Carpal Tunnel Syndrome – The Nemesis of the Hand

Carpal Tunnel Syndrome symptoms usually occur without incident. Symptoms usually begin at night or in the early hours of the morning, waking up the individual with a funny sensation or burning in the hand. Symptoms may include numbness, tingling and burning in the palm side of the thumb, second, third and part of the fourth fingers. The individual may notice clumsiness of usage as well as reduced grip strength and a history of dropping objects. Occasionally, the patient may experience a change in color of the hand as well as muscle atrophy. These symptoms can start out vaguely and light in nature but can progress to a severely disabling condition where the individual cannot use their hand for any functional tasks.

Most adults have heard the term Carpal Tunnel Syndrome. But do you know what that term means, what are the main signs and symptoms and what are the common causes that the individual may be engaged in that will create this sometimes debilitating disorder? Before you consider surgery, try Kulp Physical Therapy and Massage, as we are not your average physical therapist. We will give you solutions to reduce your symptoms right away. Read on to learn more about Carpal Tunnel Syndrome and its treatment.

The definition Carpal Tunnel Syndrome refers to a type of nerve disorder where the median nerve, (nerve that travels down the arm into the palm side of the hand), is either compressed or entrapped by some other anatomical structure along the course of the nerve. It is primarily associated with a cumulative trauma disorder, (previously described as a repetitive motion syndrome), in which the individual performs an occupation requiring constant, repetitive motions over long periods, sometimes in peculiar positions and often with the exposure to high frequency vibration and to direct trauma. The primary location of Carpal Tunnel Syndrome is at the palmer surface of the wrist where it meets the hand. There are many causes to Carpal Tunnel Syndrome. Some causes include, but are not limited to osteoarthritis, rheumatoid arthritis, pregnancy, inflammation of the ligaments, (flexor retinaculum), and even reactions to contraceptive pills to name a few. Fractures and dislocation of the forearm bones and carpal bones and even adhesions related to forearm, wrist and hand surgeries can cause symptoms of Carpal Tunnel Syndrome. Did you know that 47% of carpal tunnel syndrome comes from occupational causes? Occupations that require continuous usage of the hands such as typist, data entry workers, hair stylist, computer engineers and programmers, cashiers, butchers, assemblers and instrumental musicians are just some examples of occupations prone to Carpal Tunnel Syndrome. It occurs more in women than men and is usually one sided, (1).

There are other disorders that can influence and create symptoms that may mimic a Carpal Tunnel Syndrome Disorder. Disorders of the Cervical Spine at the Sixth and Seventh Nerve Root, Thoracic Outlet Syndrome, and Muscle Entrapment Syndromes, including the Scalene, Subscapularis, Pectoralis Minor and, Pronator Teres Muscles can all give a Carpal Tunnel Syndrome like symptom.

One of the primary issues and quandaries that confront the individual with a Carpal Tunnel Syndrome symptom is finding a therapist who is capable of making a correct diagnosis and then applying that information to perform correct treatments. Being able to differentiate and analyze the individual’s symptoms and isolate the anatomical structures is one of the key factors that separate the physical therapists at Kulp Physical Therapy and Massage from their competitors. Through thorough evaluation of range of motion, strength, sensory systems and evaluation of the median nerve and its ability to slide correctly along its course is essential for correct diagnosis. Manual palpation of the anatomical structures, including the bones, joints and muscles is a developed skill that takes time to develop in the physical therapist. The physical therapists at Kulp Physical Therapy and Massage have these skills.

Once a diagnosis is made and the offending structures are isolated, the physical therapists at Kulp Physical Therapy and Massage will utilize a variety of hands-on manual techniques including Travell Manual Trigger Point Treatment, Myofascial Release Technique, Joint Mobilizations, and Adverse Neural Tension Gliding Techniques. Physical therapists will also perform stretching techniques, postural, active and resistive exercises as well as movement impairment syndrome exercises in the clinic. The physical therapist will also prescribe an exercise program to be used at home that will help the individual heal themselves through their own efforts. It is an essential part of therapy for the individual to actively participate in their treatment. This is one of the most important concepts of treatment that we utilize to help the individual get better. With the individuals help, we will analyze the individual’s home and work environment and help them develop a correct ergonomic environment to help reduce the external stressors that go into causing the Carpal Tunnel Syndrome symptom. The physical therapist will also utilize modalities such as ultrasound, electrical stimulation, phonophoresis, iontophoresis and hot and cold therapies that will help the individual’s symptoms calm and begin the healing process. We also has an Orthopedic Massage Therapist who is skilled at using Massage Therapy to help the individual reduce their muscle tension symptoms that can range through the individual’s body and influence their posture, stress and pain as a result of Carpal Tunnel Syndrome.

Carpal Tunnel Syndrome can be treated by Kulp Physical Therapy and Massage and can bring you back to a happy, functional life. We have two nationally certified trigger point therapists with expert treatment of myofascial pain syndromes. We have been treating Carpal Tunnel Syndrome with over 40 years of combined experience. We are certain we can help you with your Carpal Tunnel Syndrome symptoms and we look forward to hearing from you so we can assist in your care.

(1) Mock L. Carpal Tunnel Syndrome. In Whyte Ferguson, L, Gerwin R, eds. Clinical Mastery in the Treatment of Myofascial Pain. Baltimore. Lippincott Williams and Wilkins. 2005: 146-147.

(2)Travell JG, Simons DG. Myofascial Pain and Dysfunction, The Trigger Point Manual, Vol. 1. Baltimore. Williams and Wilkins. 1993.