Category Archives for "carpel tunnel syndrome"

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

Preventing Repetitive Strain Injuries At A Desk Job

Labour-intensive industries get a lot of attention when it comes to work-related injuries, but employees who work in office settings are also at risk. Poor ergonomics and organization can lead to common office injuries such as computer eye strains, falls and most importantly, repetitive use injuries.

Our bones and muscles make up our musculoskeletal system. This system allows us to perform activities such as walking, running, and anything requiring the movement of the body. A repetitive strain injury occurs when repeated movements produce stress on your body. Unfortunately, many office jobs require repetitive motions to fulfill our duties, and for this reason, they are the most common type of injury found in the office (WCB). Examples of repetitive strain injuries include carpal tunnel, tendonitis, radial tunnel syndrome, and others.

Symptoms of repetitive strain injuries include:
  · Dull aching
  · Loss of sensation (numbness) especially at night
  · Tingling and burning sensations
  · Swelling around wrist/hand
  · Clumsiness (impaired dexterity, loss of ability to grasp items, etc.)
  · Muscle weakness, fatigue, and/or spasms

Prevention:
  · Stop or reduce the intensity of activity causing the pain
  · Taking breaks from repetitive tasks
  · While at the desk…
      · Ensure proper ergonomics
      · Avoid slouching
      · Avoid bending the wrists when typing
      · Avoid hitting the keys too hard when typing
      · Don’t grip the mouse too tightly
      · Ensure you are working in an appropriate temperature
Standing up and performing stretches such as the following:

WCB (n.d.) Office Ergonomics. Retrieved from: https://www.wcb.ab.ca/assets/pdfs/public/office_ergo.pdf

Stretches for Carpal Tunnel Syndrome Relief

Carpal tunnel syndrome is a condition that arises from pressure against the median nerve that passes through the carpal tunnel in the wrist. Conditions that cause this syndrome may include pain or inflammation of the joints and soft tissues in the arm from obesity, rheumatoid arthritis, gout, diabetes, lupus or dislocated bones. Work or exercise related injuries from repetitive hand and wrist movements can also cause swelling in the surrounding tendons. Symptoms can range from moderate to severe pain, numbness, and weakness in the wrist and hand.
Interventions and Exercises
In some extreme cases, surgery may be the ideal option for treatment. However, more than a third of patients do not return to work immediately after the operation and may take more than 8 weeks to recover. Therefore, physical therapy has been concluded by researchers to be as effective as surgery in reducing pain, improving function, and increasing grip strength. In one study, a combination of manual therapy focused on the neck and median nerve along with stretching exercises has shown to produce faster outcomes than those who had surgery at a 1-month mark assessment. Some stretchesthat can be done at home can be found below:

1. Rotate your wrist up, down, and from side to side. Repeat 4 times.
2. Stretch your fingers far apart and then relax them. Repeat 4  times.

3. Hold a prayer position for 30 seconds by putting your hands together in front of your stomach near the waistline. Repeat 4 times.

4. Stretch your wrist by extending one arm straight in front of you with the palm facing the floor. Then using the other hand, gently bend the downward facing hand until you reach your maximum point of flexibility. Hold this position for 30 seconds, alternate hands, and repeat about 2 times on each side. See image below.

5. Similar to stretch #4, extend one arm straight out in front of you but with the palm facing up. Then using the other hand, gently bend the upward facing hand until you reach maximum range of motion and hold for 30 seconds, alternate hands, repeat about 2 times on each side. See image above.


J Orthop Sports Phys Ther 2017;47(3):162. doi:10.2519/jospt.2017.0503

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