Hand and wrist complaints

Carpal Tunnel Syndrome is essentially a pinching of a nerve in the wrist (the median nerve). At the wrist joint, this nerve runs in the middle and in the center of the lower arm. The nerve is surrounded by a number of muscle tendons (the finger flexor tendons) which together run through a narrow canal formed by carpal bones and the aponeurosis between the pinky and the base of the thumb. When this nerve gets pinched in this tunnel it is referred to as Carpal Tunnel Syndrome.

Complaints:

Symptoms generally include a numb, pins and needles-like or painful feeling at the palm of the hand. There may also be loss of strength in the hand, especially of the flexor muscles of the fingers and the thumb. In many cases, there is an increase in symptoms (pain) during the night. ‘Shaking it out’ with the hands is a common phenomenon in an attempt to alleviate the pain in patients with (starting) CTS.

Causes:

(Tendon) swelling: Possibly due to overload, vibration, repetitive movements.

Pregnancy: Hormonal changes

Rheumatoid arthritis: Inflammation/formation of soft tissue

Trauma: Anatomical abnormalities of the bone/position of the wrist after a fall, for example.

Diabetes: Is a risk factor.

Assessment:

Using diagnostics, the OMT will be able to determine whether you have Carpal Tunnel Syndrome. Following the diagnosis, we will determine what is causing your complaint. If there is a serious impingement of the nerve, an operation might be indicated (Carpal tunnel release). In many cases, proper treatment can help you avoid getting an operation. If an operation has already taken place, manual therapy is also indicated in order to avoid post-operative complications.

Treatment:

Postural/ergonomic advice for home and/or at work.

Optimizing wrist mobility and the kinetic chain of the affected arm.

Optimizing nerve and tendon mobility.

Using traction and other local treatment techniques on the affected joint.