Carpal Tunnel Syndrome

Sanika Lawate
Sanika Lawate Executive Assistant at AHS

Overview

Carpal Tunnel Syndrome, or CTS, is a prevalent condition that affects many Americans annually. CTS symptoms are usually seen in older adults after the age of 45 and more women suffer from the syndrome than men; CTS symptoms happen more when sleeping due to the hand positions of patients (Sevy & Varacallo, 2021). Sevy and Varacallo (2021) state that extended use of the hand can exacerbate the condition. In addition to overuse of the hand, comorbidities, which is when a patient has one or more condition(s) in addition to an existing one like CTS, can cause symptoms to arise— Sevy & Varacallo (2021) mention obesity, arthritis, and genetic diseases as some examples of these comorbidities. 

What is Carpal Tunnel Syndrome, or CTS, and how does it present itself? 

CTS is a type of neuropathy that affects the nerves in the hand. The prefix neuro- signifies nerves/nervous system, and the suffix pathy- means disease. The name of the neuropathy is from the name of a small tunnel in the wrist called the carpal tunnel (Faust & Jennings, 2016). The nerve affected is called the median nerve, which runs through the carpal tunnel, hence why CTS is also called median nerve compression (Faust & Jennings, 2016). The median nerve is important because it is why the hand has sensations and it allows for movement by the thumb (Faust & Jennings, 2016). Therefore, when it is “compressed” or “entrapped”, it causes problems with sensation and the patient feels an intense amount of pressure in that area (Sevy & Varacallo, 2021). 

How is CTS treated?

Our OTD, Emily Dayton, recommends median nerve glides to manage the pain and discomfort that accompanies the symptoms. According to Faust and Jennings (2016), the patient can either choose to mitigate the pain with exercises or medication; however, if symptoms are debilitating, surgery is a possibility. The authors list a few methods, in addition to median hand glides, to combat CTS symptoms (Faust & Jennings, 2016):

Non-Invasive Treatments

  • Splints or casts: these help ensure that your hand is placed in a way that does not rouse symptoms (Faust & Jennings, 2016).
  • NSAIDs: painkillers can reduce pain 
  • Preventative measures or adjustments to incorrect positions: CTS can worsen if people are not educated about the proper way to use and put their hand(s). One of the important aspects of OT is using the knowledge of ergonomics to make workplaces or homes easier to access for injured or disabled people. Making certain adjustments to how a patient works or to their environment can mediate symptoms (Faust & Jennings, 2016).
  • Steroids: Stronger than NSAIDs, steroids or steroid shots can give temporary respite to people with crippling symptoms (Faust & Jennings, 2016).

Invasive

  • Carpal Tunnel Release Surgery:  In addition to the treatments above, Faust and Jennings (2016) mention this as another alternative for patients who have worsening symptoms. If the above treatments have no effect, this surgery can stop symptoms. 
    • Open: With the hand numbed by anaesthesia, the surgeon will try to add more space to the carpal tunnel so the median nerve has more room and less pressure on it (Faust & Jennings, 2016).
    • Endoscopic: It has the same outcome as the open carpal tunnel release but the surgeon uses a camera (Faust & Jennings, 2016).

How can we help?

Emily Dayton, our OTD, can treat people suffering from CTS. During a session with her, she will fit patients with an orthotic (wrist brace). During an appointment, she will give patients exercises such as median nerve glides and tendon glides that they can do with her and at home. Research suggests that ultrasound may be helpful with pain management, so Emily conducts ultrasounds in our clinic to help reduce pain. After six weeks, she will re-evaluate the patient’s symptoms, and if symptoms have stayed the same or worsened, she might recommend that the patient talk to their doctor about surgery.

If you have been diagnosed with CTS or believe you may be experiencing symptoms, please don’t hesitate to reach out and our OTD can help you.

 

References:

Faust, K., & Jennings, C.D. (2016). Carpal tunnel syndrome. OrthoInfo from the American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases–conditions/carpal-tunnel-syndrome/

Sevy, J.O., & Varacallo, M. (2016). Carpal tunnel syndrome. StatPearls.https://www.ncbi.nlm.nih.gov/books/NBK448179/



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