If you experience pain in your hand and arm along with numbness or a tingling feeling, you may have carpal tunnel syndrome (CTS). People who have a family history of CTS may not be able to avoid this condition and will likely experience it at some point between the ages of 18 and 64.
The good news is that, thanks to physical therapy science, CTS is highly treatable with PT, often without the need for surgery. If surgery is necessary to relieve symptoms of CTS, therapy following surgery can restore your wrist’s strength and prevent future problems.
What is Carpal Tunnel Syndrome?
The carpal tunnel is a narrow, rigid passageway of ligament and bones at the base of the hand. The median nerve and muscle tendons pass through the carpal tunnel and control the muscles in the palm of the hand, allowing the fingers to move. The median nerve also ensures that you have normal sensation or feeling in your thumb, index finger, middle finger, and ring finger.
Carpal tunnel syndrome occurs when tissue swells, causing pressure to build up inside the carpal tunnel and pinches the median nerve. It causes numbness and tingling in the hand and arm as a result of this pinched nerve. Over time, the increased pressure on the median nerve affects the areas of the hand that the nerve supplies.
Diagnosing Carpal Tunnel Syndrome
CTS usually presents as hand weakness or pain, numbness, or tingling in all fingers except the pinky finger. If left untreated, moderate symptoms can develop into nerve damage or severe issues requiring surgery.
Factors that increase your risk for CTS include an unhealthy lifestyle, a wrist fracture, or health conditions such as rheumatoid arthritis. Before diagnosing you with CTS, your physical therapist will ask you questions about the symptoms you experience and will do a physical examination to check for signs of swelling, tenderness, or deformities.
Your physical therapist may also consult with your primary healthcare provider or any other healthcare professional to determine the presence of other risk factors.
Physical Therapy (PT) for Carpal Tunnel Syndrome
The treatments for CTS depend on the severity of the condition and can range from medical advice to surgery. Your physical therapist will provide you with a customized treatment plan that may include a therapeutic exercise program and medication.
Conservative Physical Therapy
In the case of early-stage CTS, conservative treatment is often sufficient to reduce symptoms. This program may include:
- Undergoing patient education to help you keep your body and wrists in a healthy, neutral position while working
- Wearing wrist splints to stabilize your wrist and reduce pressure on the median nerve
- Doing regular carpal tunnel exercises to strengthen the muscles surrounding your wrist
- Undergoing heat and cold treatments to relieve pain
Your physical therapist may also recommend moderate stretch exercising to improve the mobility and function of your fingers and wrist. The most common stretching exercises include:
- Prayer stretch exercises
- Wrist flexor stretch exercises
- Wrist extensor stretch exercises
Conservative treatments, including wrist flexion and other carpal tunnel exercises, can prevent the need for surgery. However, in the case of advanced CTS, a surgical procedure may be necessary to remove the swollen tissue and relieve pressure on the nerves of the hand and forearm.
PT After Carpal Tunnel Surgery
After undergoing surgery, your health care provider will typically recommend therapy to:
- Improve your wrist’s strength, flexibility, and function
- Help you adopt healthy habits to prevent future issues with your wrist, hand, and fingers
- Prevent scar tissue from forming around the surgical site
Post-surgery treatments include various exercises to stretch and strengthen your wrists. Your therapist may also recommend nerve gliding exercises, which involve bending your wrist backward so that the palm side of your hand and your fingers face away from you.
When doing nerve gliding exercises, follow your therapist’s instructions closely to avoid making your symptoms worse.
As part of post-surgery, your therapist will also provide scar management to keep your skin flexible. Factors determining which scar management treatments you need include:
- The proximity of the scar to the nerves
- The shape and size of the scar
- The type of scar (hypertrophic or keloid scarring)
- The scar’s sensitivity to clothing, jewelry, and other surfaces
After surgery, your therapist will do a thorough examination, consider the surgeon’s recommendations, and provide you with a custom post-surgery therapy plan.
Effective Treatment for Carpal Tunnel Syndrome
When you notice symptoms of CTS, seeking early treatment is critical to prevent severe issues with your wrist and hand. Contact us today to schedule a thorough examination and consultation with one of our professional physical therapists.
