Carpal Tunnel Syndrome and Physical Therapy

We don’t often realize how much we use our hands and wrists in our daily lives – until we begin experiencing pain. Carpal tunnel syndrome (CTS) is a relatively common condition of the wrist and hand that can affect the use of your whole arm. It is caused by pressure on the nerve at the base of the palm (median nerve). Fortunately for most people who develop CTS, physical therapy treatment can often relieve pain and numbness and restore normal use of the hand, wrist, and arm without the need for surgery.

What is Carpal Tunnel Syndrome?

The carpal tunnel is a narrow channel on the palm side of your wrist, about the width of your thumb. The tunnel protects the median nerve and the tendons that bend your fingers. Pressure on the nerve can cause pain and weakness in your wrist and hand and numbness or tingling in your fingers. This pressure is caused by crowding or irritation of the median nerve in the carpal tunnel and can lead to CTS.

Carpal tunnel syndrome can develop through daily work activities such as using a keyboard & computer and performing assembly line work. Some leisure activities such as sewing, racquetball, and playing certain string instruments can lead to CTS. But its not just daily activities that can cause the syndrome. Certain health conditions can also lead to CTS, including inflammation of the tendons in the wrist, injuries to the wrist, hormone changes, diabetes, arthritis, and certain medication use.

Signs and Symptoms
CTS typically starts slowly, with symptoms such as burning, tingling, “pins and needles,” or numbness in the palm of the hand and fingers. Often the symptoms are more noticeable during the night, and people report being awakened by symptoms. Many people feel the need to “shake out” their hands to try to relieve the symptoms.As the condition progresses, the symptoms become noticeable during the day and can get worse when holding certain items. Weakness of the hand and more constant numbness may occur if the pressure on the nerve continues. You may find that you drop objects unexpectedly or have a weakness in your grip.

How Is Carpal Tunnel Syndrome Diagnosed?
As physical therapists, we are experts in the movement and function of the body and will conduct an evaluation to determine all of the factors that may be contributing to your condition. We may test the grip strength of your fingers and thumb, do sensory and range of motion tests, or do x-rays and electrical studies to determine the transmission of the nerve and the severity of the CTS.

How Can a Physical Therapist Help You?
After the evaluation, we will prescribe a treatment plan based on your specific case and condition. Depending on the cause of your carpal tunnel syndrome, your therapy program may include education regarding wrist positions and proper neck and upper back posture, exercises to increase the strength of the muscles in your fingers and forearm, stretching exercises to improve the flexibility of the wrist and hand, use of heat/cold treatments, use of a night splint to reduce discomfort, or a worksite visit to assess your work station. Your physical therapist will also consider your home and leisure activities, with recommendations such as wearing gloves to keep your wrist and hands warm, and limiting activities that aggravate the condition.

As always, the goals of physical therapy are to reduce your symptoms without the need for surgery, to enable you to continue moving pain free, and to help you resume your normal activities.

Can Carpal Tunnel Syndrome Be Prevented?

There are no proven strategies for preventing carpal tunnel syndrome, but there are ways to minimize stress to your hands and wrists.

Reduce force: Many people use more force than needed when performing work with their hands. Relax your grip to avoid muscle fatigue and strain. When writing for long periods of time use a larger-handle pen or soft gel grip.

Take frequent breaks:
When doing repeated activities, give your hands a break by performing stretching exercises. If possible, alternate your hands when completing some tasks.
Neutral wrist position:
Avoid bending your wrists by keeping them in a straight or “neutral” position.

Work area adjustment:
Have one of our physical therapists examine your work area to make sure it fits your body properly. Making simple adjustments can help to avoid unnecessary strain.

Improve your posture: Believe it or not, proper alignment of your trunk, neck, and shoulders can prevent excessive strain and improper positioning of the wrists and hands.

Keep your hands warm:
 You are more likely to develop hand pain and stiffness if you work in a cold environment. If you can’t control the temperature, be sure to wear gloves to keep your hands and wrists warm.
Maintain good health:
Paying attention to your general health is an important step in preventing CTS. Staying physically fit and maintaining a healthy weight may help control diseases and conditions that may contribute to the onset of CTS.

As always, if you have questions regarding carpal tunnel syndrome, and whether therapy can help your situation, feel free to contact any of our 5 clinics and we would be happy to help you. Remember, you don’t have to live with pain.

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