side symptoms, it is recommended to move more. Hiking, walking up the stairs and morning exercises will warm up your muscles well and keep them in good shape.
• If you have a monotonous, sedentary job, remember to take short breaks. Stretch well, bend and stretch your limbs.
• If you spend a long time at the computer, regularly stretch your hands (shaking and rotational movements) and change the position of your legs. This will prevent loss of sensation in the limbs.

These recommendations are effective if the leakage is not caused by any disease. In any case, if side symptoms occur frequently, you should consult a doctor who will prescribe full examination to determine the cause of numbness in the limbs and draw up a treatment plan.

Treatment of numbness in the hands

Treatment of numbness in the hands is a pathology that is faced not only by older people, but by young people in the prime of life. Numbness of the hands is increasingly associated with carpal tunnel syndrome. This disease occurs in those who work in one position for a long time and strain their hands. The leakage is accompanied by burning and painful sensations in the fingers. In this case, the cause of the pathology is pinching of the median nerve, which passes through the carpal tunnel.

Long monotonous work causes swelling and inflammation of the tendons, which compress the nerve and cause numbness in the hand. At first, the symptom appears in the morning, but without proper treatment, unpleasant sensations occur not only during the day, but also at night. Leakage can occur when endocrine disorders, injuries, inflammatory processes in joints and osteochondrosis of the cervical spine. It is impossible to independently determine the cause of the pathology, as it is impossible to select effective treatment. That is why it is necessary to seek medical help. A correct diagnosis is an opportunity to begin treatment; otherwise, you may completely lose mobility of both the hand and fingers.

• To treat numbness in the hands, it is recommended to do gymnastics: raise your hands up, clench and unclench your fingers, rub your wrists. Make a fist with your hand, move your hand back and forth, and rub each finger thoroughly.
• Traditional medicine offers many recipes for the treatment of numbness in the hands and fingers. One of the recipes involves the use of pickles. Cut the vegetable into cubes, mix with hot pepper pods and pour 500 ml of vodka. For a week, the medicine must be infused in a dark place, then strained and rubbed on your hands and fingers.
• Contrasting hand baths help cure numbness. It is necessary to prepare two containers with cold and hot water. First, hands are lowered into one container, then into the second, repeating the procedure 4-5 times. After this, it is recommended to rub your hands thoroughly.

In addition to therapeutic measures, do not forget about the prevention of numbness in the hands. Blood vessels and joints suffer greatly from salty, hot and spicy foods, nicotine and alcohol. Try to lead a healthy lifestyle, eat more fresh foods and greens. Do not wear synthetic gloves and keep your hands warm. Take regular breaks during monotonous work, stretch your arms, and rotate your hands. And don’t forget that numbness in the hands is not just a temporary problem, but a symptom of a disease. Leaking may indicate an impending stroke, worsening vascular condition, or diabetes mellitus. Treat promptly chronic diseases and contact a specialist at the first disturbing symptoms.

Treatment for numbness in the left hand

Treatment of numbness in the left hand is a process aimed at restoring normal functioning of the upper limb. This condition can appear spontaneously or arise for a number of more serious reasons.

The main causes of numbness in the left hand:

• With osteochondrosis, numbness of the left hand occurs due to narrowing of the intervertebral spaces and poor circulation.
• Diseases of the cardiovascular system - heart attacks, stroke, heart attack and other disorders, lead not only to numbness of the limbs, but also to short-term loss of speech, impairment thought processes, breathing.
• Injuries to the left forearm and shoulder, intervertebral hernias and reasons such as intoxication of the body, incorrect posture during sleep, stress, vitamin deficiency also lead to numbness of the left limb.

Treatment is aimed at restoring blood circulation and normal functioning of the limb. For therapy, special gymnastics and physiotherapy are used. If the swelling is caused by shoulder injuries, then treatment is aimed at normalizing the activity of the shoulder; for this, the injured limb is fixed.

For numbness in the left hand caused by a stroke or heart attack, treatment takes place in a hospital setting. Without proper attention, irreversible consequences can occur. If the loss of sensitivity is caused by overwork or Raynaud's syndrome, then the main therapy is a change in place and mode of operation. For carpal tunnel numbness, treatment involves regular kneading of the hands and fingers to restore blood circulation.

