CARPAL TUNNEL SYNDROME
Symptoms: Pain, numbness/tingling, aching of the wrist and fingers (mostly the middle and index). Onset is usually progressive and is felt in the mornings or with repetitive wrist/finger movement with wrists bent forward or backwards (ie typing)
Causes: This condition is caused by compression of the median nerve at the wrist. The carpel bones of the wrist create a tunnel that allows the tendons of the forearm to the fingers and wrist pass through. This tunnel has a roof composed of a dense ligament that caps this tunnel. With excessive gliding of the tendons with the wrist out of a neutral position, friction can cause inflammation to build in this compartment putting pressure on the median nerve causing pain at and along the path of the nerve into the hand/fingers. Sleeping with wrist in “resting” flexed position also increases pressure exerted on this area
Relief: Gentle stretching, soft tissue mobilization/massage of the wrist ligaments/tendons/carpel bones. Modalities to relieve inflammation such as Ultrasound, Laser, E-stim, hot/cold, and Anti-inflammatory medications delivered through phonophorisis (ultrasound) or Iontophorisis (medicated patch) may be performed. Modifying the activity or resting the extremity may be recommended to allow healing to occur. Your therapist may recommend and fit you for a supportive brace to help support the extremity. Commonly an assessment and treatment of the neck, shoulder and elbow can improve overall nerve mobility and overall symptoms.