Tunnel Syndrome - Conservative Tests & Treatments
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
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"!
Jeff Anliker, LMT, is a Therapist and Inventor
Exercise Products that are utilized
by Corporations, Consumers and Medical
Facilities around the world for the prevention
and rehabilitation of repetitive strain