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By: Amy Houchens, PT, CHT
TAI – Redmond Physical Therapy
Your carpal tunnel is comprised of 8 small bones in your wrist called carpals that form an arch shape. The base of the arch is spanned on the front of your wrist area by a taut structure called a retinacular ligament. Tunnel size varies based on individual anatomy but is about the size of a nickel. There are 9 flexor tendons (2 for each finger, and one for the thumb) and the median nerve that travel through the tunnel.
What is/causes Carpal Tunnel Syndrome?
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Carpal Tunnel Syndrome occurs when the structures traveling through the carpal tunnel swell or are compressed. This reduces blood flow to the median nerve causing numbness, tingling, and pain in the thumb, index, middle and half of the ring fingers. Pain can also occur up the median nerve distribution toward the elbow, shoulder, and neck regions. Weakness and muscle atrophy in the hand are later effects of prolonged carpal tunnel syndrome.
Compression can occur due to swelling/inflammation of the tendons from overuse, prolonged wrist positioning in extreme ranges, or instability of the carpal bones. It can also be associated with pregnancy due to increased fluid in the tissues.
What can I do to treat/prevent Carpal Tunnel Syndrome?
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Symptoms are commonly worse at night due to positioning and/or fluid stasis in the hand. A splint that holds the wrist in a neutral position can be very helpful to reduce or eliminate nocturnal symptoms.
Try to avoid aggravating factors such as prolonged, repetitive and small/tight grip activities. Use no more than the force necessary to complete tasks. Varying activities and short rest/stretch breaks for the hand can be helpful. Try using tools with ergonomic, padded or built up grip circumference when possible.
Avoid working in extreme wrist positions when possible. Other risk factors include vibration, cold environment, smoking, and diabetes.
Seeing a hand therapist can be helpful for evaluation of your upper extremity to address any muscle imbalances or postural problems that may be contributing to hand overuse. Tendon and nerve gliding exercises and well as a good stretching routine can also be helpful. Your therapist can work with you on specific activity and equipment recommendations as well.
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