, Salem, MA


November 7, 2008

Left untreated, Carpal Tunnel Syndrome can do irreversible damage

One of the fastest growing diagnoses in the country, Carpal Tunnel Syndrome affects millions of Americans each year.

Symptoms of carpal tunnel syndrome include both motor and sensory changes in the thumb and first two fingers. Most patients have moderate to severe pain, often preventing them from getting a full night's sleep. Strength loss, which is common in chronic cases will make opening jars, holding a plate of food, grasping the handlebars on a bike or writing with a pen nearly impossible.

In CTS, the median nerve that passes through the tunnel in the wrist is compressed. Compression of this nerve causes a patient to have pain, sensation changes and, in severe cases, loss of motor strength. The median nerve is extremely sensitive to even the smallest amount of pressure. Whether the compression originates from scar tissue inside of the tunnel or thickening of wrist tendons (from overuse) outside of the tunnel, the result is the same.

In order to treat CTS, your physical therapist must know the mechanism of injury as there are many ways to acquire the condition. Cashiers, clerks and people who use computers are at high risk whereas people that do not repetitively use their wrists, change positions frequently and demonstrate proper ergonomics are at low risk.

If left untreated, carpal tunnel syndrome may cause permanent loss of function. This is seen in patients who have atrophy or withering (shrinking) of the large muscle of the thumb. In these cases, it is extremely important for a patient to seek medical attention because the disease is beginning to do irreparable damage.

There are a number of treatment options, both surgical and non-surgical, for carpal tunnel syndrome. First-line defense is to wear a brace that prevents bending and extending the wrist. Repeated movement of the wrist adds to tunnel compression — the origin of symptoms. When the wrist is kept in a neutral position, the inflammation is reduced and eventually dissipates.

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