What is carpal tunnel syndrome and what are the symptoms?
Carpal Tunnel is the most prevalent nerve entrapment injury for adults; presenting in 3-6 percent of the general population (ClareHarrisabKarenWalker-Bone, 2015). There are a variety of symptoms depending on the severity of median nerve compression. Common indicators include numbness, pins and needles and in more severe cases weakness in grip and pinch strength (William J. Molinari, 2018).
What are the different types of surgery that can be performed to treat carpal tunnel syndrome?
Due to the numerous symptoms the allied health profession has a variety of treatment options depending on the severity of neural compression.
In more severe cases where conservative management has failed surgery is recommended (Jennifer Wipperman, 2016). One of the more common procedures is an open carpal tunnel release, this procedure involves releasing the transverse carpal ligament in order to decompress the median nerve as it passes through the carpal tunnel (Jeremy D. P. Bland MB, 2007).
What are the costs associated with surgery?
Nonetheless, the medical profession recognises the simultaneous occurrence of carpal tunnel syndrome with more proximal nerve injuries.
This occurrence has been labelled as “double crush injuries”. It is the theory that there are multiple points of compression along a peripheral nerve that can coexist and synergistically increase symptom intensity (Kane, Daniels, & Akelman, 2015).
This theory has emerged due to findings in a small population of post operative clients that have ongoing symptoms or the return of their carpal tunnel despite having surgery (Kane, Daniels, & Akelman, 2015).
Is there anything else that can be done to relieve the symptoms of carpal tunnel syndrome?
Neck pain is one of the more common coexisting symptoms, generally stemming from cervical radiculopathy (C. S. Chow, 2005). Further imaging or electrodiagnostic studies can often determine if there is a cervical radiculopathy. Irrespective of neck pain carpal tunnel release surgery may still be indicated due to the severity of the neural compression at the wrist joint (Jennifer Wipperman, 2016).
Nonetheless, as the cervical plexus of nerves divide into the median nerve it is reasonable to assume there may be a connection (ClareHarrisabKarenWalker-Bone, 2015).
Due to this anatomical connection there is evidence to support physiotherapy in managing carpal tunnel clients and treating more proximal weaknesses in conjunction with hand therapy focussing on the wrist.
The Pilates method continues to gain recognition for managing neural conditions (Bohlander, 2014). Through the combination of mobility, strengthening and stretching exercises a physiotherapist can tailor an exercise program to an individual and address entire neural systems.
When evaluating the research, the author considers it essential to complete a full body assessment before proceeding with carpal tunnel surgery. This will ensure more proximal injuries are not missed and can be co-managed.
Final thoughts on Carpal tunnel surgery
Carpal tunnel syndrome is a condition that affects the hands and wrists. The symptoms can be managed through different types of surgery, but there are risks associated with these surgeries.
Recovery time varies depending on the type of surgery performed, and the costs can range from several hundred to thousands of dollars.
There are other options available for those who do not want or cannot undergo surgery, such as physiotherapy. Although more research is needed to confirm its efficacy, physiotherapy may be a viable option for managing carpal tunnel syndrome.
If you are experiencing symptoms of carpal tunnel syndrome, please speak to your doctor about the best treatment options for you or book online with Action Rehab today for a second opinion.
Bohlander, V. G. (2014). Therapeutic Pilates: Applications. Berlin: Springer.
- S. Chow, L. K. (2005). IS SYMPTOMATOLOGY USEFUL IN DISTINGUISHING BETWEEN CARPAL TUNNEL SYNDROME AND CERVICAL SPONDYLOSIS? Hand Surgery, 1-5 .
ClareHarrisabKarenWalker-Bone, L. N. (2015). Carpal tunnel syndrome and work. Best Practice & Research Clinical Rheumatology, 440-453.
Jennifer Wipperman, M. M. (2016). Carpal Tunnel Syndrome: Diagnosis and Management. American Family Physician, 993-999.
Jeremy D. P. Bland MB, C. (2007). Treatment of carpal tunnel syndrome. Muscle & Nerve , 167-171.
Kane, P. M., Daniels, A. H., & Akelman, E. M. (2015). Double Crush Syndrome. Journal of the American Academy of Orthopaedic Surgeons, 558-562.
William J. Molinari, I. M. (2018). The Double Crush Syndrome. the Journal Of Hand Surgery , 799-801.