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Carpal Tunnel Syndrome

Physical Therapy

Have you started to notice any numbness and tingling in your hand? You may be experiencing something called carpal tunnel syndrome.

Most people have heard of carpal tunnel syndrome in the past, but many are unsure of what exactly it means. Carpal tunnel syndrome is a common condition caused by compression of the median nerve at the wrist. This condition typically worsens over time with repetitive stress, making early recognition and treatment a crucial part of recovery.

Most cases of carpal tunnel can be treated conservatively with physical therapy, a splint, or simple activity modifications. However, prolonged pressure on your median nerve can lead to permanent damage and associated symptoms which may require surgical intervention.

Understanding the importance of WHY carpal tunnel syndrome is setting in all comes down to anatomy. If you’re familiar with the basics, the “tunnel” being referred to is a one-inch space between the carpal bones of the hand and the flexor retinaculum/transverse carpal ligament (fibrous connective tissue) on the palmar surface of your wrist. Inside this one-inch space lies nine wrist flexor tendons, and the main culprit: the median nerve.

carpel tunnel syndrome hand

The median nerve is a major peripheral nerve, with extensive implications in terms of sensation and motor function for the upper extremity. It originates from the brachial plexus in the neck, travels down the arm into the hand, responsible for innervating multiple muscles along the way. It provides sensation to the thumb, index finger, middle finger, and inside portion of the ring finger, mainly on the palmar surface of the hand.

Carpal tunnel syndrome is usually caused by a variety of factors, but the most common are:

  • Repetitive use of the hand
  • Pregnancy
  • Health conditions: Diabetes, Thyroid issues, Arthritis
  • Obesity
  • Inflammation
  • Anatomical variants
  • Constant wrist flexion overpressure
  • Menopause
  • Medication side effects
  • Posture
  • Workplace and poor ergonomics
  • Cold environments

Some symptoms indicative of carpal tunnel syndrome are:

  • Numbness
  • Tingling
  • Weakness
  • “Shocks” of pain
  • Dropping of objects

The pain a carpal tunnel sufferer experiences is usually gradual, coming and going throughout the day but not limiting function with most activities. Over time, the pain intensifies and becomes constant and severe, to the point where it can affect you even as you sleep. At this stage, the best thing you can do is schedule an appointment with a Physical Therapist who can perform an examination to rule out any other serious conditions and confirm you are indeed suffering from  carpal tunnel. Knowing your diagnosis can help play a major role in treating your symptoms, as well as preventing them from progressing or returning in the future.

Treatment for carpal tunnel syndrome is different for every patient, but the main goal is clear across the board: relieve the pressure of the median nerve at the wrist. A conservative approach is usually taken first which includes stretches, soft tissue massage, strengthening, modalities, postural restoration, and education about ergonomics and to take breaks or avoid/alter activities that make the pain worse. The next step would be wearing a splint to keep the wrist in an extension position, especially at night. If the patient is not making any progress at this point, it can be assumed that there is more significant damage to the nerve, possibly leading to more aggressive treatments such as medications, injections, or surgery to relieve the pressure from the transverse ligament.

Do you suspect you may be suffering from carpal tunnel syndrome? If so, it’s important to seek rehabilitation before your problem becomes more severe. Get in touch with us and work with one of our highly qualified Physical Therapists in Kew Gardens, Glendale or Manhasset.

References 

Ghasemi-Rad, M., Nosair, E., Vegh, A., Mohammadi, A., Akkad, A., Lesha, E., Mohammadi, M. H., Sayed, D.,

Davarian, A., Maleki-Miyandoab, T., & Hasan, A. (2014). A handy review of carpal tunnel syndrome:

From anatomy to diagnosis and treatment. World journal of radiology, 6(6), 284–300. https://doi.org/10.4329/wjr.v6.i6.284

https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/symptoms-causes/syc-20355603 (2020)

Presazzi, A., Bortolotto, C., Zacchino, M., Madonia, L., & Draghi, F. (2011). Carpal tunnel: Normal anatomy, anatomical variants and ultrasound technique. Journal of ultrasound, 14(1), 40–46.

https://doi.org/10.1016/j.jus.2011.01.006

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