Below is a great article written by Drs. Tim Flynn and Terry Gebhart, members of the American Academy of Orthopedic Manual Physical Therapy, discussing the important contributions of the neck and upper arm in symptoms of carpal tunnel syndrome, and how we shouldn't focus on just the wrist in management of this common problem.
NECK KEY TO CARPAL TUNNEL TREATMENT
If you experience wrist and hand pain with numbness or tingling into your hand, you may have been diagnosed with carpal tunnel syndrome. Other common symptoms include weakness in the thumb muscles, loss of hand motion and increased pain at night.
Carpal tunnel syndrome affects 2 percent to 5 percent of the population and most commonly affects individuals between the ages of 40 and 60. It frequently affects individuals whose occupations require the wrist to be flexed or extended for long periods of time such as computer work. Additionally, repetitive motion or gripping activities and exposure to repetitive vibrations such as power tools can contribute to carpal tunnel syndrome.
Common treatments for carpel tunnel syndrome include rest, anti-inflammatory medication, night splints to immobilize the wrist, physical therapy and steroid injections. If these options fail, surgery may be recommended.
Although carpal tunnel syndrome is caused by increased pressure on the median nerve that travels through the carpel tunnel at the wrist, it is important to remember that the median nerve originates in the neck and the neck must be addressed when treating carpal tunnel syndrome.
While 14 percent of individuals with carpal tunnel syndrome have neck pain, neck pain does not need to be present in order for the neck to be a contributing factor to symptoms. The key point is to treat the upper extremity nerve and muscle system and not simply focus on the location of pain. In the case of carpel tunnel syndrome, this means treating the upper back, neck and the course of the nerve from the neck to the shoulder, elbow, wrist and hand. Even if nerve testing reveals poor conduction to the median nerve at the carpal tunnel, this can frequently be improved by treating the system without the need for surgery.
A thorough examination by your physical therapist will help you determine the best conservative treatment options for you. This treatment will frequently include gentle spinal manipulation of the upper back and neck, nerve sliding/gliding exercises to treat the nerve from your neck to your hand and hands-on techniques to mobilize the bones of the wrist and hand.
Tight bands or knots called trigger points are commonly found in the muscles of the forearm and the muscles around the upper back and neck in patients with carpal tunnel syndrome. These can be treated with trigger point dry needling or massage.
The repetitive motions or stress associated with carpal tunnel syndrome can also cause tightness in the soft tissues such as muscles, tendons and ligaments around the carpal tunnel. Manual therapy techniques can help reduce this stiffness.
Finally, poor posture will place increased stress on the nerves coming out from the neck and going to the hand. Maintaining good posture and taking frequent breaks when working at your computer will help alleviate this stress.
If you experience wrist and hand pain with numbness or tingling into your hand, you may have been diagnosed with carpal tunnel syndrome. Other common symptoms include weakness in the thumb muscles, loss of hand motion and increased pain at night.
Carpal tunnel syndrome affects 2 percent to 5 percent of the population and most commonly affects individuals between the ages of 40 and 60. It frequently affects individuals whose occupations require the wrist to be flexed or extended for long periods of time such as computer work. Additionally, repetitive motion or gripping activities and exposure to repetitive vibrations such as power tools can contribute to carpal tunnel syndrome.
Common treatments for carpel tunnel syndrome include rest, anti-inflammatory medication, night splints to immobilize the wrist, physical therapy and steroid injections. If these options fail, surgery may be recommended.
Although carpal tunnel syndrome is caused by increased pressure on the median nerve that travels through the carpel tunnel at the wrist, it is important to remember that the median nerve originates in the neck and the neck must be addressed when treating carpal tunnel syndrome.
While 14 percent of individuals with carpal tunnel syndrome have neck pain, neck pain does not need to be present in order for the neck to be a contributing factor to symptoms. The key point is to treat the upper extremity nerve and muscle system and not simply focus on the location of pain. In the case of carpel tunnel syndrome, this means treating the upper back, neck and the course of the nerve from the neck to the shoulder, elbow, wrist and hand. Even if nerve testing reveals poor conduction to the median nerve at the carpal tunnel, this can frequently be improved by treating the system without the need for surgery.
A thorough examination by your physical therapist will help you determine the best conservative treatment options for you. This treatment will frequently include gentle spinal manipulation of the upper back and neck, nerve sliding/gliding exercises to treat the nerve from your neck to your hand and hands-on techniques to mobilize the bones of the wrist and hand.
Tight bands or knots called trigger points are commonly found in the muscles of the forearm and the muscles around the upper back and neck in patients with carpal tunnel syndrome. These can be treated with trigger point dry needling or massage.
The repetitive motions or stress associated with carpal tunnel syndrome can also cause tightness in the soft tissues such as muscles, tendons and ligaments around the carpal tunnel. Manual therapy techniques can help reduce this stiffness.
Finally, poor posture will place increased stress on the nerves coming out from the neck and going to the hand. Maintaining good posture and taking frequent breaks when working at your computer will help alleviate this stress.
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