Carpal Tunnel Syndrome
By Mikayla Andersen, SPTA
Carpal tunnel syndrome is a peripheral nerve entrapment injury that occurs as a result of compression of the median nerve where it passes through the carpal tunnel. The carpal tunnel is created by the transverse carpal ligament, scaphoid tuberosity and trapezium, hook of the hamate and pisiform, and the volar radiocarpal ligament. The median nerve, FDP, FDS, FPL pass through the carpal tunnel.
Etiology: Unclear, however associated conditions that contribute to CTS include repetitive use, rheumatoid arthritis, pregnancy, diabetes, cumulative trauma disorders, tumor, hypothyroidism, and wrist sprain or fracture.
Signs and Symptoms: Sensory changes and paresthesia along the median nerve distribution in the hand. It can also radiate into the upper extremity, shoulder, and neck. Some symptoms you may have are: night pain, weakness of the hand, muscle
atrophy, decreased grip strength, clumsiness, and decreased wrist mobility.
Diagnosis: Electromyography and electroneurographic studies can be used to diagnose a motor conduction delay along the median nerve within the carpal tunnel. MRI’s are also used to identify inflammation of the nerve, altered tendon or nerve positioning within the tunnel or thickening of the tendon sheath. Tinel’s sign, and phalen’s test can be used to assist when confirming the diagnosis.
Treatment: No universally accepted treatment, however, patients will initially receive conservative management including splinting, ergonomic measures, local corticosteroid injections, and physical therapy management. In physical therapy, patients can expect to receive carpal mobilization, and gentle stretching. Severe cases may require surgical release of the carpal tunnel. Post surgical physical therapy intervention should include the use of moist heat with electrical stimulation, iontophoresis, cryotherapy, gentle massage, desensitization of the scar, tendon gliding exercises, and AROM. Patients should initially avoid wrist flexion and a forceful grasp. Patients should see improvement of symptoms within four to six weeks. If they have to do surgery, rehab may last six to eight weeks.
If you think you may have carpal tunnel syndrome, or would like to try non-surgical treatment options for your symptoms, call Rock and Armor at 209-917-2660 or visit www.rockandarmor.com