Carpal tunnel is usually diagnosed when a patient reports that they have numbness along the median nerve distribution in their fingers, most commonly on one side.
When accurately diagnosed the median nerve becomes compressed through the carpal tunnel causing numbness. This is found by nerve conduction studies to see if nerve conduction in the fingers is being comprimized.
We want to make sure you are correctly diagnosed before subjecting yourself to a carpal tunnel surgery.
The median nerve may become entrapped as it passes through:
- The Ligament of Sruthers
- Only 10% of the population has this.
- It's a ligament that attaches from the inside elbow to the humerus.
- This is directly over the median nerve.
- Inflammation can often put pressure on the median nerve and refer numbness into the fingers.
- Pronator Teres
- This muscle can be found just below the elbow crease.
- This is a muscle that is activated when typing or using a mouse.
- The muscle can cause chronic irritation of the median nerve.
Humans were meant to move. We have opposable thumbs making us incredibly talented with our hands. Like most muscluloskeletal dysfunctions, repetitive stress causes the most disruption. Often times, activities such as:
- Playing guitar
- Lifting or carrying something heavy
- Feeding or holding infants
Many activities put stress and tension on the muscles involved with the median nerve. Numbness alone doesn't always mean carpal tunnel syndrome.
Knowing anatomy is absolutely the most important component to ruling out median nerve pathologies.
Understanding the mechanism and actions of the muscles helps paint the story.
We find the chronicity of the ailment, including date and time: Is it worse when you wake up? Is it worse after work?
These types of questions get us to the action of muscles that could be irritating the nerves involved in the area.
Then we can begin strengthening opposing muscles and decreasing tension of chronically tight and overworked muscles.
The chronicity significantly affects the outcome, and acute pain usually goes away faster than chronic pain. However, the treatment is relatively similar.
Like most musculoskeletal disorders, we must identify the movement causing the pain and then adapt to create an effective treatment plan.
- Modify the movement that's provoking the pain.
- Lengthen chronically tight and irritated muscles.
- Using isometric exercises often decreases the perceived threat.
- Myofascial release employing
- Strength the opposing muscle group with exercises on the forearm.
- Perform stretches and glides that mobilize the median nerve.