Also known as: Carpal Tunnel, CTS, Median Nerve Pain
In every part of the body, nerves supply the brain with information. This could be from movement, pain, temperature and much more. The hands and wrist specifically receive innervation from the median nerve, which originates in the neck and travels down the arm and into the wrist and hand. This nerve controls feeling in the thumb, index, middle, and ring fingers (notice the pinky is left out). Along with feeling, the nerve innervates the muscles at the base of the thumb as well. In Carpal Tunnel Syndrome, the median nerve becomes compressed as it flows through the wrist, causing painful sensations that are often times debilitating. This can affect grip strength and sensory ability in the hand. For optimum recovery, early diagnosis and treatment can prevent the injury from worsening. The repercussions of late treatment or misdiagnosis can include nerve damage. Fortunately, there are clear flags that let the patient and physician know that the injury is Carpal Tunnel Syndrome.
The signs and symptoms of Carpal Tunnel Syndrome include:
- Tingling or electric shock
- Occurs in the thumb, index, middle, and ring fingers.
- The median nerve does not innervate the pinky, so you will not feel pain here
- The Tinel Test doctors can see if by pressing on the nerve it causes any of these symptoms
- Loss in grip strength
- Pain that travels up the arm
This injury has no clear cause, but seems to follow individuals that work in settings reliant on handiwork and typing. Carpal Tunnel can affect pregnant women as well, due to the fluid retention that puts pressure on the carpal tunnel, compressing the median nerve.
In the wrist, the carpal tunnel is the primary component of concern. The carpal tunnel is a corridor in the wrist that encloses wrist flexor tendons and the median nerve, and contains a thick tissue called the transverse carpal ligament. This is largely responsible for the nerve compression, due to its inability to expand. Surrounding this tunnel are the carpal bones, or the small, uniquely shaped bones that do not play a large role in carpal tunnel syndrome.
Referring to the median nerve, it originates in the neck as several nerves, and then joins together to create a single unit that travels down into the arm, wrist, and hand.
If you want a more in-depth anatomy of the wrist and carpal tunnel, check out this video.
How Can You Treat Some of the Symptoms?
Some of the remedies to abate the symptoms are readily available in your very own household. Medical professionals everywhere encourage patients to implement the RICE method. Rice stands for:
- Rest – Limit or completely stop the activity that aggravates the symptoms if possible. This can include adjusting any keyboards or tools that have a poor set-up.
- Ice – Without putting ice directly on the skin, apply a cold pack for approximately 20 minutes.
- Compression – Wrist braces are available, and encourage a straight wrist to reduce pressure on the median nerve. The splint is wearable during the day and at night.
- Elevate – Does not apply to carpal tunnel syndrome, but maintaining a neutral position for the wrist during inactivity can help prevent the symptoms.
There are several other treatment methods that are potentially beneficial to the individual:
- Physical Therapy: They provide a thorough evaluation, dictate an exercise and stretching plan, and use modalities such as Electrical Stimulation and Ultrasound to decrease the pain. They can also professionally apply the Kinesio Tape and focus on your form and how it relates to your injury.
- Steroid Injection: This may help reduce inflammation and reduce the symptoms. Unfortunately this method is oftentimes temporary.
- Surgery: Carpal tunnel surgery can be open or endoscopic. Research more and consult with your physician and surgeon to ensure what is right for you.
- Drugs: NSAIDS, or non-steroidal anti-inflammatory drugs such as ibuprofen, can also provide short-term pain relief. We encourage you to receive an assessment from the physical therapist if the pain continues or increases in intensity.
Mid-County Physical Therapy Can Help You
During your one-on-one evaluation with the skilled therapist at Mid-County Physical Therapy, they will get to know you and your physical habits to help establish a foundation for your treatment. They will monitor and document your range of motion, techniques, and current pain-level to get a better idea of what they can do for your improvement. Before you receive treatment, it can also be beneficial to document some things such as:
- What movements cause it?
- When does it begin during activity?
- How long does it last?
- Have your home remedies stopped working?
- Do you want to maintain or improve your current fitness level?
- What are your goals?
Keeping track of this information can be essential for both you and your physical therapist.
Mid-County Physical Therapy also offers a wide variety of treatments to treat and heal your pain. Your condition could improve with a strengthening plan, which the therapist constructs based off of your individual experience. The clinic’s open-plan gym includes equipment to suit your strengthening needs while our technicians monitor to encourage proper form and maximum pain relief.
If the therapist determines you may need technique retraining, they will create a personal plan to work individually with you on form and techniques. Our clinic is also proud to offer dry-needling, kinesio taping, and even the BioQPulse. Call or contact us today to learn more about our treatment plans.