Carpel Tunnel Syndrome
What is Carpel Tunnel Syndrome?
When the median nerve which runs from forearm in to the palm of the hand gets pressed at the wrist, carpal syndrome occurs. Median nerve is responsible for the sensations at palm side of the thumb and fingers. It also controls impulses to small muscles in the hand that allow the fingers and thumb to move. The narrow passage which house median nerve and tendons is called the carpel tunnel. When the tendon get irritated it thickness and as a result the median nerve is squeezed between the tendons. Other causes can also lead to swelling and narrowing of the carpel tunnel. This may result in pain, weakness or numbness in hand and wrist, which radiates to upper arm.


What are the symptoms?
Symptoms may include frequent burning, tingling or itching numbness in the palm of the hand and the fingers, especially the thumb, index and middle fingers. Since people sleep with flexed wrist, they may feel the symptoms at night. As the symptoms get worsened, they may feel the tingling sensation during the day. Symptoms may also include decreased grip strength and in chronic cases people are unable to tell between hot and cold as the muscles at the base of the thumb may waste away.
What are the causes?
It can be a combination of factors that causes the carpel tunnel to get narrower and thus putting pressure on the median nerve and tendons rather than the problem with the nerve itself. It can be due to congenital predisposition, which means that the carpel tunnel can be smaller in some people compared to others. Other contributing factors may include trauma or injury to the wrist that cause swelling (sprain or fracture),over activity of pituitary gland, hypothyroidism, rheumatoid arthritis, mechanical problems in the wrist and joint, work stress, repeated use of vibrating hand tools, fluid retention during pregnancy or menopause or development of a cyst or tumor in the canal. Poor ergonomics and improper positioning of wrist can also contribute to Carpel Tunnel Syndrome.
 Who is at risk?
Women are more susceptible of getting carpel tunnel syndrome when compared men as their carpel tunnel are smaller. Person with diabetes or other metabolic disorders are at high risk of getting carpel tunnel syndrome as it affects the nerves .Usually; carpel tunnel syndrome is more common in adults. People who tend to work on computers for a long period of time like college students, business men, computer programmers are also at risk.
Physical Therapy Treatment for Carpel Tunnel Syndrome
Physical therapy helps you to reduce symptoms as well as help you to get back to normal activities. The therapy program may include education regarding changing wrist positions, proper neck and upper posture, safe use of utensils, tools or other implements, importance of stretch breaks in daily routine etc. Your physical therapist will recommend you exercise which strengthen muscles in your hand, finger forearm and also trunk and postural back muscles in some cases. Stretching exercises to improve the flexibility of the wrist hand and fingers and included in the regime. A physical therapist may also use modalities such as hot packs, cold packs and ultrasound to relieve pain. They may also prescribe you with home exercise program (HEP).Only an experienced physical therapist can do the correct evaluation and guide you through a proper rehabilitation program.
References
Carpal Tunnel Syndrome Fact Sheet. (n.d.). Retrieved July 01, 2013, from National Institue of Neurological Disorders and Stroke: http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm
Physical Therapist's Guide to Carpal Tunnel Syndrome . (n.d.). Retrieved July 01, 2013, from Move Forward: http://www.moveforwardpt.com/symptomsconditionsdetail.aspx?cid=9f3cdf74-3f6f-40ca-b641-d559302a08fc