Thursday, November 22, 2007

Carpal Tunnel Syndrome and Manual Therapy

What is Tunnel Carpal Syndrome?
Carpal tunnel syndrome (CTS) is a condition in which the median nerve in the wrist is compressed. This causes numbness and pain in the fingers and hand.

What is going on in the body?
A ligament and the bones at the base of the palm of the hand, just beyond the wrist, form the carpal tunnel. Through this tunnel passes the median nerve and tendons going to the fingers and thumb. The median nerve conducts sensation from the palm side of the thumb and fingers, except for the little finger. It also carries impulses to small muscles in the hand, particularly at the palm side of the base of the thumb. If the pressure in the carpal tunnel increases enough, the median nerve is compressed.

What are the causes and risks of the condition?
CTS can be caused by anything that increases pressure on the nerve in the carpal tunnel. CTS has been associated with repetitive stress injury. This type of injury occurs when a part of the body is used repeatedly or overused. People who use computers or vibrating tools are at particular risk. Factory workers on assembly lines, or those who do repeated actions involving the wrist, may develop CTS.

Exercises for relief from Carpal Tunnel Syndrome
While you are receiving treatment for Carpal Tunnel Syndrome regular exercise sessions can help your rapid recovery. We have included some photos and explanations of recommended exercises.
The following exercises may be prescribed by your healthcare provider in conjunction with Low Level Laser therapy. In the photos you will see below, the right wrist is the one being exercised. If your left wrist is affected, do the same exercises with the left hand.

When doing each of these exercises, the hand should be flexed until a sensation of stretching is felt in the arm. The position should be held for 10 to 15 seconds for each of 10 repetitions. Try to this set of exercises three times a day.
Exercises 1 and 2 flex and extend the hand and stretch the wrist. Bend the hand as shown in the photos and apply moderate pressure to it with the other hand.

Exercise 1 - Wrist Flexion Bend the hand being exercised backward ( palm away from you ), as shown in the photos. With the fingers of the other hand, apply pressure.

Exercise 2 - Wrist ExtensionBend the hand being exercised forward ( palm toward you ), as shown in the photos. With the fingers of the other hand, apply pressure.
Exercises 3 and 4 are similar to 1 and 2 except that an object, such as a pad provides the resistance to the hand, instead of your other hand.

Exercise 3 - Wrist Flexion against surfaceWith your arm held vertically, press your hand, palm down, on a firm surface, as shown in the photo.

Exercise 4 - Wrist Extension against surfaceWith your arm held vertically, press your hand, palm up, on a firm surface, as shown in the photo.
Exercises 5 and 6 involve the side to side range of motion of the hand.

Exercise 5 - (Radial Deviation)Place your hand palm downward. Grasp the fingers of the hand to be exercised with your other hand (as shown in the photo) and twist the hand toward you. Keep the hand horizontal.

Exercise 6 - (Ulnar Deviation)Place your hand palm downward. Grasp the fingers of the hand to be exercised with your other hand (as shown in the photo) and twist the hand away from you. Keep the hand horizontal.

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