Carpal tunnel disease is quite common in the population. It is an affectation by compression of the median nerve in its passage through the wrist, in a narrowing between the bones of the wrist and the transverse ligament which we call carpal tunnel.
It is associated with repetitive movements, rheumatoid arthritis, pregnancy, wrist fractures, acromegaly and other conditions. It is very common for inflammation of the flexor tendons of the hand to cause increased pressure in the carpal tunnel that will trigger nerve neuralgia.
Diagnosis of carpal tunnel syndrome:
It is important to make a good anamnesis and to know the activity of each patient. There are different orthopedic tests that suggest this entrapment, although the most objective and necessary test will be electromyography. Imaging tests such as X-ray or MRI are a good complement to help make a more accurate diagnosis.
A great number of pathologies or nerve compressions can give rise to these symptoms at the level of the wrist and fingers, and they do not necessarily have to be carpal tunnel syndrome. For this reason, it is essential to explore all possible nerve entrapment from the place of origin of the nerve roots in the cervical spine until they reach the carpal tunnel itself.
Symptoms of this injury:
- “Burning” type pain, which may increase at night.
- Tingling or paresthesia of the thumb, index and middle fingers.
- Loss of sensation in these fingers.
- Loss of strength and atrophy of the thumb musculature.
Treatment of carpal tunnel syndrome:
Surgical treatment is often resorted to. However, numerous studies certify the short and medium term efficacy of conservative treatment with manual therapy on the different points of nerve entrapment.
For this purpose, techniques such as the following are applied:
The biomechanical exploration begins by assessing the mobility restrictions in the patient’s spine, paying special attention to the cervical region. It is important to release the existing tensions both at the muscular level in the “closing chains” of the injured upper limb and the neural compromises in the path of the affected nerve as it passes through the different structures until it reaches the hand.
Recovery from carpal tunnel syndrome
It will depend on the degree of injury, the causes that provoked it and the time that the patient has had it, as well as the regenerative capacity that the patient has in front of the lesional processes. All this can cause the recovery to take place in 2-3 weeks or 2-3 months. Although the most frequent statistically speaking is 6 weeks.
CARPAL TUNNEL SYNDROME. FREQUENTLY ASKED QUESTIONS
How is the treatment planning?
The planning of this type of therapy is always personalized, being basic the osteopathic approach for this type of injury. The objectives are to calm the inflammation, decompress these points of entrapment, relax the muscles of the forearm and arm and give mobility to the median nerve.
Should I suspend professional or sporting activity?
It will depend on each case, if the professional or sporting gesture has not intervened in the appearance of the injury, there will be no reason to suspend it, but if it is not thus it will be necessary to graduate the efforts. The majority of injuries of this type allow to continue doing a moderate activity controlling the efforts, all this will be coordinated by the physiotherapist,
How many sessions do I need to start noticing improvement?
Between 1 and 2 sessions are usually necessary to start the improvement.
How much time should pass between sessions?
It will depend on each case, the most common is to perform one session per week.
Can emotional stress cause this injury?
Yes, sometimes there are no physical or metabolic factors important enough to justify the appearance of this injury, however there are psychic factors. To help the body stop generating this irritation/inflammation of nerve fibers causing pain, it is very important that the patient becomes aware of the relationship between stress-injury and try to establish strategies to reduce the impact of stress on the body. For this purpose, tools such as Coaching and Clinical Psychology are of great help.
This post is also available in: Spanish
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