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Occupational Therapy Treatment Of Carpal Tunnel Syndrome

Carpal Tunnel Syndrome Part 4 Rehab Prevention

(soft music) The goals of therapy for a patient who comes in preoperatively with carpal tunnel symptoms is first, to try to decrease their symptoms both during activity and at night. Second is to increase their independance with their daily activities and their work activities. Three is to provide the patient with modifications.

And adaptive equipment for at wotk or at home. And four is to make sure that patient is independent with their home program and the adaptations you have given them. When they come in for therapy, we get a comprehensive background on their medical history, the history of their illness. Find out which activities are bothering them.

I assess their range of motion, their strength, sensation. Based on what their limitations are, set goals for that patient from there. Typically people are not coming in with significant limitations in range of motion or in strength, it’s typically sensory problems. So that is addressed by changes in their lifestyle or sleeping patterns and things like that.

Typically splinting for people with carpal tunnel syndrome involves a static wrist splint. We typically tell people to start with wearing the splint at night time during sleep, because that’s the most common time when people are assuming those bad postures. These are available commercially in drug stores. Physicians offices cary them.

We give them out to patients here. This is an example of the one we carry here, but there’s a lot of different varieties of them. The goals of therapy for a patient after surgery are one, make sure the patient is independent with their home program and can perform their exorcises on their own after they’re finished seeing us. Two, to increase the motion of their hand.

And their wrist and their thumb to within normal limits of the opposing hand. Three, increase their strength to a functional level so that they’re independent with their daily activities. Four, make sure the patient is able to manage their scar and continue with management of the scar beyond when they’re in therapy. So the exercises after carpal tunnel surgery.

Are typically given to our patients prior to surgery. When they set up their appointment for surgery, they’re given a packet of exercises and told to initiate those right after surgery. The sooner they can move, the better. Exercises that we typically give people include tendon gliding exercises. The purpose of tendon glides is to allow.

Top 3 Exercises for Carpal Tunnel Syndrome

This is the Top 3 Exercises for Carpal Tunnel Syndrome. Carpal tunnel syndrome involves a nerve called the median nerve. The median nerve starts at C5 to T1 which is right here. So about the middle lower part of your neck. The nerve travels down your arm, down the front of your arm, in front your elbow and into the hand. It innervates or gives sensation to the thumb, index finger, middle finger and half of the ring finger. So that is your median nerve. That is the nerve that is problematic in carpal tunnel syndrome. The carpal tunnel is right here. So carpal means wrist bones. There is actually a little tunnel formed with a little sheath over top where that median nerve goes.

Through. People with carpal tunnel syndrome what they will see is they will have numbness in that area. Then this area right here in the thumb is called the thenar eminence, that area will begin wasting away. What happens is frequently that is becoming pinched here. Also what can happen is you can get pressure on the median nerve in the neck, in this area right here especially with an elevated first rib. It can also happen down the arm as well. So these are the top 3 exercises that we do for carpal tunnel syndrome. Frequent problems are this. This movement right here. If that is painful or causes numbness or tingling into your hands especially into this area, that is.

Carpal tunnel. That is called Phalen’s or reverse Phalen’s test. Exercise 1 that we do for carpal tunnel syndrome. To stretch the median nerve, you do palm up, hand down, elbow straight. You should feel a stretch right through here. Then what you can do is take your ear to the opposite shoulder. So you head is going away from you hand. In the we do a 30 second hold. As people get more advanced, they put their hand on the wall and lean the opposite way. 30 second hold, 3 times. Another thing that we do is a something called a median nerve release and it goes like this: Hand stretched out, make a fist, first. Hold it for 5 seconds. Hand out straight,.

Hold 5 seconds. Make almost like a puppet position, hold 5 seconds. Palm up, hold 5 seconds. Reach underneath, grab the thumb, pull back, hold 5 seconds. That is exercise 2. Frequently we will have people go through that 2 or 3 times. Exercise 3 is called a first rib stretch. What we do is this: we take a towel, if I have carpal tunnel on the right side, and I have some sort of tightness right here in what is called the brachial plexus but basically right here, this area. If somebody has carpal tunnel and they are going like this a lot especially if they are a rightsided sleeper, this is an area that we want to address. You can get carpal tunnel symptoms from pressure.

On the median nerve right here. It is frequently missed even with an xray or an MRI. What we do is we put the towel directly on this area which your first rib is right here. The towel is over top of your shoulder, pull down, one arm in the front, one hand in the back. Then you lean the opposite direction. You are going to feel a really nice stretch right through here. In the here, we do a 30 second hold, 3 times. That is the top 3 exercises for carpal tunnel syndrome.

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