Carpal Tunnel Syndrome refers to the compression of the Median Nerve within the carpal tunnel.
5 Ways to identify Carpal Tunnel Syndrome
1. Dull aching pain, tingling, pins and needles or numbness present in the thumb and the next two and a half fingers (pictured below) 2. Symptoms come on gradually 3. Positive Phalen's Test, Reverse Phalen's Test and Tinel's Test 4. Pain becomes worse with repetitive wrist activities which involved gripping, bending of the wrist forwards and extending the wrist backwards 5. Weakness of the wrist muscles/reduced grip strength in chronic cases
Phalens Test - Place hands together in prayer position and hold position for 30 seconds. Place the back of your hands together and point fingers to the floor and hold the positon for 30 seconds. If this provokes tingling, pins and needles, pain and numbness in the thumb and/or two and a half fingers the test is positive.
Tinel's Test - Tap the middle of your wrist just below the wrist crease for a few minutes. A positive test follows if this reproduces your pain, pins and needles, tingling or numbness in the thumb, or the first two and a half fingers.
4 KEY things everyone with Carpal Tunnel Syndrome MUST do
- Modification/reduction of repetitive wrist activities
- Bracing to support the wrist during repetitive tasks (pictured below)
- Soft tissue release and dry needling to release tight forearm muscles
- Median nerve glides to reduce irritation to the Median Nerve (pictured below)
- Wrist strengthening exercises to support the wrist
Median Nerve Glides - Hold your affected arm outstretched away from your body with the palm facing up and the wrist extended backwards. Then side tilt your head away from the injured arm, which you'll notice causes a stretch in the forearm and return your head to the starting position.
Do you know June's story ?
Adam is a 56 year old florist who presented with a 6 month history of dull aching pain in his right wrist. His discomfort commenced gradually and presented with pain in his thumb, index and middle finger in addition to constant pins and needles. He regularly spends his days cutting the stems off roses and organizing flowers into bouquets, with the repetition making his symptoms worse.
In his initial assessment Adam tested positive to the Phalens, Reverse Phalens and Tinel's tests in addition to having had median nerve entrapment on a nerve conduction study. As Adam is self employed he was reluctant to give up working, so opted to use a wrist brace to offset his symptoms. The wrist brace, coupled with massage to release his tight forearm musculature and wrist strengthening exercises saw Adam pain free and happy to avoid surgery after 8 weeks of treatment.
Wrist braces can be helpful in reducing the amount of bending of the wrist in order to reduce stress on the Median Nerve, and help you get back to your day to day life much easier.
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