Carpal tunnel
syndrome occurs when the median nerve is compressed at the carpal tunnel of the
wrist (formed by the flexor retinaculum and the carpal bones). This painful
disorder typically occurs in association with activities that place repetitive
stress through the flexor tendons. When this tension is excessive due to too
much repetition or high force, damage to the tendons may occur. This results in
swelling and inflammation of the tendons, thereby reducing the dimensions of
the carpal tunnel, compressing the median nerve (responsible for supplying some
sensation and motor control to the hand). This syndrome is associated with
repetitive occupational trauma, rheumatoid arthritis, pregnancy, acromegaly,
wrist fractures, and other conditions.
Some of the Carpal
Tunnel Syndrome (CTS) sufferers will usually experience the following symptoms
in their hand or fingers: hand pain or aching, pins and needles, numbness at
night, burning, weakness or cramping and swelling. The incidence of carpal
tunnel syndrome is located from 0.1 to over 10 percent. Although carpal tunnel
syndrome can occur at any age, it is commonly seen in patients greater than 50
(is more common in women). The diagnosis of the carpal tunnel syndrome is based
on an analysis of a physiotherapist, or general doctor, about the symptoms.
They usually use various tests such as Phalen’s test, Tinel’s test or the wrist
flexion/median nerve compression test.
Most cases of
carpal tunnel syndrome are usually treated with the appropriate physiotherapy.
This includes careful assessment by the physiotherapist to determine which
factors have contributed to the development of the condition. The
physiotherapist will address: carpal bone mobilization and flexor retinaculum
stretching to open the carpal tunnel, nerve and tendon gliding exercises to
ensure full unrestricted nerve motion is available, muscle and soft tissue
extensibility, cervicothoracic spine to correct any referral or double crush
syndromes, grip and pinch, thumb abduction and forearm strengthening in later
phases, comprehensive upper limb, wrist and hand ROM strengthening and
endurance exercises and posture, fine motor and hand dexterity exercises. The
treatment of this syndrome includes: ultrasound, traction, splints, medication,
electrical stimulation, ice or heat treatment, gliding exercises and manual
therapy. During recovery, the patient should follow the RICE protocol (rest,
ice, compression and elevation). A surgery may be required to decompress the
median nerve.
To conclude, it is
very important to take this condition seriously. This syndrome can cause loss
of independence.
Bibliography:
Carpal Tunnel Syndrome. s.f. <http://www.physioadvisor.com.au/9250550/carpal-tunnel-syndrome-symptoms-diagnosis-trea.htm>.
Carpal Tunnel Syndrome. s.f. <http://www.physioadvisor.com.au/9250550/carpal-tunnel-syndrome-symptoms-diagnosis-trea.htm>.
Gómez Conesa, Antonia and Gisbert Serrano. "Carpal Tunnel
Syndrome." Fisioterapia (2004): 170-185.
Miller, John. Physio
Works. March 22, 2015.
<http://physioworks.com.au/injuries-conditions-1/carpal-tunnel-syndrome>.
Mishock, John R. Mishock Physical Therapy and Associates.
2014.
<http://www.mishockpt.com/physical-therapy-a-treatment-option-for-carpal-tunnel-syndrome/>
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