Are you not doing WM? Today, I will talk about carpal tunnel syndrome, which is a condition related to the median nerve. The title of my talk is If you know the source of carpal tunnel syndrome, everything becomes easy. 

You may have heard of carpal tunnel syndrome. Most of us are familiar with it. It occurs when there is increased pressure in the carpal tunnel, which affects the nerve passing through it. This pressure on the nerve leads to the symptoms we associate with the syndrome. The problem is that the majority of causes remain unidentified. We do not fully understand why the pressure in the tunnel increases. This ambiguity is why it is still referred to as idiopathic.

Anatomically, the carpal tunnel consists of nine tendons and the median nerve, which are surrounded by bone and the transverse carpal ligament. Here, you can see the wrist. This is the right hand. The wrist is structured in such a way that the transverse carpal ligament is present, enclosing the nine tendons.

이 이야기는 손목에 관한 것입니다. 손목에는 뼈가 있고, 그 바깥쪽에는 힘줄이 있습니다. 이 힘줄은 근육과 연결되어 있으며, 그 힘줄이 바로 여기 지나갑니다. 그리고 여기에 정중신경이 있습니다. 그런데 이 부분이 어떤 이유로 좁아지게 되면 신경이 쉽게 눌리게 됩니다. 이 신경은 단단하기 때문에 잘 느껴지지 않지만, 신경은 쉽게 압박을 받을 수 있습니다. 그러면 눌리게 되면 당연히 통증을 느끼거나 찌릿찌릿한 느낌이 오게 됩니다. 그 다음에 감각이 없어지기도 하고, 어떤 경우에는 물건을 떨어뜨리기도 합니다. 그러다가 지나치게 되면 힘이 약해지게 됩니다.

Muscles do not wear out, but this part, especially the palm, becomes weak. When there are questions about this, it is often felt in the forearm, shoulder, chest, and sometimes even in the side of the body. This feeling can be transmitted in various ways. Typically, symptoms arise during the night, and when they occur, shaking the hand can exacerbate the symptoms. This is a common sensation in the wrist, but it occurs much less frequently than other issues. However, it may indicate ulnar impaction syndrome. So, the symptoms are in the wrist, which is not related to nerves. It's not a nerve issue; rather, if the ulnar bone is longer than normal, it can cause discomfort when we twist the wrist sideways. That’s when we feel this syndrome. This is entirely different from the mechanism of nerve compression.

There is a number, but through repetition, it becomes a planetary issue. If you look here, there is a distance and a punishment. What this means for us is that it signifies something or a rebound. It comes down like this, allowing for twisting and turning, which is why it is connected. It supports and adds to it, forming a shape. In between, there is a triangular fibrocartilage. When it compresses like this, it gets pressed down on the medical side, causing issues. As for the fourth position, it is known that the support is somewhat different. Then, regarding the risk factors, what are they? The risk factors are present from birth or due to environmental conditions, so there are two aspects. There are those who are narrow from birth, and then there are those who have sustained wrist injuries or...

In some cases, it may be necessary to repeatedly use that, or it can occur due to certain medical conditions. If you look more closely, repetitive trauma here refers to the wrist bending, where the tunnel is bent. When this posture and movement persist for a long time or when excessive pressure is applied—especially when the angle is not right while using a computer keyboard—such situations can lead to issues. If something is wrong with the alignment, it can also cause problems. When you perform actions, there are techniques involved. If the posture is not good, it can lead to strain. You might see that the wrist is bent in an awkward position. This can happen when playing in a relaxed state, where the force applied is not well balanced, leading to issues with strength control. Additionally, using the hands excessively can also be problematic.

