Carpal tunnel syndrome or CTS, is a painful condition that can affect one or both hands. Traditionally, CTS affected the middle-aged or seniors, however, due to the increasing use of computers, tablets, smartphones, and video game controllers, the condition is beginning to show up in younger-aged individuals. Regardless of a person’s age, if they are experiencing chronic symptoms such as hand or wrist pain, numbness and/or tingling in these areas, or difficulty grasping and retaining objects, it’s important to seek treatment in order to avoid permanent hand and wrist nerve damage.
Carpal Tunnel Anatomy
Carpal tunnel syndrome is named for a narrow tunnel medical professionals refer to as the “carpal tunnel”, that travels through the wrist area. The carpal tunnel is primarily comprised of the transverse carpal ligament. The median nerve is the primary nerve that passes through the carpal tunnel. This nerve carries important information that originates in the brain, travels through the cervical area, down the arm, eventually reaching the fingers and other hand structures. Sometimes the carpal tunnel ligament, along with nearby tissues, becomes swollen and/or thickens from overuse. When tissues swell in and around the carpal tunnel, they compress the median nerve. This leads to pain and other symptoms such as numbness or tingling in areas throughout the hand.
Chronic overuse of the hands and/or wrists is one of the main causes of carpal tunnel syndrome. Extensive use of computers and handheld devices such as video controllers, smartphones, etc. are a major culprit behind CTS. Other factors such as excess weight can play a factor since accumulating fat tissue in the lower arms, wrists, and hands leave less room for normal tissue and nerves to properly do their job. Anyone that extensively uses their hands such as factory workers, truck drivers, grocery check-out clerks, hairstylists, and the like is also susceptible to CTS. Of course, it is also possible to injure the wrist area through trauma such as a sports injury or vehicle accident.
Carpal Tunnel Syndrome Symptoms
Many CTS sufferers first notice a problem when their hands burn or become numb during sleep. This is because one or both of their wrists may be in a bent posture for long periods, thus placing additional pressure on the median nerve. If the individual continues to ignore the symptoms, they will likely experience more and more pain during activities in which they use their wrists and/or hands. Symptoms can vary from only having numbness in some or all of the fingers to numbness, tingling, pain, and burning, throughout the entire wrist and hand region(s). If an individual continues to ignore their symptoms, nerves in the hand and wrist can lose their ability to function normally and the individual may begin to experience hand grip weakness to the point where they frequently drop objects residing in their hand(s).
Home Tests for CTS
Of course, it’s always important to seek a professional medical diagnosis for any health issue, however, there are some home tests an individual can perform that can provide some clues as to whether a person has carpal tunnel syndrome or is experiencing something else. The “Phalen’s Test” is a test that individuals can conduct at home. With this test, the individual sits or stands, elbows out to the side, and brings the exterior portion of their hands together in front of them, with their hands pointing downward. If after holding the position for 60 seconds, they experience numbness or tingling in their hands and/or fingers, it could be an indication of CTS. Another test, called the “Reverse Phalen’s Test”, is where the individual brings their palms together again, only this time their hands point upward as if praying. Again, hold the upward position for 60 seconds. If an individual experiences hand tingling or numbness, this is also an indication they could have CTS.
Solutions
Surgery is typically not the first solution a physician recommends for their CTS patients. Most physicians tend to employ conservative measures such as physical therapy because oftentimes patients can find relief without surgery. In the initial stages of treatment, physical therapist techniques include using ultrasound and ice application/massage to help relieve pain. They can also introduce gentle stretching exercises and soft/deep tissue mobilization to help relax tense muscles and reduce swelling of irritated tissues. As the patient continues to improve, a physical therapist can show patients effective strengthening exercises designed to support wrist and hand structures.
With rest, medications to reduce swelling, along with PT stretching, strengthening, and retraining to eliminate poor hand and wrist postures, many patients find complete relief from carpal tunnel syndrome. If you would like to know more about how physical therapy can effectively treat CTS, please call Cawley Rehab at 570-208-2787 or email us at cawleyptfrank@gmail.com.