Treatment for numbness in the little finger of the left hand

Treatment of numbness in the little finger of the left hand is a problem with which people increasingly turn to a neurologist. The main cause of numbness is prolonged work at the computer and severe tension in the arm muscles. Monotonous movements lead to pinching of the nerves of the hand, which causes loss of sensitivity. Streakness in the little finger of the left hand can be caused by tunnel syndrome, that is, pinching of ligaments and nerves by muscles and bones. In advanced cases, tunnel syndrome causes not only numbness, but also painful sensations and burning sensations, both in the little finger of the left hand and throughout the entire limb.

Streakness of the little finger can be associated with serious diseases that require detailed diagnosis. These include ischemia of the limbs, diseases of the cardiovascular system, intervertebral hernias, injuries, osteochondrosis, pinched nerves, infectious diseases, hypothermia and more. Even previous bronchitis can lead to numbness in the little finger of the left hand. That is why diagnosis is very important to draw up a treatment plan.

• Treatment begins with a consultation with a neurologist and surgeon. Doctors do x-rays, tomography and screenings of the injured limb. As a rule, it consists of taking medications, a course of therapeutic massage, physiotherapy and maintaining the correct work and rest regime.
• In particularly advanced cases and with numbness caused by serious reasons, therapy can be carried out in a hospital. As a rule, it is possible to cure numbness in the little finger of the left hand using conservative methods.
• If the pathology appears due to tunnel syndrome, then surgical intervention. The operation involves reducing the pressure of the canal that is compressing the nerve. This improves blood flow in the limb and restores damaged nerve sheaths.

Treatment for numbness in the fingers of the left hand

Treatment of numbness in the fingers of the left hand largely depends on the cause that led to this pathology. If numbness appears due to an uncomfortable position or monotonous work, then it is enough to perform a couple of gymnastic exercises to knead the limb and this will restore its normal functioning. For numbness caused by osteochondrosis, carpal tunnel syndrome, spinal curvature, arthrosis, circulatory and lymph circulation disorders, the complex of treatment measures is lengthy and consists of both medication and manual therapy.

When treating numbness in the fingers of the left hand, the main task of doctors is to restore the functioning of the limb without surgical and pharmacological intervention, which can harm the entire body.

• For treatment, complexes of special therapeutic exercises and therapeutic massage are used. This allows you to restore normal blood supply to the tissues of the fingers and hand. In addition to massage, acupuncture and osteopathy can be used.
• The initial task of the attending physician is to eliminate the cause of the leakage. If loss of sensitivity in the fingers of the left hand appeared during pregnancy, then the expectant mother is lymphatic drainage massage and acupuncture. Thanks to this, the circulatory and lymphatic systems begin to function normally, not only numbness goes away, but also swelling due to compression of the nerves.
• Treatment of numbness in the fingers of the left hand due to osteochondrosis is a complex of therapeutic measures. The patient is subjected to traction to eliminate pinched nerve fibers. In addition, medications are prescribed to restore intervertebral discs and cartilage tissue.

Treatment for numbness in the right hand

Treatment of numbness in the right hand begins with establishing the cause of the pathology. Sudden complete or partial loss of sensitivity can be caused by both serious diseases and disorders in the body, and simple compression of nerves and stagnation of blood due to incorrect posture or prolonged stay in an uncomfortable position. Despite the fact that many ignore the leakage, it must be treated, since the pathology can become permanent.

Numbness of the right hand very often occurs due to injury brachial plexus nerves, elbow or wrist, in this case, in addition to loss of sensitivity, painful sensations, burning and tingling are observed. Excessive pressure on the hands also leads to numbness. This mainly occurs due to incorrect position during sleep, carrying heavy loads or prolonged monotonous work in one position. Don't forget about carpal tunnel syndrome, which occurs due to compression of the nerves of the hand. Neuropathy, kidney disease, hernia intervertebral disc and spinal cord injuries also lead to loss of sensation.

At long-term symptoms numbness of the right hand, appropriate treatment is necessary. For effective therapy, it is recommended to contact a neurologist who will conduct a full diagnosis of the body and find out the true cause of loss of sensitivity. If the leakage is accompanied by painful sensations, the patient is prescribed drugs to relieve pain and antidepressants. Physiotherapy is mandatory, which restores the normal functioning of the muscles and tissues of the limb.

Treatment of numbness in the fingers of the right hand

Treatment of numbness in the fingers of the right hand is a fairly common procedure faced by patients of any age. Loss of sensitivity occurs for many reasons, the simplest are incorrect posture during sleep, and more serious are injuries, diseases of the cervical area and spine.