Such conditions on Earth are continuously on the rise. So, I wonder if there are any metabolic diseases among the diseases related to diabetes. Why does the vascular system only seem to be affected in that direction? Blood vessels and nerves almost always go together. In the case of arthritis, if there is a problem with the joints, they can narrow, and there could also be growths or tumors. Naturally, in cases of obesity, stagnation occurs. The same goes for pregnancy. If there is a problem like hypothyroidism in the neck, the thyroid function decreases, causing pressure in the chest. This is because as the thyroid hormone levels drop, the body compensates by increasing the size of the glands, which can put pressure on the neck. In such cases, the kidneys can also be affected, especially with long-term dialysis. Eventually, everything becomes apparent, including the skin and even the internal organs.

Because of that, it is similar to being narrowed down. The effect becomes apparent. But as an examiner, it's quite simple. You take the wrist and position it like this, and the pressure is felt here, right? If the wrist is turned like this, at a 90-degree angle, and if it is deeply pressed like this, after about three seconds, you might feel a tingling sensation in the wrist, or you may experience numbness or a loss of sensation. In such cases, if the pain worsens, it could indicate carpal tunnel syndrome. For diagnosis, we conduct an electromyography test, which involves nerve and muscle tests. Essentially, nerves are like electrical wires. So, if we organize this, starting from here, it is all connected and runs down like electrical wires, maintaining a certain length.

So, among those regular employees, what part encountered problems? It now depends on how quickly or slowly they respond, how much they react, or whether the transmission of signals occurs between the nerves and the speed of that transmission. While observing various factors, we can determine that the wrist is where the most issues arise. However, in many cases, it is not clear which specific part is problematic when the issue spans from one point to another. 

Treatment often involves the use of splints or braces, which you may have heard of. Anti-inflammatory medications are also used, as well as vitamin B injections, and sometimes steroids are injected into the wrist. Here, a 1000 mg injection is administered to reduce inflammation. When these treatments are not effective, symptoms such as atrophy may occur.

When you are upstairs, at that time, you might end up cutting a ligament. It's simple; it can be done in about 10 minutes. However, I think it's necessary to do what I consider to be essential work. In most cases, if you know this, you can prevent wide-range injuries. Prevention is more successful when used for a long time. Similarly, if you stay in a bent position for a long time, you should avoid that. So, make sure to stretch sufficiently, then adjust the intensity, and also maintain good posture. Additionally, you can stretch your wrists like this, holding both sides and doing stretches here and here. It can be tough. What can we do? In a broadcast, we can do this, but you can also grab one hand and pull it to the side while not moving the other, pulling both sides. This part will feel a bit...

It will become looser. So, there are exercises that have been set up, and there are also exercises for consumption. There are various kinds of these, but if you watch on YouTube, you will find a lot of information available. However, that is not the main focus here. Let's take a more fundamental approach. The principle mentioned earlier, related to the faucet, is what we are discussing. What this means is that air, or energy, or nerves pass through a certain pipe, and when that happens, there can be turbulence in the lower part, or balance can be created. It's similar to how water flows out of a hose. This phenomenon is something we experience in various ways. However, in relation to nerves, particularly the carpal tunnel syndrome, we need to address the underlying issues more fundamentally.

I will explain it to you. As you can see, here is the spine, and then the spinal cord passes through here, from the fifth lumbar vertebra to the seventh lumbar vertebra. There are nerve roots that emerge from this section, and they meet to form what is called the nerve plexus. This is referred to as the sacral nerve plexus, and as you can see, it is quite complex. The reason it is complex is that the connections allow for compensation; even if one part is damaged, other parts can supplement its function. This system is well-established, so even if a nerve in one area is damaged, it is important for our survival that we do not experience significant impairment. This is especially crucial for the hands and feet, which are well-developed to handle such collisions. As I mentioned earlier...

The blood vessels and my nerves go together. Here, the arteries are connected to the heart, and when they exit the heart, they rise up, forming the aorta. The aorta curves and descends. As it rises, it connects directly to the left, which is linked to the brachial plexus, and on the right, it connects to the subclavian artery. After that, the next major artery is the brachial artery, which is a very large artery. Centered around the humerus, you can see the median nerve here, and there is also the ulnar nerve or the radial nerve. These are interconnected in various ways. Among these, the three main nerves that go to the hand are the median nerve and the ulnar nerve. What we are discussing is the issues that arise when the median nerve encounters problems. Then, if you look further down, you will see that the median nerve is quite long.

