Most cases of CTS can be effectively treated with manual therapy and self managed care.
The carpal tunnel is located on the palm side of your wrist. Its main role is to protect the most important nerve to your hand and the nine tendons that help bend your fingers. When this nerve is compressed, it causes numbness, tingling and eventually hand weakness.
Various factors can contribute to the development of Carpal Tunnel Syndrome including the anatomy of your wrist, underlying health problems, and patterns of repetitive hand use.
Carpal Tunnel Syndrome and Trigger Points
Most cases of CTS can be effectively treated with manual therapy. This typically includes treating trigger points in the scalenes, trapezius, triceps, and the wrist flexors and extensors.
Stretching is an important part of the rehabilitation process and should begin as soon as pain allows and be continued throughout the rehabilitation program and beyond - good maintenance prevents re-injury.
The following program comprises muscle stretching (muscles of the forearm) as well as neural stretches, and is typical of the type of program that your therapist may recommend.
Use common sense when stretching or performing any exercises at home. Start slowly and stop if you feel more pain than you feel comfortable with. Even simple stretching exercises can be dangerous if performed incorrectly. It's always best to seek professional advice.
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Neural Stretch (for ulna nerve)
The ulnar nerve runs very close to the medial epicondyle (bony bit on the inside of the elbow), and may become trapped by scar tissue.• Adopt the position shown above
• The stretch can be increased by placing something under the elbow to raise it up, which increases the amount the upper arm is lifted relative to the shoulder
Hold stretch for 5 seconds, repeat 5 times and aim to stretch at least 3 times a day
• With one hand, gently take the opposite hand
• Pull slightly to the opposite side
• At the same time, gently bend neck to the side - with forehead pointing down
• The neck should be bent to the side that the arm is pulling to
• Sit up straight in a chair. Sit to the front, not against the back of the chair. Sitting up will help you to strengthen the muscles you need for good posture
• Think of lifting the crown of your head to the ceiling. Be careful not to tip the head back. Your chin should be parallel to the floor
• Without tipping the head in any direction, pull your chin and head straight back. You will feel a stretch in the back of your neck
• Start with your palms together in front of your chest, just below your chin
• Slowly lower your hands towards your waistline
• Keep your hands close to your stomach and your palms together, until you feel a mild to moderate stretch under your forearms
• Hold the arm straight out before you with the palm facing outwards
• With the opposite arm, pull fingers towards you for maximal stretch
Hold stretch for 20-30 seconds and repeat 3 times, twice daily
• Bend your fingers so that they are facing downwards
• With your opposite hand gently pull the fingers back towards your torso.
Hold for 20-30 seconds and repeat 3 times, twice daily
• Hold position for two seconds, then lower
Repeat 30 times, twice daily
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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