Before prescribing treatment for numbness, a diagnosis is required to determine the cause of the pathology. To do this, the patient undergoes an X-ray of the cervical spine to identify disturbances in the area of ​​compression of blood vessels and nerve endings. In addition, a spine scan, magnetic resonance imaging, electroencephalography and vascular patency study are performed.

Based on the diagnostic results, a set of therapeutic measures is selected to eliminate numbness in the fingers of the right hand. For therapy use:

• Drug treatment - allows you to eliminate the inflammatory process, remove swelling, spasms and pain.
• Taking chondroprotectors and a vitamin complex are necessary for therapeutic effects on affected areas that cause loss of sensitivity in the fingers.
• Gymnastics, manual therapy, physiotherapy help to quickly eliminate numbness due to active muscle contraction.
• Acupuncture, hirudotherapy, vacuum therapy and alternative medicine are used as additional therapeutic methods to enhance therapeutic effect main therapy.

Treatment of numbness in the right hand

Treatment of numbness in the right hand is carried out by a neurologist after diagnosing the patient’s condition and identifying the causes of loss of sensitivity. Treatment of numbness is a long process, so it is better to prevent the pathological development of the disease. Loss of sensitivity occurs in joints that suffer from nicotine and alcohol, spicy, salty foods. Maintaining a healthy lifestyle and eating fresh foods is the best way to take care of the condition of your joints and prevent stiffness.

Numbness in the right hand very often occurs due to poor circulation. That is why it is necessary to keep your hands warm and regularly perform finger exercises in order to prevent numbness. In some cases, loss of sensitivity occurs due to diseases of the cardiovascular system, deterioration of blood vessels, stroke and diabetes. Timely seeking medical help and a set of therapeutic measures at the initial stage can prevent the severe consequences of numbness, which can lead to complete loss of sensitivity in the limb.

Treatment for hand numbness during sleep

Treatment of hand numbness during sleep is a popular procedure, as many people experience that after sleep their hands become numb and lose sensitivity. Of course, if the numbness is caused precisely by numbness in the limbs, then there is no need to worry; simple hand exercises will restore sensitivity. But in some cases, wicking occurs even more serious reasons caused by various diseases and disorders in the functioning of the body. It is sensitively impossible to determine the cause of the loss on your own, therefore, if such symptoms occur frequently, it is recommended to consult a neurologist or surgeon.

The doctor conducts an examination and prescribes tests; based on the results of the diagnostics, a treatment plan for hand numbness during sleep is drawn up, which depends on the cause of the pathology. Timely diagnosis is the key effective complex therapeutic measures that will restore sensitivity in the hands.

There are certain factors that cause numbness in your hands during sleep. The first group includes simple factors that can be eliminated on your own. The second group consists of complex factors that require careful diagnosis and treatment. Let's look at the main reasons that cause loss of sensitivity in the hands:

• An uncomfortable position during sleep, especially in the neck, can lead to muscle strain and disruption of blood access to tissues. To eliminate this problem, it is recommended to change the pillow and position while sleeping.
• The appearance of a blood clot in an artery is a serious problem, the first symptom of which is loss of sensitivity during sleep. You can check for this disease yourself. If the numbness does not go away within an hour of waking up, you should immediately seek medical help.

If numbness is caused by a serious group of factors, then a complex of therapeutic measures is carried out using medications and various physiotherapeutic procedures. With simple leakage factors, treatment can be carried out independently. Light gymnastics hands, massage, rubbing and contrast showers will perfectly restore sensitivity and improve blood circulation.

There are diagnostic methods to determine the severity of hand numbness. So, raise your arms above your head for a second, if there is no stiffness, tingling or painful sensations, then everything is fine. If numbness of the hands occurs very often during sleep, then you can use several traditional medicine methods that will certainly help restore sensitivity in the limbs.

• Prepare a warming compress, 50 ml ammonia mix with 10 ml of camphor alcohol and dilute with a liter of water. Dissolve a spoonful of salt in the resulting mixture and rub your fingers and wrists with the resulting solution before going to bed.
• A thermal contrast agent is also suitable to combat wicking. Prepare two containers with cold and hot water. Hold your hands in each container for seconds, 5-6 times. After this, apply moisturizer or turpentine ointment to your hands, put on warm gloves and go to bed. A course of 10 procedures will relieve numbness.
• A light honey compress is also suitable for prevention. Apply a thin layer of honey to your hands and wrap them with a piece of cotton cloth. A course of 3-5 procedures will restore normal functioning and relieve numbness.

