Carpal Tunnel Therapy
Cindy Glaenzer, a certified hand therapist, discusses therapy treatment options for carpal tunnel.
What is carpal tunnel syndrome?
Carpal tunnel is an entrapment of the median nerve at the wrist. The bottom of the bones is the carpal bones, where it gets its name; the top is the transverse carpal ligament. Two flexor tendons for each finger and one for your thumb run through the carpal tunnel with one nerve called the median nerve. You use your flexor tendons a lot for gripping, and those tendons take up more space and put pressure on the median nerve. That gives you numbness and tingling to your thumb, index finger, long finger, and half of your ring finger.
Talk about non-surgical treatment options.
There are lots of things that you can do for conservative treatment. Just because you have it doesn’t mean you have to have surgery. If it’s been there for a long time and it gets to be constant numbness and tingling, then it’s definitely time to have surgery before you lose muscle strength in your thumb.
One of the things we do is splint you at night. We would give you a wrist orthoses or wrist splint so that you don’t sleep with your wrist in flexion because you don’t know where your wrist is when you’re sleeping. Some people fight dragons at night, and some people sleep with their hands tucked up underneath their pillow. That puts pressure on the nerve, much like if I sit on my foot and my foot goes to sleep. We eliminate that problem by putting them in a splint at night.
We have them do tendon glides. We have them move their fingers in a certain way in order to help glide that and then stretch the full length of those flexor tendons so that they can get the length back. It takes care of some of that numbness and tingling.
We talk about posture a lot because a lot of times that’s just one of the spots where there is pressure on the nerve. It can be from forward shoulders, forward head. It can be the position that they drive in. They’re white-knuckle drivers, and they’re really nervous and are squeezing so hard. We can scoot their seat up. We can change the position at their desk. There are lots of things that we can do to help alleviate the pressure on that nerve in their hand.