Carpal Tunnel Syndrome - Symptoms, Tests & Treatments
by Jeff P. Anliker, LMT
Carpal tunnel syndrome (CTS) is a devastating injury that
affects more than 8 million people in the United States and
continues to increase each and every year.
Carpal tunnel syndrome is one of many repetitive strain
injuries (RSI’s) that are everywhere; homes, offices, assembly
lines, grocery stores, book clubs, construction sites, dental
offices, everywhere! Because carpal tunnel syndrome is so
commonplace, and its effects so devastating, it is important to
be knowledgeable of how it occurs, what its symptoms are, the
testing methods used and what treatment options are available,
as the prevention of any injury, especially carpal tunnel,
begins with education.
Carpal tunnel syndrome is a disorder affecting the median
nerve, which supplies function to the thumb, index, middle and
one half of the ring finger. Usually the symptoms are most
prevalent in the thumb, index and middle fingers (Sometimes
one-half of the ring finger) and include numbness, tingling,
paresthesia (pins and needles), pain and tightness in the front
of the hand, wrist and forearm. These symptoms do not have to
occur simultaneously, and may only affect one finger one day
and then three fingers a few days later.
If a doctor provides a carpal tunnel diagnoses and the symptoms
are in the ring and little fingers, it is NOT carpal tunnel
syndrome! The ulnar nerve, not the median nerve, supplies
function to the ring and little finger. Repetitive strain
disorders affecting these two fingers are usually either
Guyon’s syndrome, entrapment of the ulnar nerve in the guyon’s
canal at the wrist junction, or cubital tunnel syndrome,
entrapment of the ulnar nerve at the elbow junction. This is a
common mistake made by many, many physicians and is completely
inexcusable as they often recommend surgery for the patient,
causing the patient to undergo an unnecessary procedure, and
what makes it worse, for the wrong disorder!
If symptoms of carpal tunnel syndrome do arise, doctors will
recommend that a nerve conduction velocity (NCV) test or an
Electromoyogram (EMG) be performed to see if carpal tunnel
syndrome truly exists. These tests are often painful to the
individual being tested, very expensive, and often give false
positives and false negatives. This is why it is recommended
that manual carpal tunnel tests be performed in order to obtain
a more accurate (and much cheaper) diagnosis. Manual carpal
tunnel tests take no longer than 10 minutes, have a high
accuracy rate, are painless and are very cheap in comparison to
the NCV and EMG tests.
The recommended manual carpal tunnel tests consist of the
following:
· Phalen’s Test: The wrist is flexed for 30 to 60 seconds in
order to compress the median nerve and duplicate/increase the
symptoms.
· Reverse Phalen’s Test: The wrist is extended for 30 to 60
seconds in order to stretch the median nerve and
duplicate/increase the symptoms. Stretching the median nerve if
it is already impinged will duplicate/increase the symptoms if a
patient has carpal tunnel syndrome.
· Tinnel Sign: Tapping directly over the median nerve at the
wrist junction will cause carpal tunnel symptoms to exhibit
themselves.
· Compression Test: Direct pressure is applied over the
location of the median nerve for 30-60 seconds to see if carpal
tunnel symptoms are exhibited.
If a positive diagnosis comes back, most doctors will push for
surgery, a procedure that has a terrible success rate and is to
only be performed as a last resort once all other conservative
treatment methods have been utilized. Conservative therapy is
the key to successfully recovering from carpal tunnel syndrome
and obtaining not only short-term but long-term relief as well.
The following is a list of conservative treatments that should
be utilized in order to help prevent carpal tunnel syndrome
from developing, but also rehabilitating carpal tunnel syndrome
after it is already present.
· Ergonomics: Utilize proper ergonomic tools and equipment when
working.
· Breaks: Take short breaks every 30 minutes when working in
order to help reduce excessive strain on the hands.
· Stretches: Stretch the muscles that ‘close’ the hands as
these are the muscles that are exercised all day long in
activities such as typing, writing, gripping a steering wheel,
using a computer mouse, carrying groceries and everything else
that is done day in and day out. When a muscle is involved in
exercise, it becomes shorter, therefore it needs to be
stretched and lengthened both during and after the exercises
are completed. (End of day)
· Exercises: Exercise and strengthen the muscles that are used
to ‘open’ the hands, as these muscles do not receive much
direct stimuli / exercise. (i.e. People do not turn doorknobs,
hold things, type, use a computer mouse or lift things with the
backs of their hands.)
The information provided above reveals how carpal tunnel
syndrome occurs, what its symptoms are, the testing methods
most commonly used and the best conservative treatment options
that are used to thwart its existence.
It is very important for individuals to become well acquainted
with the proper information and tools in order to maintain and
increase their level of health and productivity. It is also
important for people to speak to their doctors regarding their
health concerns, and if someone is involved in an occupation
that is considered high-risk for carpal tunnel, they should
discuss this with their physician, but is even more critical
that people become self educated as no one can take care of you
better than “YOU”!
ABOUT THE AUTHOR
Jeff P. Anliker, LMT, is a Therapist and
Inventor of Therapeutic Exercise Products that are utilized by
Corporations, Consumers and Medical Facilities around the
world. Balance Systems, Inc. http://www.repetitive-strain.com
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