CARPAL TUNNEL SYNDROME
Dr. Deepika Kaushal (BPT)
Physiotherapist,
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 than men
- 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 stretching/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