Carpal Tunnel Syndrome
Description
Carpal Tunnel Syndrome (CTS) is the most common upper extrememity nerve entrapment disorder. The median nerve becomes trapped in the fibro-osseous tunnel at the wrist. Objective findings generally include positive provocation tests, such as Tinel’s, Phalen’s, and Upper Limb Tension Test. There are a number of conditions that increase a person’s risk of developing CTS. (Congenital predisposition: the carpal tunnel space is smaller is some individuals; disease: diabetes, rheumatoid arthritis; female gender; occupation: jobs requiring use of vibratory tools, assembly workers, seamstresses; pregnancy)
Signs & Symptoms
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Diagnostic Tests
-Tinel’s Test (sensitivity .60 & specificity .67) -Upper Limb Tension Test |
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PT Implications
Conservative
- Included splinting, anti-inflammatory medications, corticosteroid injections, and physical therapy.
- Physical therapy and occupational therapy is involved in educating patients about activity and workplace modifications.
- Physical therapy exercises typical include stretching and strengthening upper extremity musculature.
- Surgery is usually used as a last resort after conservative therapy has failed.
- The goal of surgery is to reduce pressure on the median nerve; allowing the nerve and tendons to glide with more ease.