From here, the armpit is not functioning properly, and in middle age, muscles and nerves do not connect well. After passing through the wrist, the muscles connect from there. Primarily, it will be more about the inner muscles rather than the outer ones. As it connects and descends, it changes significantly, splitting like this. This nerve, known as the median nerve, is a combination of motor and sensory nerves. The sensory nerves manage sensations in specific areas, such as the palmar surface of the hand, particularly the tips of the thumb, index finger, and part of the fourth finger. The median nerve also governs the sensation in the back of the middle finger. On the motor nerve side, there are several muscles here, numbered one through eight. It passes through these areas as well. Additionally, there are muscles and ligaments that bend the thumb, which are also quite thick.

The wrist protection does not pass through, and there are many muscles outside here. The muscles in the wrist are connected to many muscles that link to the median nerve. If you look a little more closely, you can see that there are five major branches that come down directly from here, and then there are four types that split. Among them, the ones that go to the wrist mainly consist of these three. Here, there are also flexor muscles. This means that these muscles are the ones that go to the fingers. The muscles that are responsible for this have all been named, and they are referred to by various names, but that is not important. What matters is that these muscles pass through the carpal tunnel. These three major ones pass through, and the other muscles also connect and are connected from before. Therefore, there are many muscles from the ankle to the wrist, and those on the inside are...

The brachial plexus is connected through the nerves. You can think of it like that. However, this nerve is only connected, so it is often mentioned in a straightforward manner. From the moment we are born, the brachial plexus is susceptible to injuries. In the past, when I played sports, there were cases where injuries occurred. For example, when a tool or object was inserted and pulled out, it caused a lot of tension. When this happens, injuries can occur in this area. In the past, there were many cases of cervical neuropathy, particularly with issues related to the brachial plexus. So, when I look at this area, it seems strange. There can be problems in the upper part of the arm and the shoulder. In such cases, it is referred to as 2R bell paralysis. This occurs when there are injuries from the cervical nerves, particularly from the 4th to the 6th cervical vertebrae. Symptoms appear when these areas are affected. Then, from the 7th cervical vertebra...

Next, regarding the thoracic spine, if there are issues, it can be referred to as crunchy, leading to paralysis below the ankles and problems in the hands. Do you understand? However, these issues do not always lead to severe problems; they can be minor issues that we actually feel as symptoms. Nevertheless, these problems can gradually worsen and impact us over time. Looking at it in more detail, if there are scar tissues forming on the spinal nerves, or if tumor tissues are growing, or if inflammation occurs, it can lead to complications. Additionally, if there is a hematoma in the area, it can also create problems. As you can see here, the median nerve exits from the spinal cord, forming an M shape, and it continues to the area behind, which is the thoracic region.

The inner part of this wrist corresponds to the ulnar nerve. This nerve is involved in the brachial plexus, and it's not only about that, but there are also lumbar and sacral nerves that can be affected similarly. The reason is that these nerves can encounter issues in a similar way. Interestingly, as these nerves pass through, there is the neck area involved, specifically the sternocleidomastoid muscle. If we consider the shape of the neck and face, this muscle rises from the thoracic spine, creating a gap, and then there are solid areas that can be palpated. Thus, there are structures that rise in the thoracic region, and there are also ulnar nerve branches that come up. Right behind that, there is the radial nerve, followed by anterior and middle branches that pass through the brachial plexus.

Passing through this, there is definitely pressure depending on the situation. How it comes to the front paw is that, right here, after that, the distance has become narrower. Usually, it is like this, but as it pulls, it becomes more constricted. This is referred to as a sciatic entanglement. When this happens, the surrounding nerves become narrower, and the area also shrinks. You don't need to know the detailed names, but I am explaining this in detail so that you understand the importance of the neck. Similarly, the same issues can occur with the cervical spine, and there can also be problems with the wrists. As it goes down to the wrists, there can be hypertrophy or enlargement, or if it doesn't stretch, the thickened muscles can become more pronounced. Therefore, especially when lifting, the nerves in this area are affected.

