The common painful condition known as carpal tunnel syndrome (also abbreviated as CTS) is caused by compression of the median nerve within the wrist. Pain, numbness, and weakness in the parts of the hand that are supplied by the median nerve are the hallmarks of carpal tunnel syndrome (CTS). “Pins and needles” can be a symptom that some people with carpal tunnel syndrome (CTS) experience in the thumb, index, and middle fingers, as well as half of the ring finger, in addition to pain in the wrist. Below the wrist, at the back of the hand, there is a passageway called the carpal tunnel that is made up of ligaments and bones.
This passageway is where the median nerve and tendons pass through. The carpal tunnel is typically quite congested, and there is only a small amount of space within it to accommodate the tendons and nerves that need to travel through it. If something, like an inflammatory swelling or an injury, takes up extra room in the canal, the nerve that is located in the canal will become compressed, also known as “pinched.” Consequently, this causes symptoms of CTS.
Diagnosis of CTS
In order to accurately diagnose and treat carpal tunnel syndrome (CTS), physical therapists collaborate closely with other medical professionals. The symptoms of CTS are fairly typical, and a diagnosis of the condition can frequently be made without the need for extensive testing. Physical therapists are experts in the motion and function of the body, and they will perform an evaluation to determine all of the factors that may be contributing to your condition. They will then devise a treatment plan to address all of these factors.
The following is a list of possible diagnostic procedures for carpal tunnel syndrome (CTS):
In order to rule out other conditions, your neck and the rest of your upper extremities will be examined. Many patients have been given the diagnosis of CTS, only to find out later that the pain was actually coming from another part of their body.
- a measure of the tensile strength of the fingers and thumb
- Examining the senses
- The range of motion in the hand and wrist
The wrist flexion test, also known as the Phalen test
Involves your physical therapist instructing you to squeeze the palms of your hands together for 60 seconds. CTS may be present if you experience tingling or numbness in your fingers within the first sixty seconds of an activity.
Taps will be administered over the median nerve in the wrist by your physical therapist using either a reflex hammer or their finger. Tingling in the thumb, index, and middle fingers could be a sign of carpal tunnel syndrome.
Electromyography (EMG) and nerve conduction velocity (NCV) are both types of electrical studies. The transmission of the nerve and the severity of the CTS can both be determined through these tests.
If there is reason to suspect an anatomical abnormality or if there was a recent traumatic event, the doctor may order x-rays.
Your physical therapist may, in certain circumstances, suggest that you see a physician or another qualified medical professional for additional testing or treatment.
Surgery or Physical Therapy
The correct style of treatment for CTS should always be assessed on a case by case basis. An acute case may require surgical intervention. There is however a growing body of evidence, such as this study from the Journal of Orthapedic & Sports Physiotherapy, that shows physical therapy can be as equally effective as surgery in the treatment of CTS and in some cases helps return full hand function more quickly than the more invasive surgical option. So, what does physical therapy treatment of CTS involve?
Your treatment plan for CTS may include the following, depending on the underlying causes of the condition:
Instruction in relation to:
- Altering the positions of the wrists (ie, avoiding prolonged bent wrist positions)
- Position of the head, shoulders, and upper back (ie, avoiding forwards head or slouching)
- use of sharp utensils, tools, or other implements in a safe manner, in the event that sensory changes are recognised
- “stretch breaks” should be taken throughout the course of your work or daily routine.
- Strengthening the muscles in your hand, fingers, and forearm—and in some cases the core and postural back muscles as well—can be accomplished through the practise of various exercises.
- Flexibility of the wrist, hand, and fingers can be improved through the practise of stretching exercises.
- Treatments involving the application of heat or cold to alleviate pain
- Utilization of a night splint in order to lessen the level of discomfort
- A visit to your workplace to evaluate the conditions there. For instance, if you work on a computer while seated at a desk, it is essential that the keyboard be in the correct alignment so that you do not have to work with your wrists bent. This will help you avoid repetitive stress injuries.
- Enhancing the ergonomics of tool and utensil handles by making them larger and adding more material so that they can be more securely gripped
- If vibration is a factor at your place of employment, you should wear anti-vibration gloves or wrap anti-vibration wraps around the tool handles.
Your physical therapist will also take into account your home life and the activities you enjoy doing in your spare time. They may provide you with advice such as wearing gloves to keep the wrists and hands warm and avoiding activities that make your condition worse, such as playing racquet sports, until your symptoms improve.
The purpose of physical therapy is to alleviate your symptoms without the need for surgical intervention, to make it possible for you to be as active and functional as is humanly possible, and to assist you in returning to your normal activities at work, at home, and in your leisure time.
Start your CTS treatment and recovery with Transcend Health
Start your journey back to a pain free fully functioning hand by contacting the experienced team at Transcend Health. After careful assessment you’ll be given a tailored treatment plan designed to get you back to normal as quickly and effectively as possible. To discuss CTS or any other type of musculoskeletal issue call on 02 4961 3399 or email firstname.lastname@example.org