Today I would like to hop on and then explain a very common condition that’s affecting people’s hands and upper extremity a lot of people are questioning about – it’s the carpal tunnel syndrome.
A lot of times when people feel like they have some numbness-tingling and then shooting sensation into your arms all the way into your hands and then they were told that they have carpal tunnel syndrome.
A lot of people are just wondering if that’s true and then what they should do with it and that’s the reason why I came on today.
Carpal tunnel syndrome means the median nerve that is all the way from the neck passing through the chest, the thoracic outlet to the front part of the arm all the way into our hand. The median nerve is being entrapped or being pinched by the muscle.
When the nerve has more tension, it’s getting more angry and the patient usually would feel some shooting pain and then some numbness-tingling especially at the front part of their hand, the palm of their hand, and if in some worse cases some people might even lose their grip strength.
They’re gripping would be weaker in some extreme cases and this is definitely something that people should pay attention to.
Somebody if they have any sort of diabetes or any condition that’s affecting their blood circulation usually they would have a higher risk of having carpal tunnel syndrome just because the nerves really need the nurturing and blood supply from the blood vessels around it.
If somebody has decreased blood circulation especially at the end of their limbs then the nerves can get angrier much easier. That’s why diabetes is a risk factor.
When somebody is getting diagnosed with carpal tunnel syndrome the problem is they’re automatically sent into a surgery to release that.
Theoretically if the ligament on top of the carpal tunnel where the median nerve is going into the hand is being cut and released then the pressure would be relieved.
No more carpal tunnel syndrome, no more pressure to the nerve.
Not necessarily the case in reality because a lot of the time the pressure is from the other nine tendons also passing through the carpal tunnel. Those tendons that help with bending-straightening our fingers, bending-straightening our thumb.
Those tendons are getting inflamed because of repetitive use the tendons are getting thicker and then they are developing some friction, inflammation. That’s where the pressure is coming from.
If we don’t address that then just releasing the ligament on top of the carpal tunnel is not resolving the root cause of the problem. After they get out of the surgery people would develop scar tissue and can further limit the space under the carpal tunnel and then some people would say the condition is getting worse after the surgery.
From a physical therapist and occupational therapist standpoint, we definitely advocate for any conservative treatment like seeing a PT or an OT, to do some exercises, to facilitate proper range of motion, proper gliding of the tendons that’s passing through the carpal tunnel into our hands to facilitate circulation to relieve the pressure within the carpal tunnel before going to the surgery.
Usually with conservative treatment a lot of folks we’ve seen here really got tremendous effects and they don’t really feel like they need the surgery.
Another problem that we’re seeing and a lot of people ask us, a pattern we recognize is that any time when somebody feels some numbness-tingling in their hands they are automatically put on the label carpal tunnel syndrome.
The fact is that it’s not always the case because like I said earlier, the median nerve originates from the nerve roots in the cervical spine it passed through the shoulder, the front of the chest all the way into your hands.
There are multiple sites, multiple muscles that can potentially cause entrapment of the carpal tunnel of the median nerve. Carpal tunnel is one but at the forearm the pronator teres muscle and coming up here at our axillary region, the pectoralis minor, and then even getting closer to the neck, the scalene muscles.
All these muscles can potentially cause entrapment, pinching the median nerve and then the patient can have some similar symptoms of numbness-tingling they are feeling in the hand. Often time they just automatically got labeled with carpal tunnel syndrome.
A lot of chance it’s not pressure here, it is pressure somewhere else and then they might be sent into a surgery and then do a carpal tunnel release whereas the entrapment, the pinching site, is somewhere else. Apparently in that case surgery wouldn’t be fixing the problem.
That’s the important thing of a proper evaluation prior to starting any treatment. It is very important to find the root cause of the problem.
That’s why at CORE Therapy and Pilates we always let the patients do a discovery session when they first come in to see either me or Stephen so that we can really spend that time to evaluate and then know the client’s condition better. And then do the most accurate and relevant treatment accordingly.
That’s just a little bit of introduction about carpal tunnel syndrome – the most common condition of the upper extremity.
If you guys have any questions my name is Dr Andy Tseng, physical therapist and occupational therapist at CORE Therapy and Pilates.
Feel free to contact us through our phone number, 512-215-4227, or our website therapyandpilates.com.
Either myself or Stephen would be happy to speak with you and then to address any of your concerns and potentially work with you and help you get better.
That’s what I got for today and I hope you guys have a great day!
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