And most importantly, don’t sit at the computer before bed. Simply clicking a computer mouse can cause paresthesia. Because of this, you go to bed with slight swelling, which only increases due to immobility during sleep.

Treatment of hand numbness due to osteochondrosis

Treatment of hand numbness due to osteochondrosis depends on the form and severity of the disease. The main feature of osteochondrosis is that the disease may affect parts of the body that have nothing to do with the site of the lesion. For example, osteochondrosis of the fingers and hands occurs due to infectious diseases, with damage to the immune system and metabolic disorders. In most cases, numbness in the hands and pain in the fingers indicates osteochondrosis. In addition to numbness, there is pain and burning in the hands and fingers, and degenerative changes in cartilage tissue are also possible.

Symptoms of hand numbness caused by osteochondrosis:

• Hands and fingers go numb, pain and paralysis of the limbs appear.
• The leakage is accompanied by a sharp, aching and shooting pain. Pain occurs when trying to move your fingers.
• For no apparent reason, tingling appears in the fingers and any part of the hand.
• With hypothermia and prolonged exposure to the cold, the hands acquire an unnatural pale color.

If a set of therapeutic measures is not started in time, the leakage will lead to complete destruction of cartilage tissue and paralysis of the limbs. Another striking symptom of osteochondrosis is the inability to move your fingers after sleep. Treatment of numbness in the hands due to osteochondrosis is carried out to maintain the normal functioning of the limbs. Since it is impossible to completely cure osteochondrosis, regular treatment preventive actions will prevent the progression of leakage.

Treatment of hand numbness due to osteochondrosis of the cervical spine

Therapeutic procedures are aimed at preventing the progression of the disease. Used to treat numbness conservative methods. The complex for restoring finger sensitivity consists of medication and physiotherapy.

• Drug treatment consists of taking anti-inflammatory and painkillers. The doctor may prescribe intramuscular injections, injections of vitamins, ointments and gels that relieve inflammation, relieve pain and eliminate numbness.
• Physiotherapy is a set of procedures aimed at eliminating inflammation, relaxing muscle tissue and restoring blood circulation. For this purpose, electrophoresis, laser therapy, magnetic therapy and current therapy are used.

After the treatment complex it will disappear for a while, but despite this it is necessary to observe preventive measures. Regular light massage, therapeutic exercises, rubbing and warming up the fingers and hands will prevent loss of sensitivity in the hands and fingers.

Treatment of numbness of the hands due to osteochondrosis of the extremities

With such a lesion, treatment consists of a complex of medications and physical procedures. The patient needs to regularly perform a set of exercises to prevent numbness in the hands and fingers. You can start gymnastics with a short warm-up: tapping your fists on the surface of your hands, clenching and unclenching your fists, rotating your hands, rubbing your fingers. After this, it is recommended to apply a warming ointment or cream to your hands and knead your hands.

Drug treatment for hand numbness

Drug treatment for numbness of the hands is the elimination of the inflammatory process, swelling, reduction of pain and muscle spasms. The complex of therapeutic measures consists of improving blood circulation and removing harmful microorganisms that lead to pathological metabolism. Patients are prescribed simple medications that reduce pain and anti-inflammatory drugs, such as Nimesil and Nurofen.

For treatment, medications are used that eliminate rheumatic joint pain, muscle spasms and pain due to numbness caused by neuralgia. For numbness caused by carpal tunnel syndrome, steroid injections are used for treatment, usually corticosteroid drugs. Neurologists prescribe ointments and gels that stimulate blood circulation and restore normal functioning of the muscular system.

In addition to the medicinal complex of therapeutic measures, physiotherapy is used for therapy:

• Reflexology (acupuncture) - used to influence biologically active points, helps restore nerve function and improves innervation of the limbs.
• Osteopathy is a gentle technique for eliminating muscle and ligamentous tension that leads to numbness in the hands.
• Electrophoresis - using a weak magnetic field, medications are painlessly injected into the affected areas. The most popular drug that helps eliminate sensitivity disorders is Lidaza.
• Manual therapy – used to relax soft tissues, tone joints and relieve stiffness.

