6/24/2021Can Physical Therapy Help with Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a common condition that causes pain, numbness, and weakness in the wrist and hand. CTS can affect the use of the entire arm. It is caused by pressure on the nerve at the base of the palm (median nerve). Because of the constant demands people place on their hands and wrists, surgery may be needed when symptoms are severe. For many people with CTS, however, physical therapy treatment can relieve pain and numbness. It often can help restore normal hand, wrist, and arm use without the need for surgery.

What is Carpal Tunnel Syndrome?

The carpal tunnel is a narrow passageway (about the size of a dime) on the palm side of your wrist. The tunnel protects the median nerve and the tendons that bend your fingers. When the tunnel narrows due to injury or other conditions, or the tendons and nerves in the tunnel swell and take up more space, pressure on the nerve increases. A wrist fracture or arthritis can cause the size of the tunnel to become smaller. The tendons or nerves can enlarge due to either inflammation or tendon changes with age. Pressure on the nerve can cause pain and weakness in your wrist and hand and numbness or tingling in some fingers. The most affected fingers are the thumb, index, middle, and sometimes, the ring finger. If this increased pressure continues over a long period, it can lead to CTS.

Extreme wrist positions and repeated finger use with a lot of force or vibration can contribute to CTS.

CTS is common in professions such as assembly-line work (meat packing in particular). It also is common among people with jobs requiring the use of hand tools, especially tools that vibrate. Although too much keyboard computer use can cause CTS, people who do assembly-line work are more likely to develop it. Using hand-held mobile devices, sewing, video gaming, and playing racquet sports or string instruments like the violin also can cause CTS.

The following health conditions also may lead to CTS in some people:

• Inflammation and swelling of the tendons of the wrist.
• Injuries to the wrist (strain, sprain, dislocation, fracture).
• Hormone or metabolic changes (pregnancy, menopause, thyroid imbalance).
• Fluid retention.
• Diabetes.
• Medications (such as steroids or chemotherapy).
• Degenerative and rheumatoid arthritis.

Signs and Symptoms

CTS usually starts gradually. Many people report waking up with numbness, tingling, or burning in their thumb, index, and middle fingers. Sometimes, the ring finger is affected. Many people feel the need to “shake out” their hands to try to relieve their symptoms.

As the condition worsens, the symptoms become more noticeable during the day. Symptoms often are worse when:

• Grasping heavy objects.
• Using a computer.
• Holding a cell phone.
• Gripping anything for a long period of time.

Hand weakness and more constant numbness may occur if the pressure on the nerve continues. You may find that you drop objects unexpectedly.

How Can a PT Help?

Your physical therapist will develop a personalized treatment plan based on your specific case.

Conservative Care

With early-stage CTS, conservative care is recommended as a first step. Physical therapy treatment can be effective to reduce your symptoms and help you get back to your everyday activities.

Depending on the causes of your CTS, your physical therapy program may include:

• Patient education. Your physical therapist will teach you ways to improve your condition and keep it from getting worse. This may include education on the importance of:
  • Changing wrist positions (such as avoiding bent-wrist positions for long periods).
  • Proper neck and upper-back posture (avoiding forward-head posture or slouching).
  • Safety precautions when using sharp utensils, tools, or other implements. This is especially important if your physical therapist detects changes in your levels of feeling.
  • “Stretch breaks” during your work or daily routine.
• Stretching exercises. Your physical therapist will teach you gentle stretching exercises to improve your wrist, hand, and finger flexibility.
• Strengthening exercises. Your physical therapist may teach you exercises to strengthen muscles to help you keep better posture. Once your symptoms have decreased, strengthening exercises for the hand, wrist, and forearm may be prescribed.
• Splinting. Your physical therapist may recommend that you use a splint at night to reduce discomfort.
• Cold and heat treatments. Your physical therapist may use cold or heat treatments, or recommend you use ice or heat to relieve pain.

They may also recommend options for your work, home, and leisure activities as part of your treatment plan. These may include:

• A work site assessment. If you sit at a desk and work on a computer, it is important to properly align your keyboard to avoid working in a bent-wrist position.
• Increasing the size of tool and utensil handles by adding extra material for a more comfortable grip.
• Using special gloves or wraps around tool handles to reduce vibration if it is a factor at your workplace.
• Wearing gloves to keep your wrist and hands warm.
• Reducing or stopping activities that increase your symptoms until they are less frequent or intense.

The goals of physical therapy are to:

• Reduce your symptoms without the need for surgery.
• Allow you to be as active and functional as possible.
• Help you resume your normal work, home, and leisure activities.

*Information and complete article can be found on Choosept.com or https://www.choosept.com/symptomsconditionsdetail/physical-therapy-guide-to-carpal-tunnel-syndrome