Carpal Tunnel Syndrome – Dahra Zamudio

Hey guys, it's Dahra from Insync Physiotherapy here. And I'm here to talk about carpal tunnel syndrome and how physiotherapy can help individuals with this condition. So basically carpal tunnel syndrome is a compression of one of the nerves that travels through your forearm known as the median nerve.

So usually include pain, numbness, or the feeling of pins and needles and tingling in your hands. And typically involves some variation of the thumb, the index finger, middle finger, and one half of the ring finger, the side closest to your thumb. Here's a simple stretch, often prescribed, that stretches out the wrist flexors and decreases the compression of the median nerve.

So you lock your elbow out straight. Use your other hand to pull your wrist back until you feel a stretch in your forearm and hold this position for about 30 seconds and perform it three times a day. 

If you do suffer from this condition, physiotherapist can also give advice about workplace ergonomics and activity modifications that could potentially be exacerbating your symptoms. Physiotherapists can also guide you through therapeutic modalities and prescribe you a gradual progressive exercise program to help relieve your symptoms and get you back to the activities that you enjoy.

In the present day, with the onset of the Covid-19 pandemic, those who now need to work at home or have more free time at home, may find themselves spending more time on electronic devices. The issues that may arise from all this screen time is carpal tunnel syndrome.Generally those who have diabetes or arthritis are vulnerable to carpal tunnel syndrome. This includes: pregnant women (because of water retention), workers in trades or manufacturing jobs, the fishing industry, cleaning, culinary, cashiers, hairdressers, and those who participate in yoga, ultimate, and knit religiously.

Anatomically, the Carpal tunnel is found on the anterior side of the wrist and is known as the narrow passageway for 9 tendons and an important nerve known as the median nerve. When people complain about pain in their wrist, the pain is referred to as carpal tunnel syndrome which the National Institute of Neurological Disorders and Stroke states is“- the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself.”

Carpal tunnel is a result of repetitive hand movements such as typing on your laptop or texting on your phone. It is also associated with improper positioning of the hand, mechanical stress on the palm, and grip holds. The pain felt is due to the lack of lubrication between the tendon and sheaths in the wrist causing friction with movement which leads to inflammation of the tendon area. The inflammation puts pressure on the median nerve in the carpal tunnel. With any injury, improper healing can lead to susceptibility to repeated injury and chronic pain. If carpal tunnel is left untreated the inflammation can lead to the thickening of the tendon and fibrous sheath resulting in decreased mobility in the wrist.

This syndrome causes numbness, tingling and pain in each digit and the thumb which the median nerve innervates. The pain may also radiate to the forearm and is intense enough to wake people or prevent people from sleeping. The median nerve controls the thumb, middle and ring finger, index finger and is vital in carrying movement and stimulus signals from the control centre, our brain.

Prevention Methods:
use of a splint to prevent further compromisation of the median nerve.
holding the wrist in dorsiflexion, having the wrist in a 70 degree angle toward you) overnight to relieve symptoms. Dorsiflexion stretches are a good way to alleviate wrist tightness.
corticosteroid injections into the carpal tunnel can be used.
If surgery is needed a surgical decompression of the carpal tunnel Will be done.

How can a physiotherapist help? Physiotherapists will guide you through a variety of therapeutic modalities and how to properly execute these exercises and stretches to relieve the strain as well as prescribe easy at home or at work exercises for instant relief of pain