Do you have Carpal Tunnel syndrome?

In my physical therapy clinic carpal tunnel syndrome is one of the conditions we see in our patients and the most common peripheral neuropathies. Generally this condition affects older individuals over 40 years of age and women are more frequently affected than men. The median nerve passes through this closed compartment along with the flexor tendons and vascular structures. We often have symptoms of median nerve compression after passing through this tunnel but the median nerve can be compromised or "pinched" at sites along the arm or at the cervical spine. A thorough clinical examination paired with nerve conduction studies can ensure at one point the median nerve is compressed at what stage of injury. In some cases you may have multiple sites that are affecting how these nerve functions discussed in the work by David Butler. What does that mean? You can have other sites that can "pinch" or "compress" the nerve at the elbow, humerus, pronator muscle, and flexor digitorum profundus. Similar to a water through a hose that is stepped on has decreased flow this same affect occurs in nerves.

What are sign and symptoms?

It is commmon to have tingling, pain, and numnbess in the thumb, index, and middle finger that makes up the areas of the hand that the median nerve provides sensation. At night pain it is common that these symptoms worsen therefore bracing can help with the management of night pain.


How do we diagnosis Carpal Tunnel Syndrome?

We suggest trying these two tests to give you an idea if you may have Carpal Tunnel using the Phalens test and Tinels Compression test. In the video if you test positive for one or both you should seek a orthopedic evaluation from your doctor to see what options you may have.


Our approach is to identify the repetitive activity that might be triggering these symptoms with frequent stretching breaks.

In addition taking NSAIDS, topical, B vitamins, turmeric, gentle stretches, night splinting can be an effective strategy in the early stages of carpal tunnel.

Common stretches to treat Carpal Tunnel Syndrome the following:
Pec minor stretches, cervical stretches scalenes, cervical retractions, wrist flexor/extensor stretches are many of the recommended stretches. Also,
getting up every 3060 min to allow 3min break to break the cycle can be beneficial. Another exercises is gentle nerve gliding can decrease symptoms and improve comfort.

All this being said if you have underlying problems controlling daibetes, Hypothyroidism, and RA can make these approaches less successful.

If not responsive to conservative treatment or have weakness in thenar region, sensation loss 2 point discrimination, abnormal nerve conduction studies, and no response for a year you may be surgical candidate.

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