Treatment of hand numbness with folk remedies

Treatment of numbness in the hands with folk remedies is a simple and affordable method of eliminating loss of sensitivity. Of course, to determine the true cause of loss of sensitivity, it is necessary to seek medical help. We offer you the most effective traditional medicine methods for treating hand numbness at home:

• Numbness of the fingers and wrists very often occurs in older people. The limbs not only go numb, but begin to ache, burn and twist. To prevent the process of numbness, it is recommended to consume eggshells once a week. Powdered eggshells are suitable for these purposes. A spoonful of shells should be washed down with a glass of water.
• If loss of sensation is accompanied severe pain, then the following recipe is suitable for this. Take an enamel pan, pour 2 liters of milk, a liter of water into it, add 50 g of honey and 600 g of salt. The mixture must be placed on low heat and heated to 60 degrees. Part of the solution can be applied to your hands as a compress or made into a medicinal bath. The solution can be used to treat numbness in both the hands and feet. Course procedures.
• Take dry wild rosemary and infuse it for 7 days. apple cider vinegar. To prepare the solution, a suitable proportion is 1 part plant and 3 parts vinegar. The solution must be rubbed into numb limbs three times a day.
• To prepare the following remedy, you need to take a couple of cloves of garlic, crush it and place it in a jar. Pour the garlic into 400 ml of vodka and leave for 14 days in a dark place. Every day the container must be shaken thoroughly to infuse the product. You need to take the infusion orally, 3-5 drops mixed in a spoon of water. Course 4-6 weeks.
• Black pepper is great for improving blood circulation, as it thins the blood. Pour 100 g of ground pepper into a liter of vegetable oil and cook over medium heat for minutes. As soon as the product has cooled, it can be rubbed into numb limbs.
• A medicinal mixture of celery, parsley, honey and two lemons will help restore sensitivity. You need to take a kilogram of greens, and 250 ml of honey. Grind the ingredients into porridge and mix. It is recommended to take 3 tablespoons of the medicinal mixture in the morning on an empty stomach.
• If your fingers and hands are numb, then a woolen thread is suitable for treatment. Tie it on your wrist like a bracelet and don't take it off. The contact of wool with skin will improve blood circulation, and after a while you will forget about numbness.

In addition to traditional medicine methods, to treat numbness you must follow simple recommendations. To improve blood circulation, engage in physical activity. Even light physical activity or long walks will have a beneficial effect on the functioning of the body. Don’t forget about therapeutic exercises for your hands. Regularly stretch your fingers, make rotational movements with your hands, clench and unclench your hands. Another set of therapeutic measures is strengthening blood vessels and treating diseases of the cardiovascular system. A glass of warm water on an empty stomach will be an excellent prevention of loss of sensitivity in the limbs.

Treatment for numbness in the hands can be carried out as follows: using medicinal methods, and with the help of traditional medicine, physiotherapy and even surgical intervention. Prevention, physical activity and a healthy lifestyle are an ideal set of treatment measures for hand numbness.

Medical Expert Editor

Portnov Alexey Alexandrovich

Education: Kyiv National Medical University named after. A.A. Bogomolets, specialty - “General Medicine”

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ATTENTION! SELF-MEDICATION CAN BE HARMFUL FOR YOUR HEALTH!

Be sure to consult with a qualified specialist so as not to harm your health!

Leptin, the satiety hormone, was discovered not so long ago. And perhaps not everyone knows that exceeding its level in a person’s blood is fraught with the development of many serious diseases: heart attacks, vascular complications, etc. Considerable hopes were pinned on the discovery of this hormone, but so far the scientific world has not been able to create a drug that can make leptin help people suffering from obesity. Therefore, today the activity of leptin can be seriously affected only by a radical revision of one’s own lifestyle and diet.

How to Restore Leptin Sensitivity: Important Steps

1. Your breakfast should contain food containing protein. And you need to eat such a breakfast no more than an hour after waking up. Subsequent meals do not require a large amount of protein, and if about 30 g of protein is enough for breakfast, then in just a day you need to eat about 100 g of food containing protein. This tactic will help reduce your food cravings for fructose and other sugars.
2. You should not include more than 30 g of fructose in your menu, since infatuation with this monosaccharide increases resistance to leptin, which leads, in particular, to damage to the main metabolic organ - the liver.
3. There is no need to completely give up carbohydrates: they are required for the coordinated functioning of all hormones, effective fat burning, electrolyte balance and a feeling of fullness after eating. It would only be correct to reduce their quantity to a minimum due to fast-acting carbohydrates (sweet fruits, flour, potatoes, rice). Another important point is to significantly limit the consumption of carbohydrates for breakfast.
4. Be sure to make sure that your diet contains foods containing zinc, since this microelement helps not only strengthen the immune system. Insufficient zinc in the body can lead to insulin resistance and the risk of diabetes.
5. Vitamin D and magnesium are required to restore sensitivity to leptin. This tandem can counteract obesity and complex changes associated with metabolic disorders. This couple is also able to counteract the occurrence of diabetes, osteoporosis, diseases provoked by our own immunity, as well as diseases of the reproductive system. In addition, a lack of magnesium in the body affects a significant deterioration in the quality of sleep. In turn, constant lack of sleep leads to a decrease in leptin levels and, on the contrary, increases the level of ghrelin, the appetite hormone.
6. Make it a rule to eat only the right fats - nuts, butter and coconut oil, avocado - and some animal fats (for example, goose).