You will feel pressure on the combined butter. One thing is that the blood vessels do not pass through the eternal. Therefore, even if there are symptoms of the carpal tunnel syndrome, it doesn't matter if your hands are cold or warm. If your hands are warm, it means that blood is circulating well. However, there can be new issues because the radial artery or the ulnar artery does not pass through the carpal tunnel. So what are the important points that will eventually become treatment points? As the median nerve descends, it splits and branches out in various places. These areas can all be important pressure points. Additionally, the muscles inside that are involved in movement have a significant role in the areas where there is rigidity. So, if any part is pressed or painful, those areas are important.

Efforts can often lead to pain. This can be used to treat vocal issues. Therefore, the voice is fundamentally very important. In fact, in information therapy, the reason that Monk Park Jung-bu checks the voice here is precisely because it is that important. Throughout life, we also consider the C4 area, and here you can see that the C6 is also significant. Of course, the central nervous system primarily comes from C5. In the context of the National Assembly, it goes up to OT1, but this number is not that crucial. When checking the upper eight areas, we can determine whether pressing a point causes pain or not. We can also look at this from C1 to C8 or even to C10, so it is possible to interpret the data in various ways. Please check and see if you have any pain.

You can press the area or just refer to it as the area as commonly known. It might seem like you want to say I want, but it actually relates to the nerve center C5 that comes from the bone. The bone is above the spine, so if we talk about wear on the spine, the bone at C4 means that the nerve can get compressed and can be affected. So, you don’t need to worry too much about this part; just think of it as the area where you feel pain and treat it accordingly. 

Additionally, the heart corresponds to the nerve ganglia, particularly related to the index and ring fingers. You should find the second joint of the ring finger as a basic reference. Furthermore, it also includes the liver, stomach, spleen, and related nerve ganglia as additional layers. Of course, the symptoms can vary individually, so it’s essential to be cautious.

Park Jeong-ho, the teacher, has tailored his approach according to the characteristics of the director, selecting only a few key points effectively, which ensures that the diagnosis is accurate. However, generally speaking, there is a sense of guilt that I mention as a basic aspect, so it would be good for everyone to think flexibly about this. Additionally, as experience increases, the accuracy from those points can improve, and there are cases where this can also be quantified. Now, let's take a look at the basic guidelines. Here, you can see the facial features, and then there is the thoracic area. Currently, in the case of the right wrist, it is essential to address the dual color on the same day. Then, regarding the bright color, we need to check and note it down, because it may be necessary to apply strength on the opposite side, whether on the right or left, so it is important to check and record this.

You can choose one option of respect, and then, regarding the CEO ballot, following the detailed notes that came down from the center, you can mark the bold areas, then the heart, and then the second and third options. So, you can use your fourth or second finger to mark the middle of the second joint, and that will make it logically consistent. Next, regarding the nerves, you should check C4 here, and then proceed to T1 and the eighth thoracic vertebra. I have taken notes on the relevant aspects here, and this is mostly the case for the right wrist, while for the left wrist, it could be a case of carpal tunnel syndrome. So, please check this for yourself, and if there are more painful areas, you can mark those as well. If you're unsure, you may need to check both. The yellow point here is where you should check the nerves related to the CEO.

You can choose either the right or the left. Today, I will briefly talk about carpal tunnel syndrome. If you understand the underlying causes, it will be easier to approach the issue. When you hear the term carpal tunnel, don't be alarmed; it's important to understand the causes. In such cases, it is essential to operate with the concept of government therapy, as it can provide a lot of assistance. I hope you find this information helpful. Until we meet again, greetings from Seattle.

[종부테라피]_"손목 터널 증후군" - 근원을 알면 모든 것이 쉽다

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