Carpal tunnel is a condition that occurs in the wrist and in the hand. This syndrome causes pain, weakness, tingling, and numbness in the area and has the ability to impact the function of the entire arm. Oftentimes, one may notice intense swelling of the finger as well as possess the urge to “shake off” the uncomfortable feeling in the area. Carpal tunnel is a condition linked to disruption of nerve function, also known as neuropathy and results in limited mobility, or paresthesia. It occurs when one of the main nerves of the hand, known as the median nerve, is squeezed or compressed when traveling in the carpal tunnel space. The median nerve is responsible for feeling in the thumb, pointer, middle, and ring finger and also has control over small muscles in the thumb. The irritation to this nerve results in the condition, for it cannot move freely and openly through its desired path. There are three stages of carpal tunnel syndrome: mild, moderate, and severe. The condition often starts out with mild pain and reoccurs while increasing in severity. Although carpal tunnel syndrome can impact anyone, it is most commonly diagnosed in individuals between forty and sixty years.
There are a number of signs and symptoms of carpal tunnel syndrome. In the early stages, one may experience numbness in the area, specifically at night, feeling as though the fingers are of no use, intense swelling in the fingers, pain in the area, immobility and weakness, and a tingling sensation. As the condition progresses, one may report that the tingling has become constant and during the day, mild to severe discomfort/pain, worsening of pain at night, and difficulty/inability to pick up objects. In the most severe cases that remain untreated, the muscles at the base of the thumb that are controlled by the median nerve may decrease in size and begin to wither away. In this instance, some may report that they are unable to distinguish between hot and cold temperatures, thus resulting in accidental burning of the skin.
There is no main cause of carpal tunnel syndrome, but the condition has been linked to many occurrences. A sprain, fracture, or other trauma/injury of the wrist often narrows the tunnel area, thus resulting in compression and irritation of the nerve. The swelling of the injury is most accountable for the development of the condition. Additional causes include but are not limited to mechanical problems of the wrist, excessive use of vibrating hand tools, rheumatoid arthritis or other pre-existing arthritic diseases, imbalance of the thyroid, imbalance of the pituitary gland, fluid retention during pregnancy, fluid retention during menopause, existence of a cyst or other mass in the tunnel, gender (women are three times more likely to develop the condition), diabetes, applying of pressure to the wrist during sleep, and aging. Additionally, since the wrist and hand are two of the most used parts of the body, the demands placed on the area can also contribute to the development and progression of the condition.
When diagnosing the issue, a physical exam is the most common starting point. Through routine lab testing and X-ray technology, healthcare providers can identify fractures, nerve-damage, diseases, and arthritis. Specific to the wrist, the Tinel Test and the Phalen may be conducted. During the Tinel Test, the doctor taps or presses on the nerve in the wrist and looks out for a shocking reflex. During the Phalen, the doctor will request that one holds their forearms up and points the fingers downward while pressing the backs of the hands against one another. If tingling results, the test is positive.
There are a number of ways in which carpal tunnel syndrome can be prevented. One of the most common methods is the minimizing of repetitive hand movements. In doing so, less stress will be put on the affected area, thus resulting in less irritation to the median nerve. Holding the wrists straight and in a neutral position can also help prevent symptoms of the condition. It is also important to limit force and to practice relaxed gripping of the hands.
Many treatment options exist for carpal tunnel syndrome. Some of the most common non-surgical treatment options include but are not limited to wearing a wrist brace during sleep, increasing exercise and physical activity of the wrist/hand, attempt weight loss if necessary, eliminate tobacco use if applicable, and practice wrist stretching exercises recurringly throughout the day.
Physical Therapy Treatment Options
The most effective and dependable treatment option for carpal tunnel syndrome is physical therapy. Physical therapists are medical professionals who work with the patient to improve quality of life through strengthening exercises. By prescribing numerous motions and exercises, the physical therapist will work to reduce pain and increase mobility. The therapist will educate the patient on the correct positioning of the wrist to ensure that the symbols are alleviated, and that mobility is gained. One may be ordered to attend physical therapy sessions two or three times a week for about one to two months.
Physical therapy may also be ordered to further treat the condition following a surgery. This will help the wrist regain strength and proper function with the supervision of a healthcare professional. The physical therapist may also help to cure the scar in the effort of ensuring a smooth recovery.
Healthcare providers may suggest gliding exercises to assist in the treatment of carpal tunnel, for they focus on healing the nerves and tendons in the area. Gliding exercises include but are not limited to wrist rotations, median nerve glide, tendon glide (type one and type two), fist to stop sign, hand grip movement, fist to stop sign, and wrist curls.
Stretching exercises have also been said to improve pain, strength, and mobility of the affected area. Stretching exercises for the condition include but are not limited to thumb stretch, prayer stretch, finger stretch, wrist flexor stretch, wrist extensor stretch, and basic wrist stretches.
For more information about physical therapy treatment in Long Island for carpal tunnel syndrome, contact Hicksville Physical Therapy today.