1. Do not disrupt your body's natural circadian rhythms by overindulging in caffeine, sweets and alcohol.
2. Do not get carried away with snacks in cafes, fast food outlets, etc. Such food is fraught with disruption of the intestinal microflora and threatens chronic inflammation. And in principle, forget about snacks, you are drawn to them because your body is immune to leptin. Snacking disrupts the daily rhythm of leptin functioning. Imaginary ideas about their necessity to speed up the metabolic process or to maintain blood sugar at the proper level provide only new prospects for the development of obesity.
3. Don't eat at night. The evening meal and breakfast should be separated by at least half a day, because in the evening hours leptin “orchestrades” the adjustment of other hormones to the night recovery process and accelerated fat burning. Thus, by eating dinner later than 3 hours before bedtime, you interfere with the beneficial work of leptin.

Let us note that humanity has only recently come to understand the importance of restoring the body’s sensitivity to leptin, and this should be taken quite seriously.

Basics of intensive rehabilitation. Injury of the spine and spinal cord Vladimir Aleksandrovich Kachesov

RESTORING SENSITIVITY

When reading this section, you should take into account the fact that we are talking about the possibility of restoring sensitivity, and not about its normalization. With anatomical damage to the spinal cord, restoration of sensitivity occurs in a certain sequence.

Superficial skin sensitivity is restored first. Gradually, the emerging areas of skin sensitivity expand and merge. Usually, by the end of the 2nd week during an intensive rehabilitation process, superficial skin sensitivity is noted on the entire surface of the skin below the site of injury. The rate of restoration of skin sensitivity is shown in photos 10.7 and 10.8 and indicates that compensatory mechanisms are activated - collateral pathways for conducting information, and not regenerative processes in the spinal cord. Subsequently, skin sensitivity increases, but will always be less than skin sensitivity above the level of injury. In some areas, restoration of discrete types of sensitivity is observed. At the same time, the hypersensitivity of the skin above the lesion site is reduced. The hyperesthesia streak is not diagnosed at the end of the first stage of rehabilitation. Restoration of skin sensitivity is possible due to intersecting receptor zones of segmental innervation (A.V. Triumphov) and other mechanisms described in Chapter 2 of this book.

Photo 10.7 Photo 10.8

Restoration of deep sensitivity begins at the end of the second week. Initially, the patient can distinguish a strong stimulus - a blow to the sole, but cannot determine from which side he receives the signal. Then the perception threshold decreases, and the patient gradually more and more confidently determines which side the signal came from. By the end of the first month of intensive rehabilitation, deep sensitivity increases, although it may not reach normal.

Restoration of deep sensitivity is associated with improved circulation of cerebrospinal fluid, improved metabolism in the reception zones of the dura mater, forming intersecting fields and restoration of conductivity along r. meningeus. Surface sensitivity is also involved in signal differentiation. Pain sensitivity is not always restored in such patients, but its restoration has the following patterns.

Zones of pain sensitivity during intensive rehabilitation fall 5-10 cm below the level determined for segmental lesions. If C V - C VI is damaged, pain sensitivity after 2 months is determined throughout the entire upper limb and in the hands. Restoration of pain sensitivity begins with a feeling of “pins and needles”, which then turns into a burning sensation, then into a hyperpathic type of sensitivity, then pain sensitivity is clearly defined. The restoration of pain sensitivity is initially also diffuse in nature, then the localization zones merge. Pain sensitivity is a differentiated type of sensitivity and with massive lesions of the spinal cord substance, its complete restoration does not occur.

The described phenomena of functional restoration in patients with tetraplegia due to cervical trauma are also characteristic of patients with other levels of spinal cord damage and follow a certain pattern, which is outlined in this chapter. This pattern lies in the fact that, first of all, structures that are less differentiated, phylogenetically more ancient, will be restored, and then phylogenetically younger ones, which will manifest themselves in the form of corresponding functions.

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