What is the Carpal Tunnel?
To explain what carpal tunnel syndrome is, you need to know what the carpal tunnel is. Everyone has a carpal tunnel, but not everyone has carpal tunnel syndrome. Carpals are the eight bones that make up your wrist, and are located at the base of your palm. These bones form a joint with the forearm bones and the hand bones, and this forms the carpal tunnel. Inside this tunnel are nine tendons and one nerve. These tendons are what allow you to flex your fingers. The nerve is the median nerve, and it crosses the carpal tunnel and also is what causes your muscles to contract. The median nerve also tells the brain what sensations you experience on the thumb, index, middle, and half of your ring finger.
What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is caused by the compression of the median nerve, typically from swelling of the tendons around it. The first symptoms of carpal tunnel syndrome are usually numbness and tingling of the thumb, index, and middle finger, as well as pain in that area. You may also experience occasional “zings” of electricity shoot across the nerve.
What Causes Carpal Tunnel?
Carpal tunnel syndrome can be caused by anything that causes pressure on the carpal tunnel. This could be any number of things.
Things that may cause pressure in the area of the nerve are:
- Swelling in your wrist can compress the nerve
- Extreme wrist positioning (bending or extending)
- Excessive squeezing
- Repetitive hand or wrist motions
- Sleeping with your wrists in an extreme position (rather than straight)
Your therapist can work with you to identify and eliminate the reason for your symptoms. If you are looking for more information about carpal tunnel syndrome, check out the American Society of Hand Therapy’s website entry.
Treatment for Carpal Tunnel Syndrome
Discuss Symptoms with Your Physician
If you’re having any symptoms, you should first discuss this with your physician. He or she can do testing in the office to evaluate the nerve. Your physician may then recommend a nerve conduction study if he or she feels it is warranted. A nerve conduction study tests the rate at which information is passing through the nerve. Based on the speed of the information, the doctor can tell you if the nerve is working properly or if it’s being compressed.
Depending on the results from the nerve study, your physician may recommending nighttime splinting, therapy, or possibly surgery. Surgery should be considered a last resort and is typically reserved for the most severe cases of nerve compression.
Can Hand Therapy Help Carpal Tunnel Syndrome?
Hand therapy can certainly help with your carpal tunnel syndrome. Your therapist can evaluate you and work with you to determine the cause of your symptoms. Our therapists like to help you figure out what is potentially causing the numbness and then work to stop it.
Many other conditions can play a role in carpal tunnel syndrome such as tendinitis, arthritis, or thoracic outlet syndrome. Your therapist wants to rule these out in our evaluation so he or she knows how to proceed.
Once we determine the issue is indeed at the wrist, we recommend therapy for 4-6 weeks. Depending when your symptoms are most severe, your therapist may recommend a wrist splint for certain activities. We most often recommend wrist splints for nighttime. Your therapist can also review nerve glides with you which are exercises to stretch the nerves. With hand therapy, many patients are able to get relief from their symptoms.
Do you suspect your workplace environment is causing your pain and symptoms? Interested in an ergonomics assessment? If so, you could be a candidate for hand therapy services at LB Hand Therapy in Maryland. Visit our Where to Begin page to become a patient.