Previous studies had found that CTS was more prevalent in the female
population. It was postulated because morphologically,females are more prone to CTS compared to males. According to Rozali et al 2012, proper education and reassurance should be given to improve their daily life routine.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3295646/pdf/1447-056X-11-1.pdf
The type of intervention is determined, in large part, by the location/level of the nerve entrapment - in the shoulder (e.g., brachial plexus) or wrist (median nerve in carpal tunnel).
If the entrapment is localized to a protracted shoulder, retracting the shoulder may take the nerve off compression and eliminate the distal symptoms in the wrist and hand.
Professor Rothbart
An interesting question and article- thanks for sharing.
In terms of lifestyle modifications- it is known that activities that involve end of range wrist movements, particularly under load, increase the pressure within the carpal tunnel and increase symptoms (especially in those with an underlying structural compromise such as past fracture or wrist OA). This is why for mild CTS splinting is an effective management strategy. Avoiding daily or work activities involving loaded wrist extension will help. Vibration is another potential risk factor, so those with symptoms may need to avoid vibration-related activities (e.g. power tools).
It should be noted that recent weight gain and diabetes can also impact on CTS, particulary in pregnancy, so lifestyle choices that can influence weight and BGL control will help.
As Prof Rothbart suggested above, you need to ensure you are managing CTS, with thoracic outlet syndrome and cubital tunnel syndrome two other factors to consider.
Here are the basic recomendations for our patients in Hospital Costa del Sol (Spain) for CTS. Maybe they can be useful. Pictures were taken by myself. It is based in international literature and agrees with previously exposed.
Consider also the effect of double crush syndrome. A cervical radiculopathy can sensitize the median nerve at the wrist to CTS, even with positive nerve conduction testing, etc.
Typical ADL changes that improve or help ameliorate the condition include extension supports at night and intermittently during the day, and ergonomic improvement of the work station.
Ed
Hi! here are some suggestions;
1.Minimize repetitive movements that involves flexion at wrist. 2.Night splint so as to avoid flexion of wrist.3.Tendon & nerve gliding exercises. 3 Modify the activities of wrist that involves pronation and flexion to supination and flexion or supination and extension or pronation and extension as per the convenience 4. Modify griping objects with bigger grip adapters or other example here is driving a car with 8 & 4 o'clock position. If you still need more information, you can refer my book https://sapnaonline.com/basics-of-orthopedic-physiotherapy-768062
Non-surgical treatments may include behavioral changes such as reducing or eliminating repetitive hand motion, wearing wrist splints at night or receiving anti-inflammatory medication taken orally or injected into the carpal tunnel.
First, diagnose correctly. No electrophysiological study, no radiological evidence is necessary. Second: Carpal Tunnel is just the increase in pressure within the tunnel. It occurs eather by decrasing the volume of the tunnel (Wrist flexion/ extension) or by a higher volume of the content of the carpal tunnel (tendinitis, edema in pregnants, ganglion etc.) Concluded treatment is simple. 1. wristsplinting in neutral position maintains the highest diameter ( if symptoms night and day- wear splint night and day) 2. decrase the swelling of the content of the carpal tunnel- I start with injection of cortison/ local anesthtetics into the tunnel. If no success, severe symptoms, I will do carpal tunnel release.
kind regards, JE
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