Carpal tunnel syndrome (CTS) is entrapment neuropathy that affects the Median nerve. This can cause sensory and motor function deficits in the hand.
Occupational therapy has an essential role in helping people with CTS regain function and improve their quality of life.
This blog post will discuss CTS’s causes, symptoms, and treatment options. We will also explore the role of occupational therapy in helping people manage this condition.
What is carpal tunnel syndrome?
This syndrome is a form of a condition that can cause pain, numbness, and tingling in the thumb, middle finger, and half of the ring finger. A wrist fracture can reduce the tunnel area leading to non-healthy body alignment of the flexor tendons.
It creates pressure on the median nerve, which runs from the shoulder to the hand. This pressure can result from repetitive motions, such as those often used in typing or sewing.
This pressure can also result from swelling or inflammation in the tissues around the nerve. Carpal tunnel syndrome can cause pain, numbness, and tingling in the hands and wrists. Different psychosocial factors are also responsible for upper extremity disability.
It can also lead to muscle weakness in the hands in some cases. Some common risk factors include rheumatoid arthritis, obesity, and pregnancy. Sensory examination is essential for patient satisfaction during the early stages.
Symptoms of carpal tunnel syndrome
The symptoms may include numbness, tingling, and pain in the hand and wrist. The symptoms usually come on gradually and worsen over time. Many people with carpal tunnel syndrome experience relief after nonsurgical treatments such as splinting or wearing a brace. However, some people may need surgery to relieve their symptoms.’
What are entrapment neuropathies?
Entrapment neuropathies are conditions in which a nerve becomes compressed as it passes through a narrow space. This compression can cause pain, numbness, and tingling in the hand or foot.
The most common entrapment neuropathy is carpal tunnel syndrome, which occurs when the median nerve becomes compressed as it passes through the carpal tunnel in the wrist.
Other entrapment neuropathies include cubital tunnel syndrome (ulnar nerve compression at the elbow), tarsal tunnel syndrome (peroneal nerve compression at the ankle), and Guyon’s canal syndrome (reduction of the ulnar nerve at the wrist).
How are entrapment neuropathies diagnosed?
A physician will typically take a medical history and perform a physical examination to diagnose entrapment neuropathy. In some cases, a doctor orders to perform additional tests such as nerve conduction studies or magnetic resonance imaging to confirm the diagnosis.
Entrapment neuropathies are examined with conservative treatment such as rest, ice, and over-the-counter pain medication.
In some cases, a splint or brace may immobilize the affected joint and allow the nerve to heal. If these measures are unsuccessful, surgery may be necessary to release the compressed nerve.
Surgeons lately use a newer procedure called endoscopic, open carpal tunnel release for the treatment of nerve entrapment. Besides this, nonsteroidal anti-inflammatory drugs and other anti-inflammatory medications help deal with hand pain significantly.
What are the long-term effects of entrapment neuropathies?
The long-term effects of entrapment neuropathies depend on the severity of the condition. Most people experience relief from symptoms with treatment.
However, those who do not respond to conservative measures or have severe symptoms may develop permanent nerve damage. This nerve damage can lead to muscle weakness or paralysis in some cases.
What are two current treatments for carpal tunnel syndrome?
The two current treatments for carpal tunnel syndrome are conservative measures and surgery. Conservative estimates include rest, ice, and over-the-counter pain medication. Conservative management, helpful exercises, vibrating tools, and a wrist brace can improve outcomes in patients with greater risk.
Surgery is for the ones who do not respond to conservative measures or have severe symptoms. Surgery could involve making an incision in the palm and releasing the compressed nerve.
In some cases, the ligament causing the compression may also be removed. Surgery is typically effective in relieving symptoms and restoring function.
Role of Occupational Therapy
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy caused by compression of the median nerve at the wrist.
The pathophysiology of CTS is not fully understood, but it is thought to be due to a combination of anatomic and mechanical factors. Clinical features include pain, paresthesias, and weakness in the hand.
Based on history and physical examination, the diagnosis will be made, although electromyography may be helpful in some cases.
Treatment options include splinting, oral steroids, local injections, and surgery. The prognosis of CTS is generally good but can vary depending on the severity of the condition.
What does occupational therapy do for carpal tunnel?
Carpal tunnel is a condition that can cause pain, tingling, and numbness in the hand and arm. It may add pressure on the median nerve, which runs from the shoulder to the hand.
Occupational therapy can help relieve these symptoms by providing treatments such as:
● Adjusting work tasks to make them less stressful on the hands and arms
● Splinting or bracing the wrists to keep them in a neutral position
● Exercises to improve strength and flexibility in the hands and arms
● Modifying home activities to reduce stress on the hands and arms
● Cold or heat therapy to reduce inflammation and pain
● Ultrasound therapy to reduce inflammation and pain. If you have carpal tunnel, occupational therapy can help to manage your symptoms and improve your quality of life.
Manual therapy versus surgery: Which is better for carpal tunnel syndrome and neuropathic pain?
The most common treatment for CTS is surgical release of the transverse carpal ligament, which frees up space for the median nerve. However, this surgery is associated with several risks, including infection, nerve damage, and persistent pain.
An alternative to surgery is manual therapy, which effectively treats CTS and other conditions like it.
Manual therapy involves gentle, hands-on treatment from a therapist. It can include mobilization of the wrist, exercises, and education on how to protect the affected area.
Manual therapy is as effective as surgery in the treatment of CTS. It is a safe and non-invasive treatment with few risks. It is also cost-effective, making it a viable option for those who cannot afford surgery.
If you are suffering from CTS, talk to your doctor about manual therapy. It may be the best treatment option for you.
Occupational therapy treatment for carpal tunnel syndrome
Occupational therapy treatment for carpal tunnel syndrome and entrapment neuropathy may include:
Wrist splint
Using a splint to support the wrist and keep it in a neutral position can help reduce the symptoms of CTS.
Exercises
Some exercises of stretching and strengthening the muscles around the wrist can help improve function and reduce pain. Avoid repetitive hand motions, decrease repetitive activities, and wrist bent in severe cases.
Ergonomic advice
Occupational therapists can advise how to adjust your workstation or use your tools and equipment to minimize stress on the hand and wrist.
Education
The condition must be understood and learned how to manage as it is an integral part of treatment. Occupational therapists can provide information on how to protect the hand and wrist, when to seek medical help, and reduce the risk of developing CTS.
A physical or occupational therapist advises the patient not to do repetitive wrist movements that can cause persistent pain,
