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- The goals of therapy for a patient who comes in
preoperatively with carpal tunnel symptoms is first,
to try to decrease their symptoms
both during activity and at night.
Second is to increase their independance
with their daily activities and their work activities.
Three is to provide the patient with modifications
and adaptive equipment for at wotk or at home.
And four is to make sure that patient is independent
with their home program and the
adaptations you have given them.
When they come in for therapy,
we get a comprehensive background on
their medical history, the history of their illness.
Find out which activities are bothering them.
I assess their range of motion, their strength, sensation.
Based on what their limitations are,
set goals for that patient from there.
Typically people are not coming in with
significant limitations in range of motion or in strength,
it's typically sensory problems.
So that is addressed by changes in their lifestyle
or sleeping patterns and things like that.
Typically splinting for people with carpal tunnel syndrome
involves a static wrist splint.
We typically tell people to start with
wearing the splint at night time during sleep,
because that's the most common time
when people are assuming those bad postures.
These are available commercially in drug stores.
Physicians offices cary them.
We give them out to patients here.
This is an example of the one we carry here,
but there's a lot of different varieties of them.
The goals of therapy for a patient after surgery are one,
make sure the patient is independent
with their home program and can perform their exorcises
on their own after they're finished seeing us.
Two, to increase the motion of their hand
and their wrist and their thumb to within
normal limits of the opposing hand.
Three, increase their strength to a functional level
so that they're independent with their daily activities.
Four, make sure the patient is able to manage their scar
and continue with management of the scar
beyond when they're in therapy.
So the exercises after carpal tunnel surgery
are typically given to our patients prior to surgery.
When they set up their appointment for surgery,
they're given a packet of exercises and told
to initiate those right after surgery.
The sooner they can move, the better.
Exercises that we typically give people
include tendon gliding exercises.
The purpose of tendon glides is to allow
the tendons that travel through the carpal tunnel
to glide through that space so that
they do not adhere to the scar tissue,
which can interfere with mobility and cause pain.
A second exercise that we give people
is called the median nerve gliding exercise.
Serves the same purpose as the tendon gliding exercise
in that it allows the nerve that travels through that space,
to glide through the carpal tunnel, to prevent scarring.
I'll also instruct people on Theraputty exercises.
I will instruct them to not initiate that
typically until after their sutures are removed.
And it's a series of different exercises
to work on regaining their strength,
which is sometimes lost when you're dealing with
carpal tunnel syndrome over a period of time.
I instruct every patient to initiate scar massage
as soon as their sutures are removed
and the Steri-strips fall off.
And I instruct my patients to perform it
once or twice a day, for a few minutes,
with a little bit of aggressive motion on the scar,
and for as long as they can stand to do it.
Six months to a year is still beneficial.
The patient role in carpal tunnel rehab
is important, as it is with every surgery.
If a patient is compliant with their home program,
they're certainly gonna see a better
result after surgery and sooner.
- Carpal tunnel syndrome is a common source
of numbness and tingling afflicting your hands and fingers.
If you think you have carpal tunnel symptoms,
try a few simple modifications to relieve your symptoms.
These modifications include keeping you wrist
straight at night and avoid bending them down.
This puts compression on that median nerve
and this causes numbness and tingling.
You can wear a splint at night to keep them straight.
You can keep proper wrist alignment
with your daily activities.
This will minimize the pressure on that median nerve.
And try limiting activities that require
repetitive motions and heavy grasping.
Well if these modifications don't relieve your symptoms,
it's important to seek treatment.
An early diagnosis and treatment ensures
the best recovery possible.
There are a wide range of treatment options available
if you're diagnosed with carpal tunnel syndrome.
If you do need to undergo a carpal tunnel release,
the latest surgical techniques involve very small
incisions and have a very quick recovery time.
At Coordinated Health, we work as a team
to diagnose and treat your symptoms,
and you're a key member of that team.
And that's The Art of Medicine.
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