Have you ever experienced numbness or tingling in your hands and fingers? What about wrist and arm pain or weakness? Do you constantly feel the need to shake your hands out or move your fingers to find relief from symptoms? You may be familiar with the term “carpal tunnel”, more formally known as carpal tunnel syndrome (CTS). It is a wrist and hand injury that is often associated with long days on the computer, but there is much more to know about this common condition.
What is CTS?
CTS is caused by increased pressure placed on the median nerve. The median nerve originates in the neck and runs down the arm and through a narrow passageway in the wrist called the carpal tunnel. In addition to the median nerve, the carpal tunnel contains the flexor tendons that allow the fingers and thumbs to bend. When the tunnel is narrowed due to injury, or swelling of the median nerve or flexor tendons occurs, the pressure on the nerve increases. This pressure is commonly the result of repetitive hand and wrist use or prolonged extreme positioning of the wrist/hand in flexion or extension. Other factors can also contribute to CTS including anatomical factors, pregnancy, inflammatory and other health conditions, and sex.
Symptoms
The symptoms of CTS can be frustrating and make it difficult to function normally in work, hobbies, sports, and everyday activities. The most well known symptom is numbness or tingling in the fingers/hand, usually in the thumb, index, and middle finger which are innervated by the median nerve. This may occur in the ring finger as well. Additionally, one may experience pain or tingling in the hand or wrist that can travel all the way up the arm and into the shoulder. Other symptoms include hand or finger weakness/clumsiness and difficulty picking up or gripping items. Oftentimes people with CTS find relief from symptoms by shaking out their hands or moving their fingers. Typically, the symptoms of CTS come on gradually without any major injury or event occurring.
Treatment
It is important to treat carpal tunnel syndrome as soon as symptoms begin to prevent chronic pain/disability or the need for surgery. If treated early, symptoms can be relieved with conservative, non-surgical methods. These treatment options may include:
- Activity modification to limit or prevent positions that aggravate symptoms
- Wrist bracing or splinting to keep the wrist in a neutral position and reduce pressure on the median nerve
- Medications such as Advil, Ibuprofen, or other anti-inflammatory drugs for temporary pain relief
- Corticosteroid injections to reduce inflammation and swelling in the carpal tunnel
Physical therapy is another conservative treatment option that has been shown to be effective in reducing symptoms of CTS, and can be done in conjunction with the above treatments as well. A physical therapist can work with you to reduce symptoms and improve function. This may be accomplished through a number of different strategies such as:
- Stretching exercises to improve flexibility of the wrist, hand, and fingers
- Strengthening exercises to address weakness in associated muscles
- Nerve gliding exercises to allow the median nerve to experience less pressure and move more freely within the carpal tunnel
- Manual therapy to increase the mobility of the wrist/hand, fingers, and other affected joints, as well as reduce muscle tension
- Therapeutic modalities such as heat or ice to help control pain
- Patient education on wrist positioning, posture, and other valuable information to optimize recovery
If symptoms of CTS are limiting your ability to work, complete everyday tasks, or participate in your favorite hobbies or sports, physical therapy may be a good treatment option for you. Call Respire Physical Therapy today at (703) 671-1871 or click here to schedule an evaluation and begin returning to the activities that you enjoy!
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