Physiotherapy Exercises for Carpal Tunnel Syndrome

Carpal tunnel syndrome is a common peripheral neuropathy. It is a painful progressive condition that occurs when the median nerve in the wrist is compressed.

Median nerve runs form forearm to the hand. Carpal tunnel syndrome is a narrow passage in the wrist and is surrounded by carpal bones below and transverse carpal ligament across the top.

The median nerve runs through this tunnel and is responsible for sensations to the thumb, index finger, middle finger and half of the ring finger.

Prevalence rates are high in persons performing repeated wrist motions, mostly computer users. Research shows that women are three times more likely than men to get carpal tunnel syndrome, as the tunnel itself may be smaller in some women than in men. Dominant hand is usually affected first.

Causes:

1. In some cases, the cause is idiopathic i.e. unknown

2. Inflammatory condition like rheumatoid arthritis may cause this syndrome

3. Swelling or inflammation around the tendon

4. Cyst or tumour in the carpal tunnel

5. Wrist fracture or dislocation

6. Repeated use of vibrating hand tools

7. Often caused by job related activities like typing, sewing, etc.

8. Other risk factors include diabetes, hypothyroidism, obesity, fluid retention during pregnancy or menopause

Symptoms:

1. Pain is the first complaint

2. Tingling in the fingers

3. Numbness in the fingers

4. Radiating or referred pain to arm and shoulder

5. Swelling of hand and forearm

6. Weakness of grip

7. Atrophy of the thumb muscles and loss of hand function

8. Symptoms are usually worse at night and patients often “flick” their wrist to relieve the symptoms, also called as ‘flick sign’

Physiotherapy Exercises for Carpal Tunnel Syndrome

Physiotherapy Treatment:

1. To relieve pain ultrasound plays an important role.

2. Contrast baths i.e. alternating between warm and cold helps in dilation and constriction of the blood vessels, thereby reducing swelling as well as pain.

3. Carpal bone mobilisation is also helpful.

4. Nerve and tendon gliding exercises are done to ensure unrestricted nerve motion.

Tendon gliding exercise: Make a fist with your hand, then position to claw hand then straighten the fingers. Hold each position for 5 second and repeat 10 times.

Median nerve exercise: Stretch both the wrists and fingers back and hold for 5 seconds then straighten wrists and relax. Repeat the same. Make a tight fist with both hands and bend the wrist down while keeping the fist and hold for 5 second, then straighten the wrist and relax. Repeat the same.

Also Read: What is Carpal Tunnel Syndrome
Also Check: Physiotherapy Exercise for Shoulder Injuries

Exercises to improve grip as well as strengthening of forearm muscles should be done.

Wrist bend: Rest the elbow on table and bend your wrist forwards and back.

Wrist lift: Place the hand on the table and lift the fingers up and resist with the other hand.

Finger bend: gently bend the fingers at middle joints and then relax.

Hand squeeze: Squeeze a soft ball and hold for few seconds and relax.

Isolated blocking exercise: Hold down three fingers straight with other hand and bend and move only one finger. Repeat it to other fingers also.

• Stretching and normal range of motion exercises are done.
• In severe cases, a carpal tunnel splint may be used so that wrist is maintained at neutral position and minimise pressure on the carpal tunnel.

Prevalence rates are high in person performing repeated wrist motions, mostly computer users. Fine motor and hand dexterity exercise are advised. Last but not the least, proper posture and ergonomically modifications must be made.

Precautions:

1. Avoid repetitive use of the wrist joint.

2. When using vibrating devices, try to reduce the vibration to the hands with gloves.

3. When using keyboard or mouse, hands should be even or slightly lower than elbows.

4. Control the mouse with least possible grip.

5. Take frequent breaks from work and perform stretching exercises at your workstation.

SOURCE: B-Positive Health Magazine

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