PHYSICAL THERAPY FOR CARPAL TUNNEL SYNDROME

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PHYSICAL THERAPY FOR CARPAL TUNNEL SYNDROME
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Carpel Tunnel Syndrome (CTS) causes tingling,
numbness, and weakness in the wrists and hands.
Activities that require repetitive or prolonged
bending of the wrist can cause compression of the
median nerve. When the median nerve is compressed
or inflamed, it causes nerve symptoms. CTS is
more common in women, people who work with their
hands, and in certain medical conditions that
cause fluid retention and inflammation, such as
pregnancy, diabetes, and arthritis. If you have
CTS, you know how the symptoms can interfere with
your daily activities that involve gripping and
using your hand. The good news is that a trained
physical therapist can evaluate and teach you
ways to reduce your symptoms and prevent
reoccurrence! Physical Therapy for Carpal Tunnel
Syndrome A physical therapist (PT) is a medical
professional with 6-7 years of education in
musculoskeletal disorders. Most PTs have a
doctorate and then specialize in specific areas
(orthopedics, pediatrics, neurology, hands,
sports, etc.) PTS are trained to determine the
cause of your symptoms and then provide you with
education and an exercise program to reduce your
pain and regain strength and mobility. Research ha
s found that carpal tunnel therapy leads to
better outcomes in the short term and is just as
effective as surgery in the long term. Those who
received PT treatment had less pain and better
function much earlier than those who had
surgery!
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Physical Therapy Evaluation Carpel Tunnel
Syndrome (CTS) results from compression of the
median nerve at the wrist, causing uncomfortable
tingling, numbness, and grip weakness. Your PT
will first review your past medical history to
see if you have any conditions that cause fluid
or inflammation, such as pregnancy, thyroid
issues, arthritis, infection, or auto-immune
disorders. Increased fluid can cause a reduction
in space the median nerve has to pass through the
wrist. They will also review your occupational
and daily habits to see if an activity or posture
can result in overuse or trauma at the
wrist. The PT will then clear your neck .This
means that they will have you move your neck into
end rages to see if the position of your neck has
any effect on your hand symptoms. Research has
shown that 10 of isolated hand symptoms come
from your neck. The bones of your spine protect
your spinal cord. The nerves responsible for your
arm strength, sensation, and reflexes branch off
your upper cervical spine. A nerve can sometimes
become compressed at the neck as it exits the
spine. Nerve root irritation can cause symptoms
anywhere the nerve innervates. For example, the
C5 region of your spinal cord branches out to
eventually become the median nerve at your wrist.
Compression of the C5 nerve root can trigger
symptoms in structures innervated by the median
nerve and can be mistaken for CTS. Treating the
carpal tunnel at the wrist will be in vain. Only
treating the neck will reduce symptoms.  
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After clearing the spine, the PT will then
evaluate the wrist. They will assess wrist range
of motion, strength, and sensation. They will
test the wrist to see what movements/positions
reproduce your symptoms. After completing their
examination, the physical therapist will provide
education to understand the cause of Carpal
Tunnel Syndrome and how you can self-treat with
physical therapy. The goal is to avoid surgery
and get you back to full function with no
symptoms. The role of a PT is to strengthen an
individuals ability to self-manage their
condition. Best Treatment for CTS Carpal Tunnel
Physical Therapy Exercises 1. Behavior
change Changing your behavior is critical
because you can treat the symptoms, but the
symptoms will return if you do not remove the
problem. Repetitive and sustained wrist
compression triggers an inflammatory response.
The median nerve runs under a protective ligament
at the wrist as it extends into the hand.
Inflammation reduces space in this narrow canal
and can cause compression on the median nerve,
triggering symptoms. You want to create more
space to get relief so the nerve is no longer
compressed.
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2. Splint Wrist cockup splints open the carpal
tunnel area, allowing space for the nerve by
placing the wrist in a slightly extended
position. Splints are especially beneficial at
night because we often have our wrists bent while
sleeping. A splint will minimize pressure on the
nerve and, by removing stress, allow the nerve to
heal. 3. Exercises Prayer Stretch Step 1 Put
your hands together under your chin in a prayer
position. Step 2 Push your hands down to your
waist until you feel a moderate stretch. Hold for
up to 30 seconds. Repeat between two and four
times. Medial Nerve Glide Apply heat to your
hand and wrist for 15 minutes prior to doing this
stretch. After, use an ice pack for 20 minutes.
This will help prevent swelling. Hold each step
of this exercise for between three and seven
seconds.
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Step 1 Make a fist. Step 2 Extend your fingers,
keeping your thumb close to your fingers.  Step
3 Bend your hand backward, towards your
arm. Step 4 Keeping your hand in that position,
extend your thumb away from your fingers.  Step
5 Turn your forearm so your hand is palm
up. Step 6 Use your other hand to pull your
thumb back, deepening the stretch. Repeat 10-15
times per day. Tendon Glides Type One It is
also recommended to use heat for 15 minutes prior
to this exercise, and ice or cold for 20 minutes
after. Hold each of these poses for three
seconds. Step 1 Hold your hand up in front of
you, straightening all of your fingers. Step 2
Curl your fingers with your knuckles pointing up.
Your fingers will be in a hook shape. Step 3
Curl your fingers further, making a tight fist.
Repeat five to ten times per day, a few times
each day.
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Tendon Glides Type Two Use heat on your wrist
and hand for 15 minutes before doing this one as
well. Ice it for 20 minutes after. Hold each
position for three seconds. Step 1 Hold your
hand up in front of you, straightening all your
fingers. Step 2 Make your hand into a tabletop
by bending your fingers at a 90-degree
angle. Step 3 Continue bending your fingers,
bringing your fingertips to the bottom of the
palm. Safety Considerations A gentle pulling
feeling is OK, but you should not feel any sharp
pain when performing carpal tunnel physical
therapy exercises. If you do feel a sharp pain,
stop doing that exercise immediately and contact
your physical therapist. If you would like to be
seen by one of our specialists simply create an
account and schedule now!
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