Carpal Tunnel Syndrome

What is carpal tunnel syndrome?

Carpal Tunnel Syndrome (CTS) is compression or “pinched” nerve on the inside aspect of your wrist.

The median nerve and nine tendons run from your forearm to your hand through a small space in your wrist called the carpal tunnel.  When that space becomes compromised it compresses the nerve given rise to the symptoms.  The median nerve controls movement and feeling in your thumb and first three fingers (not your little finger).

What are the symptoms?

Carpal Tunnel Syndrome can cause tingling, numbness, weakness, or pain on the palm surface the fingers and hand. Some people may have pain and throbbing in their arms, elbow, shoulder and even their neck.

If you have symptoms in the little finger, different nerve may be involved.  The Ulna nerve gives feeling to the little finger and half of your ring finger.

You may first notice symptoms at night, which will wake you up at night. Relief is found by shaking your hand(s) out. Symptoms also occur with use of your hand with simple tasks such as; typing, video games, folding laundry, and any other repetitive activities.

How is carpal tunnel syndrome diagnosed?

CTS is diagnosed by performing detailed history of activities that cause an increase in symptoms. A specific exam should include; Tinnels, Phalens and compression test as well as light touch, muscle strength and range of motion of the hand/wrist.  Depending on the symptoms, more in depth studies such as x rays, needle EMG my be required, however it is not necessary and only if you are going to require surgery.

A thorough and proper exam should also include your neck, shoulder, elbow, and forearm.  The median nerve starts in your neck and travels down your arm into your wrist, any compression along the way can mimic or occur at the same time at CTS. 

You will hear stories of symptoms following surgery, this may be due to nerve compression at the neck, shoulder, elbow and wrist.   It is not uncommon CTS to exist with other conditions at the same time. These conditions are called double and triple crush syndromes and should never be overlooked or disregarded especially is surgery is recommended!  

How is it treated?

Surgery should always be the last resort and after all forms of conservative care have been exhausted.

The sooner you start treatment, the better your chances of stopping symptoms and preventing long-term damage to the nerve and requiring surgery.

Treatment provided by Dr. STEVE includes a detailed exam of the cervical spine, shoulder, elbow and wrist and all the associated muscles to locate any secondary causes of the condition. After the condition has been properly diagnosed the care would include the following: 

  • Manual therapy (skilled deep tissue massage) to all the surrounding and associated muscles.
  • Active and passive stretching of all associated joints and involved muscles.
  • Physical therapy modalities
  • Wrist traction
  • Joint mobilization
  • Hand Therapy exercise  
  • Nutritional support (B6 & B12)
  • Home care

Should I make an appointment?

YES, YES, YES.  It is never to late to start care, get a second opinion or change your therapist.  Call us today for your consult!