Carpal Tunnel Syndrome - Overview
Early recognition and effective action has a significant impact on recovery time
CTS is a terribly debilitating and frustrating condition and although we do see more and more referrals from medical doctors, it is a sad fact that many MD's simply have no idea of how effective trigger point and other therapies can be for relieving the symptoms of CTS and many other common RSI conditions.
Repetitive Strain Injuries (RSI)
The term RSI is generally considered an umbrella term for a number of upper limb disorders. There has been a massive increase in RSI over the past few decades most likely due to an increase in intense static activities.
More people are using computers, workplace stress is increasing, mobile communications are increasing, and use of smart-phones and tablets is increasing. However, there is little agreement as to the diagnosis of conditions.
There are a plethora of medical terms used to describe RSI, often resulting in confusion and frustration for the patient and practitioner alike.
Basically there are two significant groups of RSI conditions, often known as
Type 1 RSI and Type 2 RSI. Type 1 RSI conditions have a tangible pathology (i.e., measurable evidence in the form of swelling, deformation, dysfunction, etc.).
Type 2 RSI conditions do not have clear pathology, and consequently some medical professionals do not recognize them.
Type 2 RSI is also known as “Work Related Upper Limb Disorders” (WRULD). Other terms used for Type 2 RSI conditions include “diffuse RSI,” “cumulative trauma disorder,” “occupational overuse syndrome,” “non-specific pain syndrome,” “non-specific arm pain,” and “myofascial pain syndrome.”
RSI is associated with trigger points in both wrist flexors and/or extensor (especially Extensor Carpi Radialis Brevis) muscles.
Early recognition and effective action has a significant impact on recovery time. The longer it has been there, the harder it is to treat. Added to this, the rest of the body is forced to compromise or adapt, often leading to secondary and tertiary mechanical issues.
Recovery in some cases can be achieved in a few months, but it is often measured in years. Recovery can also come in stages, allowing a gradual return to normal activity. Note – Full recovery is not always possible.
Carpal Tunnel Syndrome (CTS)
One of the most common forms of RSI that we see in our clinics is Carpal Tunnel Syndrome (CTS).
This is a condition that occurs when the median nerve is restricted. The carpal tunnel is located on the palm side of the wrist and it protects the median nerve, the main nerve that enables finger flexion.
People who suffer from CTS will generally experience numbness or tingling of the thumb and fingers, particularly the index and middle fingers, as they receive sensation from the median nerve.
If pain is felt in all fingers except the little finger, it could be an indicator of CTS. It is known for these sensations to develop gradually but worsen at night.
This is often from sleeping with the wrists flexed or sleeping on one side. In severe cases, patients might experience a weakness in the hand and be prone to drop objects. Some people may also suffer from a dull ache in their hand and elbow.
Causes and Contributing Factors
Generally any pressure on the median nerve, which makes the carpal tunnel smaller, is the primary cause for this condition.
Contributing factors to CTS may include underlying health problems such as diabetes, obesity hypothyroidism, rheumatoid arthritis, and pregnancy.
In other cases, the cause is a result of the anatomy of the wrist, specifically a narrow-diameter carpal tunnel.
Another common cause is an injury to the hand that causes internal scarring or misaligned wrist bones. Often overuse of the hand and arm has been connected to CTS.
This typically refers to heavy manual work with vibrating tools, or other highly repetitive tasks even if they involve low- force motions, and also possibly work in cold temperatures.
Other people at risk include those who work repeatedly on a computer, such as typists and customer service representatives who deal with key entry, as well as grocery line workers, packers in the meat and fish industry, musicians, and mechanics, as their work entails gripping with their wrist bent.
For the same reason, we see many patients whose CTS has developed as a result of hobbies such as gardening, needlework, golfing, and canoeing.
Pregnancy is another co-morbid factor for CTS, and smoking has also been found to contribute to CTS as it limits the blood flow to the median nerve.
CTS is more commonly found in women than men. In the US, it has been noted that three in 100 men and five in 100 women experience CTS at some point in their lives. CTS is typically increased with age; however, it can affect all ages.
In addition, it is known to be hereditary, which suggests that the origin is likely to be genetic.
Carpal Tunnel Syndrome may more often be caused by trigger points than by anatomical or structural malformations.
The muscle tension created by trigger points will frequently compress nerves as they travel in the neck, shoulder, and forearm regions, and produce the symptoms commonly associated with these upper limb disorders.
There are a number of muscles that can contain trigger points that produce wrist pain and/or numbness in the hand or fingers. The following four muscles are the most commonly involved.
About NAT Courses
As a manual therapist or exercise professional, there is only one way to expand your business - education!
Learning more skills increases the services that you offer and provides more opportunity for specialization.
Every NAT course is designed to build on what you already know, to empower you to treat more clients and grow your practice, with a minimal investment in time and money.
About Niel Asher Education
Niel Asher Education is a leading provider of distance learning and continued education courses.
Established in the United Kingdom in 1999, we provide course and distance learning material for therapists and other healthcare professionals in over 40 countries.
Our courses are accredited by over 90 professional associations and national accreditation institutions including the National Academy of Sports Medicine (NASM) and National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). Full details of all international course accreditations can be found on our website.
Printed course materials and other products offered on our websites are despatched worldwide from our 3 locations in the UK (London), USA (Pennsylvania) and Australia (Melbourne).
NAMTPT AWARD 2017
We are honored to have received the 2017 "Excellence in Education" Award from the National Association of Myofascial Trigger Point Therapists.
Since 1999 Niel Asher Education has won numerous awards for education and in particular for education and services provided in the field of trigger point therapy.
Award Winning Instructors
Niel Asher Healthcare course instructors have won a host of prestigious awards including 2 lifetime achievement honorees - Stuart Hinds, Lifetime Achievement Honoree, AAMT, 2015, and Dr. Jonathan Kuttner, MD, Lifetime Achievement Honoree, NAMTPT, 2014.
If you are a qualified/licensed manual therapist or exercise/fitness professional you can expand your credentials with NAT certification.
In addition to national accreditation for continued education, each course that we offer includes "NAT Learning Credits". By taking and completing courses you can accumulate NAT credits to qualify for NAT certification.
There are currently 3 levels of NAT certification. Certifying NAT is a valuable way to show your clients that you take continued education seriously, and to promote your skills and qualifications.
NAT courses are accredited for continuing education by over 30 professional associations in North America, United Kingdom, Australia, and European Union countries. These include The National Academy of Sports Medicine, Physical Therapy Board of California, AAFA, National Certification Board for Manual Therapists and Bodyworkers, Sports Therapy Institute, and Myotherapy Australia.
Niel Asher Technique
Since 1999 the Niel Asher Technique for treating trigger points has been adopted by over 100,000 therapists worldwide, and has been applied to the treatment of a number of common musculoskeletal injuries.
The Niel Asher Technique for treating frozen shoulder was first introduced and published in 1997 and has been widely adopted by therapists and exercise professionals working within elite sports and athletics.
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This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.
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