Carpal Tunnel Syndrome Therapy

What is carpal tunnel syndrome?

The carpal tunnel is a narrow passageway surrounded by bones and ligaments on the palm side of your hand. This passageway contains tendons that allow for finger movement, as well as the median nerve. When there is inflammation of the tendons or an event, such as a fracture, that decreases the overall space in the carpal tunnel, pressure is placed onto the median nerve. Pressure placed on the median nerve is referred to as Carpal Tunnel Syndrome, or CTS, which causes symptoms such as numbing and tingling of the fingers (usually the thumb, index, middle, and half of the ring finger). Another common symptom is weakness of the hand, so you may notice yourself dropping items or having difficulty when pinching.

What activities increase my risk of developing or worsening it?

Some risk factors for developing carpal tunnel syndrome may include frequent work with vibrating tools, repetitive flexing of the wrist, and maintaining a forced grip or flexed wrist position for an extended period of time.

Other factors include wrist fracture or dislocation, pregnancy (due to fluid retention which may increase pressure in the carpal tunnel), rheumatoid arthritis, and older age. Carpal tunnel syndrome is also more common in women.

Scientific evidence, however, has not established these noted risk factors as direct causes of CTS.

I’ve heard about surgery for carpal tunnel syndrome. Do I have any non-surgical options?

The surgical option that is used on those with carpal tunnel syndrome is a carpal tunnel release. The goal of this surgery is to relieve the pressure inside of the carpal tunnel by cutting the ligament that passes over the passageway.

Surgery is not the only option available to treat carpal tunnel syndrome. In earlier phases, nonsurgical options include using a wrist splint, nonsteroidal anti-inflammatory drugs (NSAIDs) for temporary pain relief, and corticosteroids. Using a wrist splint, especially overnight while sleeping, can help to prevent the wrist from curling up into a flexed position and causing an increase in symptoms. Corticosteroids can be used to decrease inflammation and swelling inside of the carpal tunnel, which would help decrease the pressure on the median nerve.

Individuals can also seek occupational or hand therapy to learn different exercises, activity modifications, and strategies that could be used to alleviate CTS symptoms.

What should I expect in an occupational therapy session for carpal tunnel syndrome?

After the initial evaluation, where an occupational therapist (OT) gathers information needed to best treat the individual, a treatment plan is developed. That plan can include teaching the individual nerve gliding exercises, administering ultrasound therapy, using modalities for pain relief, manual therapy if other muscle groups have been affected, and education on proper body mechanics to implement at home and in the workplace.

I’m scheduled to have surgery for carpal tunnel syndrome. How can OT help my post-surgical recovery?

Occupational therapy can help in a variety of ways! For post-surgical recovery, an OT would focus on any area of concern, such as scar management and desensitization, range of motion of the fingers, and grip and finger strengthening. If there was severe nerve compression with lasting symptoms, OTs could work with the individual to help them function at the highest level possible.

Is there anything I can do to help prevent recurrences?

• Analyze your workspace and make adjustments to prevent extreme wrist flexion and/or compression of the carpal tunnel (palm of the hand). Be sure to pay attention to your posture as well, to avoid nerve compression in the shoulder and/or elbow.
• Try to sleep with a neutral or straight wrist.
• If your job requires repetitive wrist movements, take frequent breaks.
• Incorporate hand and wrist stretches into your day (at least 5 minutes).

Carpal tunnel syndrome can be treated by both physical and occupational therapists. Physical therapy is available at all of our 50+ locations, and ACCESS PT currently offers occupational therapy services in several locations including:

• Danbury, CT
• Goshen, NY
• Kingston, NY
• Middletown, NY
• Monroe, NY
• New Paltz, NY
• Bon Secours Community Hospital (Port Jervis, NY)
• St. Anthony Community Hospital (Warwick, NY)
• Good Samaritan Hospital (Suffern, NY)

If you’re suffering from carpal tunnel syndrome, give your local ACCESS PT office a call. We’d love to help!