Carpal 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 with education.

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"!

Author: Jeff Anliker, LMT, is a Therapist and Inventor of Therapeutic Exercise Products that are utilized by Corporations, Consumers and Medical Facilities around the world for the prevention and rehabilitation of repetitive strain injuries.