Every year, a significant number of patients see a physician complaining of hand numbness, tingling, and pain. Many of these patients are assumed to have nerve compression in the neck area and come to the doctor’s office with an MRI of the cervical spine. Some may even have had surgery performed in the neck area with little or no relief. The reason the pain persists may be because they have been given the wrong diagnosis.
What they might really be experiencing is known as Carpal Tunnel Syndrome (CTS), caused by compression of the median nerve at the wrist. The carpal tunnel is a pathway made of ligaments creating a tunnel through which the nerve travels. In addition to the median nerve, tendons also travel alongside the nerve. If the carpal tunnel becomes narrowed for any reason, this will cause compression on the nerve and tendons. For example, if any of the ligaments forming the tunnel get swollen, inflamed or thickened, this will limit the space available for the nerve and tendons to go through and the person may become symptomatic. It is commonly considered to be an occupational condition due to repetitive movements at the wrist.
Symptoms Associated with Carpal Tunnel Syndrome
In the beginning, a feeling of numbness and/or tingling in the hands is a very common symptom of CTS. Patients often complain that this sensation wakes them up at night.
The symptoms are improved by shaking their hands or hanging them over the side of the bed. Others report dropping things or having trouble opening jars or making a fist. When patients wait too long to seek treatment, they can develop muscle loss in the hands with weakness of the thumb.
CTS Risk Factors:
• Thyroid disorders
• Trauma to the wrist or hand
• Repetitive motion activities such as typing, writing, cycling, golfing, and tennis can exacerbate the symptoms
Several Ways to Diagnose CTS
The Neurologist will initially evaluate the patient by getting a medical history and conducting a physical exam. If CTS is suspected, an electromyogram and nerve conduction velocities test will be done to confirm the diagnosis.
According to the American Academy of Orthopedic Surgeons, “In most patients, carpal tunnel syndrome gets worse over time, so early diagnosis
and treatment are important. Early on, symptoms can often be relieved with simple measures like wearing a wrist splint or avoiding certain activities.
“If pressure on the median nerve continues, however, it can lead to nerve damage and worsening symptoms. To prevent permanent damage, surgery to take pressure off the median nerve may be recommended for some patients.”
If CTS is caught early enough, treatment with a wrist splint or a course of hand therapy may be all that is necessary. Hand Therapy utilizes modalities to decrease inflamation and increase circulation for the median nerve and flexor tendons wtihin the carpal tunnel. Joint block tendon gliding exercises, as well as, nerve glides improve function. Patient education should include information on preventive measures to prevent range of motion that exhacerbates symptoms.
Hand therapy with the use of modalities, to decrease inflammation and increase circulation to the median nerve and flexor tendons within the carpal tunnel. As well as patient education on joint block tendon gliding exercises as well as nerve glides to improve function. Education should also include, information on preventative measures, to prevent range of motion that exacerbates symptoms.
To schedule your appointment with our Certified Hand Therapist’s, please contact Innovative Therapies Group.
Innovative Therapies Group, Inc.
352-433-0091 | innovativetherapiesgroup.com