Carpal Tunnel
What is Carpal Tunnel?
Carpal Tunnel is numbness, tingling, weakness and other issues in your hand, caused by pressure on the median nerve in the wrist. This pressure can come from swelling or anything that may decrease the size of the carpal tunnel.
Causes:
- Hand/wrist use over time from desk jobs, frequently texting, typing, etc.
- Age plays a big factor, this is more common in older populations.
- Medical conditions including diabetes, rheumatoid arthritis, and thyroid gland imbalance.
- This condition can be hereditary, people may be born with smaller carpal tunnels allowing for easier compression of that median nerve.
Signs and Symptoms:
- Numbness, Tingling, Pain
- Night pain when the wrist is placed in flexion while a person sleeps
- Edema
- Spasms
- Sensations and pain traveling up the forearm
Most symptoms are felt more severely on the thumb side of the hand, and can start gradually, and can worsen as time goes on. If any of these signs or symptoms are present give your doctor or physical therapist a call!
Evaluation:
- Thorough history and symptoms will be taken.
- Strength in the muscles around the thumb will be checked.
- Testing for numbness and tingling during nerve glides are done.
- Tapping along the median nerve in the wrist to see if it produces tingling to the fingers.
- Testing the feeling in your fingers by lightly touching them when your eyes are closed.
- Neck ROM and Upper Quadrant screening can be tested to rule out any cervical spine radiculopathy
After your evaluation it is time for physical therapy!! You will start with modalities to relieve the pain and inflammation, followed by flexibility exercises, and strengthening exercises for wrist, thumb, and fingers. Once inflammation is under control, progressions will be made to address any remaining issues. Splinting/bracing at night is also typically recommended to keep the wrist in a neutral position and avoid pressure on the median nerve while sleeping.