ANKLE PAIN
CARPAL TUNNEL SYNDROME
CHRONIC PAIN
ELBOW PAIN
HIP PAIN
IMPAIRMENT & DISABILITY
KNEE PAIN
MUSCLE WEAKNESS
MYOFASCIAL PAIN
NECK & LOW BACK PAIN
NUMBNESS
SHOULDER PAIN
WRIST PAIN
BIOGRAPHY
REFERALS
Spence Rehabilitation Center
1650 45th Ave. Suite 2C
Munster, IN 46321
Visit our Porter County location!
1620 Country Club Rd. Ste E
Valparaiso, IN 46383
Phone : (219) 513-2267
 
     
 
What is Carpal Tunnel Syndrome?
Compression of the median nerve under a fibrous tissue
at the wrist called the Flexor Retinaculum.
What are some risk factors for Carpal Tunnel
Syndrome?
 
1. Diabetes
2. Thyroid problems
3. Connective tissue disease such as rheumatoid arthritis
4. Pregnancy
5. Obesity
6. Repetitive activities at work
7. Sleeping with your wrists flexed.
8. History of trauma such as wrist fracture
 
 
What are symptoms of carpal tunnel syndrome?
 
1. Wrist, hand, and forearm pain
2. Hand numbness particularly the thumb, index, middle,
and ring finger
3. Loss of hand dexterity
4. Waking up with pins and needles sensation in the hand
5. Thumb weakness
   
 
 
 
How do you Diagnose Carpal Tunnel Syndrome?
 
1. Tinel’s sign:
Taping at the palm of the hand just below the wrist
results in an electric shock like sensation.
2. Phalen’s sign:
Symptoms are reproduced when the wrist is held in
flexion for a minute.
3. Sensory exam:
Looking for loss of sensation in part of the hand
particularly around the thumb, index, and middle
finger.
4. Motor exam:
By checking grip strength, finger strength, etc.
5. Ruling out other problems:
That can imitate carpal tunnel syndrome such as a
pinched nerve in the neck or arm.
6. Get an EMG and nerve conduction study
 
 
What is an Electromyography (EMG and nerve
conduction studies)?
It is a test used to check for nerve irritation. The nerve
conduction  studies use a small  electrical  impulse to
stimulate the nerve and the impulse speed is assessed.
If there is evidence of slowing on nerve conduction
studies, the insulation around the nerve is likely being
damaged by the compression. The needle EMG uses a
small pin with a microphone attached that looks for
common wave forms caused by nerve damage. Abnormal
Findings on needle EMG indicate that some of the nerve
fibers have degenerated which usually means that the
carpal tunnel is more severe.
 
What can EMG and nerve conduction studies tell
you?
 
1. Location of nerve damage:
Whether it is at the wrist, forearm, armpit, or neck.
2. Severity of nerve damage:
Typically classified as mild, moderate, or severe.
3. How long it has been present:
Has it been around for months or years?
4. It rules out other disorders:
Such as a pinched nerve at the neck or a neuropathy.
 
How is carpal tunnel treated?
Treatment options are best determined by the symptoms
being experienced, the physical exam findings, and the
EMG results. Some treatment options include:
 
1. Carpal tunnel splints:
These splints prevent the wrists from flexing at night
which is a common contributing factor to carpal tunnel
syndrome. The splints should be worn all night, every
night, and as needed.
 
 
 
2. Nonsteroid anti-inflammatories (NSAIDS):
Naprosyn, ibuprofen, celebrex, etc.
3. Ergonomic assessment:
Typically performed by your doctor or therapist which
looks for preventable risk factors. Common
modifications include adjusting your keyboard or chair
height so that you are not performing excessive wrist
flexion while typing.
4. Carpal tunnel exercises:
Please refer to the links section for details.
5. Oral steroids:
A medrol dosepack can be tried to eliminate
symptoms.
6. Carpal Tunnel Injection:
Steroid is injected into the wrist to limit inflammation.
7. Carpal Tunnel release:
A surgical procedure used to release the fibrous tissue
that is compressing the median nerve.
 
Disclaimer
"Nothing contained on this website should be interpreted to be medical advice. This website is for general information only.
Please consult a physician for medical advice regarding any medical condition."
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