By Dr. Adam M. Cramer, PT, DPT
When people have wrist pain, they may assume the worst, saying ‘I have carpal tunnel!” The fact of the matter is, we all have carpal tunnel. The carpal tunnel is simply the space within our wrist where veins, nerves, and tendons travel from the forearm to the hand. Because of the complex nature of the wrist and hand, this tunnel can easily become compressed. Even small amounts of swelling or tight muscles can put pressure on the carpal tunnel, resulting in pain, numbness and tingling in the wrist and palm of the hand.
There are a number of ways that you can get carpal tunnel syndrome. Certain sports or occupations have a higher risk of developing carpal tunnel. One frequent culprit that causes carpal tunnel syndrome is prolonged computer use with poor ergonomic principles. Depending on the angle of your wrist, typing on a computer can be damaging.\Carpal tunnel usually develops over weeks, months, or years of repetitive motion. Because this is a condition that takes so much time to develop, it makes sense that it would take time to overcome it in a non-invasive way.
What can be done about this syndrome? Many people quickly turn to surgery when consulting with an orthopedic surgeon first but surgery never corrects the underlying problem which is how we use our hands and wrists on a daily basis. Most people who have surgery will always have the symptoms always come back because they don’t know how to manage the repetitive stresses that our hands/wrists endure on a daily basis.
When consulting with a doctor of physical therapy first practical solutions can be implemented to reduce further damage and avoiding surgery. Treatment will include the use of hands-on muscle work, tendon work, dry needling, laser therapy, massage, stretching and heat. Most individuals with carpal tunnel have limited range of motion. By providing these interventions in a one on one treatment environment, range of motion will improve decreasing stress on the carpal tunnel and therefore reducing symptoms. The best part is you’ll get to learn how to treat this yourself independently so you will be in control and know what’s going on there for successfully avoiding surgery!\
One key principle to keep in mind for carpal tunnel problem prevention is that of varied movement. Carpal tunnel syndrome arises due to repeated movements. We can override the progression of carpal tunnel syndrome by interrupting those repetitive movements. Taking frequent rest breaks when working at a desk or on a computer will help to give the muscles and tissues time to relax. Proper ergonomic techniques will allow you to have a living or workspace that is custom fit to your body.
Your physical therapist may have other specific recommendations for your treatment, such as a splint to keep your wrist properly aligned or a certain manual manipulation technique for you to use on your own. Physical therapy utilizes evidence-based practices, meaning that the methods recommended will be tried and true. Take control and avoid carpal tunnel surgery by having physical therapy first.