FREE Physical Therapy - Vol. 7- Carpal Tunnel of the Wrist, January 2007
CARPAL TUNNEL SYNDROME
Symptoms of carpal tunnel syndrome can include pain, weakness, numbness, and tingling in the fingers, thumb, wrist, and arm. These symptoms are the result of pressure on the median nerve that lies within the palm side of the wrist. The carpal tunnel is a small space formed by the bones and a ligament of the wrist, through which several tendons and the median nerve run from the forearm to the hand. The median nerve controls movements of the thumb and sensation to most of the thumb, index finger, middle finger, and part of the ring finger.
PROBLEMS
Patients usually complain of a "pins and needles" feeling in the first 3 or 4 fingers, the wrist, and possibly the forearm or shoulder. This feeling usually starts gradually, but can progress to a constant painful sensation. The pain is usually worse at night and can awaken the patient frequently. The patient may also report "clumsiness" when using the fingers.
CAUSE
Carpal tunnel syndrome is one of the most common work related injuries, is more common in women, and is most common after the age of 40. The specific cause often remains undetermined, but the condition may stem from decreased blood flow to the median nerve or direct pressure on the nerve as it passes through the tunnel. This can be the result of structural changes, cumulative effect of overuse, or direct trauma. The fluid changes that accompany pregnancy can also trigger carpal tunnel syndrome.
WHAT CAN I DO?
Avoid frequent, forceful hand and wrist movements or activities that require repeated/prolonged flexion of the wrist. Night splinting can counteract and help prevent the pain caused by excessive wrist flexion that often occurs in one's sleep pattern.
Ergonomic considerations, such as maintaining 90 degrees of elbow flexion when working at a desk, can prevent repetitive motion strain.
Strengthening and stretching exercises to consider include: wrist circles, thumb and finger stretches, finger-thumb squeezes, wrist curls with palm up and with palm down, arm curls, and shoulder shrugs.
Our goal in physical therapy is to decrease pain through the use of modalities and soft tissue mobilization; to increase flexibility and range of motion of the surrounding joints and musculature; exercises to increase grip, wrist, forearm, shoulder, and scapular strength; and proper postural education, which is key to the success of carpal tunnel syndrome treatment.
Ask your physician if physical therapy is right for you.
