Carpal Tunnel Syndrome
Imagine you’re sitting at your office desk or at home on the computer. You begin to feel the familiar tingling in your hand that’s been occurring for about a month. Suddenly pain begins to radiate from the wrist into the forearm. What’s going on? You may have carpal tunnel syndrome, the compression of a major nerve that runs through your wrist.
Carpal tunnel syndrome is a common condition of the upper extremity that affects approximately 1 out of 20 people. It occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes compressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers (although not the lateral side of the fourth finger and the whole fifth finger), as well as impulses to some small muscles in the hand that allow the fingers and thumb to move. The carpal tunnel (a narrow, rigid passageway of ligament and bones at the base of the hand) houses the median nerve and tendons that move the fingers. Sometimes, thickening from irritated tendons or other swelling narrows the tunnel and causes the median nerve to be compressed.
Multiple factors can contribute to what’s causing irritation to the median nerve and surrounding area. The carpal tunnel may be smaller in some people than others, with less room for the structures to move around in. Typically, women are three times more likely to have carpal tunnel problems than men. Trauma or injury to the area, such as a fractured bone or sprain, may cause swelling which could compress the nerve. Work professions requiring computer keyboard and mouse work as well as assembly line jobs have higher incidences of irritation to the carpal tunnel. Other factors include repetitious use of vibrating tools, hormonal changes (pregnancy, menopause), rheumatoid arthritis, and certain medications.
Carpal tunnel syndrome begins gradually with sensations of “pins and needles”, tingling, numbness, and/or burning in the median nerve distribution. The dominant hand is more commonly affected; however the syndrome can occur in both hands. Symptoms may be more noticeable at night. Pain may radiate up from the wrist to the forearm and arm. Symptoms are exacerbated with repetitive use of the hands or in excessive wrist flexion or extension (bent up or down). Shaking the hands to try to “wake them up” may also be a common sign. Weakness can occur as the syndrome progresses; one may begin to drop objects or become clumsy.
What are treatment options? Surgery tends to be the first to come to mind. This option may be appropriate; however conservative management should be the first consideration. A Physical Therapist can help to identify and eliminate or modify the cause from a workplace or recreational analysis. Tendon and nerve gliding and stretching exercises can assist regaining smooth movement and decreasing swelling through the carpal tunnel. NSAID’s may help decrease the inflammation. A resting splint, generally worn at night, can help to keep the wrist in a neutral position, eliminating excess pressure on the median nerve. The goals of Physical Therapy are to reduce your symptoms without the need for surgery, to enable you to be as active and functional as possible, and to help you resume your normal work, home, and leisure activities.
If you or someone you know has carpal tunnel syndrome call AVORA Physical Therapy at (828) 505-2664 today!
Carpal tunnel syndrome is a common condition of the upper extremity that affects approximately 1 out of 20 people. It occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes compressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers (although not the lateral side of the fourth finger and the whole fifth finger), as well as impulses to some small muscles in the hand that allow the fingers and thumb to move. The carpal tunnel (a narrow, rigid passageway of ligament and bones at the base of the hand) houses the median nerve and tendons that move the fingers. Sometimes, thickening from irritated tendons or other swelling narrows the tunnel and causes the median nerve to be compressed.
Multiple factors can contribute to what’s causing irritation to the median nerve and surrounding area. The carpal tunnel may be smaller in some people than others, with less room for the structures to move around in. Typically, women are three times more likely to have carpal tunnel problems than men. Trauma or injury to the area, such as a fractured bone or sprain, may cause swelling which could compress the nerve. Work professions requiring computer keyboard and mouse work as well as assembly line jobs have higher incidences of irritation to the carpal tunnel. Other factors include repetitious use of vibrating tools, hormonal changes (pregnancy, menopause), rheumatoid arthritis, and certain medications.
Carpal tunnel syndrome begins gradually with sensations of “pins and needles”, tingling, numbness, and/or burning in the median nerve distribution. The dominant hand is more commonly affected; however the syndrome can occur in both hands. Symptoms may be more noticeable at night. Pain may radiate up from the wrist to the forearm and arm. Symptoms are exacerbated with repetitive use of the hands or in excessive wrist flexion or extension (bent up or down). Shaking the hands to try to “wake them up” may also be a common sign. Weakness can occur as the syndrome progresses; one may begin to drop objects or become clumsy.
What are treatment options? Surgery tends to be the first to come to mind. This option may be appropriate; however conservative management should be the first consideration. A Physical Therapist can help to identify and eliminate or modify the cause from a workplace or recreational analysis. Tendon and nerve gliding and stretching exercises can assist regaining smooth movement and decreasing swelling through the carpal tunnel. NSAID’s may help decrease the inflammation. A resting splint, generally worn at night, can help to keep the wrist in a neutral position, eliminating excess pressure on the median nerve. The goals of Physical Therapy are to reduce your symptoms without the need for surgery, to enable you to be as active and functional as possible, and to help you resume your normal work, home, and leisure activities.
If you or someone you know has carpal tunnel syndrome call AVORA Physical Therapy at (828) 505-2664 today!