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Dr. Deepika Kaushal (BPT)
Kayakalp, VMRT, Holta, Palampur, Himachal Pradesh
E-mail: physiodeepika88@gmail.com

Carpal tunnel syndrome is created by pressure on the median nerve caused by the narrowing of the carpal tunnel. The narrowing can be caused by many factors including: –

  • Swelling of the tissue in carpal tunnel due to injury or fluid changes in the body.
  • Hereditary narrow carpal tunnel
  • Repetitive motions like typing or any motion of the wrist that you do over and over.
  • Tumors (rare) Medical conditions sometimes linked to CTS Certain jobs of getting the conditions, those

Jobs include: –

  • Obesity
  • Hypothyroidism
  • Pregnancy
  • Tumors/trauma
  • Rheumatoid arthritis
  • Diabetes
  • Women are 3 times more likely thanmen
  • Assembly like worker
  • Sewer / knitter
  • Baker
  • Cashier
  • Hair stylist
  • Musician

Sign and symptoms: – In severe cases

  • Dull/sharp or shooting pain
  • Numbness/tingling or a burning feeling in your thumb/index and middle finger
  • Arm pain may extend to your shoulder
  • Weakness in your hand
  • Swelling in your hand
  • Itching and numbness in palm of your hand
  • As carpal tunnel syndrome becomes more severe, you may have less grip strength because the muscle in your hand shrink, pain and muscle cramping will also become worse.
  • Muscle nerve begins to lose function because of the irritation or pressure around it.
  • Slower nerve impulses
  • Loss of feeling in the fingers
  • Loss of strength and coordination, especially the ability to use your thumb to pinch.
  • You could end up with permanent muscle damage and lose function in your hand.

Special test help diagnose carpal tunnel syndrome

  • Your doctor may ask to tap the palm side of your wrist or fully flex your wrist with your arms completely extended.
  • EMG/NCV measures the function of the nerve across the carpal tunnel.

Treatment:- Physiotherapy treatment: –

  • Lifestyle changes if your symptoms are due to repetitive motion you can take more frequent breaks or do it bit less of the activity that’s you pain. Certain tretching/strengthening exercise could help.
  • Immobilization: – use a splint/ brace.
  • Medication: – anti-inflammatory drugs
  • Surgery

Especially in mild to moderate cases

  • Ultrasound Therapy
  • Tens
  • Carpal bone mobilization/flexor retinaculum stretching to open the carpal tunnel
  • Nerve and tendon gliding exercises to ensure full unrestricted nerve motion is available
  • Muscle and soft tissue extensibility
  • Cervicothoracic spine to correct any referral of double crush syndrome
  • Grip and pinch, thumb abduction and forearm strengthening in later phase