Medical Library: Wrist – Carpal Tunnel

Carpal tunnel syndrome (CTS) is caused by excessive pressure on the median nerve as it travels through the narrow carpal tunnel at the wrist.  It may be caused by a genetic predisposition to a small carpal tunnel, fluid retention during pregnancy, dislocation or fracture at the wrist or thickening of the lining around the tendons that pass through the carpal tunnel with the median nerve. Individuals may experience pain, weakness, tingling or numbness in the thumb, index middle fingers.  As symptoms progress a weaker grip may develop with difficulty picking up and manipulating small objects. In long standing cases, the muscles at the base of the thumb may actually get smaller and atrophy. The fingers and thumb may develop a permanent loss of sensation and the ability to distinguish hot/cold, sharp/dull, smooth/rough, etc.

Early treatment is important. Hand therapy can offer various avenues to alleviate CTS. This may include splinting, specific exercises to enhance tendon and nerve gliding. Modalities such as ice/heat and ultrasound have been shown to be helpful with pain relief and blood flow. Daily activities that contribute to the individual’s CTS are discussed and recommendations are given for modification of these activities.

Hand therapy after surgery is also important. This may include controlling of post-operative swelling and pain, specific motion exercises to the wrist/hand; enhance tendon and nerve gliding, scar management, desensitization of the scar and hand, and graded strengthening.

Wrist therapy is performed at our Certified Hand Center, located in Rockford.
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