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| Spence Rehabilitation Center |
| 1650 45th Ave. Suite 2C |
| Munster, IN 46321 |
| Visit our Porter County location! |
| 1620 Country Club Rd. Ste E |
| Valparaiso, IN 46383 |
| Phone |
: (219) 513-2267 |
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What is Carpal Tunnel Syndrome? |
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Compression of the median nerve under a fibrous tissue |
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at the wrist called the Flexor Retinaculum. |
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What are some risk factors for Carpal Tunnel |
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Syndrome? |
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| 1. |
Diabetes |
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Thyroid problems |
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| 3. |
Connective tissue disease such as rheumatoid arthritis |
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| 4. |
Pregnancy |
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Obesity |
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Repetitive activities at work |
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| 7. |
Sleeping with your wrists flexed. |
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| 8. |
History of trauma such as wrist fracture |
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What are symptoms of carpal tunnel syndrome? |
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| 1. |
Wrist, hand, and forearm pain |
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Hand numbness particularly the thumb, index, middle, |
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and ring finger |
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Loss of hand dexterity |
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| 4. |
Waking up with pins and needles sensation in the hand |
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| 5. |
Thumb weakness |
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How do you Diagnose Carpal Tunnel Syndrome? |
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Tinel’s sign: |
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Taping at the palm of the hand just below the wrist |
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results in an electric shock like sensation. |
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| 2. |
Phalen’s sign: |
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Symptoms are reproduced when the wrist is held in |
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flexion for a minute. |
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| 3. |
Sensory exam: |
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Looking for loss of sensation in part of the hand |
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particularly around the thumb, index, and middle |
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finger. |
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| 4. |
Motor exam: |
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By checking grip strength, finger strength, etc. |
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| 5. |
Ruling out other problems: |
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That can imitate carpal tunnel syndrome such as a |
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pinched nerve in the neck or arm. |
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| 6. |
Get an EMG and nerve conduction study |
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What is an Electromyography (EMG and nerve |
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conduction studies)? |
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It is a test used to check for nerve irritation. The nerve |
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conduction studies use a small electrical impulse to |
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stimulate the nerve and the impulse speed is assessed. |
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If there is evidence of slowing on nerve conduction |
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studies, the insulation around the nerve is likely being |
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damaged by the compression. The needle EMG uses a
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small pin with a microphone attached that looks for
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common wave forms caused by nerve damage. Abnormal |
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Findings on needle EMG indicate that some of the nerve
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fibers have degenerated which usually means that the
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carpal tunnel is more severe. |
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What can EMG and nerve conduction studies tell |
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you? |
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Location of nerve damage: |
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Whether it is at the wrist, forearm, armpit, or neck. |
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| 2. |
Severity of nerve damage: |
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Typically classified as mild, moderate, or severe. |
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| 3. |
How long it has been present: |
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Has it been around for months or years? |
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| 4. |
It rules out other disorders: |
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Such as a pinched nerve at the neck or a neuropathy. |
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How is carpal tunnel treated? |
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Treatment options are best determined by the symptoms |
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being experienced, the physical exam findings, and the |
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EMG results. Some treatment options include: |
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| 1. |
Carpal tunnel splints: |
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These splints prevent the wrists from flexing at night |
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which is a common contributing factor to carpal tunnel |
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syndrome. The splints should be worn all night, every |
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night, and as needed. |
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| 2. |
Nonsteroid anti-inflammatories (NSAIDS): |
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Naprosyn, ibuprofen, celebrex, etc. |
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| 3. |
Ergonomic assessment: |
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Typically performed by your doctor or therapist which |
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looks for preventable risk factors. Common |
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modifications include adjusting your keyboard or chair |
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height so that you are not performing excessive wrist |
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flexion while typing. |
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| 4. |
Carpal tunnel exercises: |
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Please refer to the links section for details. |
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| 5. |
Oral steroids: |
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A medrol dosepack can be tried to eliminate |
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symptoms. |
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| 6. |
Carpal Tunnel Injection: |
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Steroid is injected into the wrist to limit inflammation. |
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| 7. |
Carpal Tunnel release: |
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A surgical procedure used to release the fibrous tissue |
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that is compressing the median nerve. |
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