Carpal Tunnel Syndrome

Carpal Tunnel Syndrome refers to a type of compression neuropathy of the median nerve. Compression neuropathy occurs when the nerve is disturbed by continuous pressure. Inside the wrist lies a tight space bordered by bones on three sides and the carpal tunnel ligament holding everything in place like a watch band. The contents of the carpal tunnel include the flexor tendons and the median nerve. The median nerve provides sensation to the thumb, index, and middle finger and the motor function of the thumb. Compressing this nerve causes numbness, tingling, and pain in the connected fingers, and eventually leads to weakness in the thumb. Carpal tunnel syndrome is the most common peripheral compression neuropathy, accounting for 90% of peripheral cases. Experts estimate that 5% of the US population suffers from carpal tunnel syndrome.

What are the symptoms of carpal tunnel syndrome?

Every person’s experience with carpal tunnel syndrome can vary slightly, but the most common symptoms include paresthesia (numbness/tingling), burning, and pain in the thumb, index, and middle fingers. Most often, patients with carpal tunnel syndrome will find themselves accidentally dropping objects and waking up in the middle of the night from hand/wrist pain. Severe cases of the carpal tunnel will cause weakness of the thumb and difficulty getting the thumb out of the palm of the hand, such as when one tries to grasp around a cup.

What are the causes of carpal tunnel syndrome?

Pressure on the median nerve causes carpal tunnel syndrome.

The median nerve runs from the forearm through a passageway in the wrist (carpal tunnel) to the hand, providing sensation to the palm side of the thumb and fingers, except the little finger. It also provides nerve signals to move the muscles around the base of the thumb (motor function).

Anything that squeezes or irritates the median nerve in the carpal tunnel space may lead to carpal tunnel syndrome. A wrist fracture can narrow the carpal tunnel and irritate the nerve, as can the swelling and inflammation caused by rheumatoid arthritis.

Many times, there is no single cause of carpal tunnel syndrome. A combination of risk factors contributes to the development of the condition.

How is carpal tunnel syndrome diagnosed?

Physicians can often diagnose carpal tunnel syndrome by confirming the symptoms and by performing a clinical examination including provocative physical examination tests to reproduce the symptoms. Patients may undergo US (ultrasound) studies in our office to examine the median nerve as it enters the carpal tunnel as well. At times Doctors require EMG (electromyography) and NCS (nerve conduction studies) to measure nerve conduction velocities to determine where and how the compression lies. Besides compressing the carpal tunnel, in rare cases, it may compress the neck and the forearm as well. PM&R or neurology doctors can perform EMG/NCS, an invasive study that involves placing small needles the size of acupuncture needles in the forearm and hand and giving small electric shocks to determine nerve function and speed.

What are the treatments for carpal tunnel syndrome?

Physical Therapy

Physical therapists diagnose and treat patients with medical problems or injuries that limit their ability to participate in their daily lives. Patients will usually see a physical therapist after a referral by their primary physician. Physical therapists work with patients who have experienced an injury or disease that has affected their movement and range of motion.

At Nextgen Pain & Injury Clinic, our team of licensed physical therapists and rehabilitation experts will focus on your total health and wellness. Regardless of the cause or source of your pain, we will develop a treatment plan with your unique issues in mind.

Our treatment philosophy emphasizes evidence-based manual and therapeutic exercise techniques that are tailored toward efficiently returning patients, athletes, and employees to their pre-injury status. We treat orthopedic and sports injuries, provide spinal rehabilitation, post-surgical rehabilitation, and industrial rehabilitation. Personalized physical therapy is used to treat a variety of conditions.

  • Chronic and acute medical problems
  • Knee pain
  • Back pain
  • Leg Pain
  • Ankle pain
  • Sports injuries
  • Musculoskeletal injuries
  • Chronic medical problems
  • Neurological conditions such as spinal cord injuries

Our mission is to help patients to return to work, improve their quality of life, reduce dependence on medication and healthcare providers, and avoid persistent injuries.

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