Non-Surgical Treatment for CTS

Carpal tunnel syndrome (CTS) is basically a pinched nerve on the palm side of the wrist. It is very common and symptoms can vary from periodic tingling to a debilitating disorder that can stop activities at home and work. The cause is usually gradual due to repeated movements, especially fast paced motions such as prolonged practicing of a musical instrument, typing, various hobbies (knitting, crocheting), as well as fast paced and/or firm gripping when assembling products on a line at work. Initially, symptoms can include tingling or numbness that gradually increases in frequency, intensity and duration followed by weakness in pinch or grip.

Because the symptoms can slowly and gradually appear, most people wait a while, sometimes years, before they seek treatment for CTS. It is important to recognize the initial signs and properly manage the condition AS EARLY AS POSSIBLE to avoid a potentially disabling CTS condition. Early treatment may be minimal and only require learning proper exercises or making minor activity modifications.

The following is a list of symptoms that should warn you to seek treatment for CTS: sleep interruptions due to numb hands/fingers (usually the 2nd, 3rd, and 4th fingers), the need to shake or flick your fingers, numbness with driving/holding onto the steering wheel, difficulty in buttoning clothing, dropping objects/weak grip or pinch, age over 50 (with these symptoms), and others. If you have other conditions such as diabetes, thyroid disease, obesity, hormone replacement/birth control pills or are pregnant, CTS is more common.

When you arrive at our clinic, we will conduct a thorough history and physical exam to determine if you are a candidate for non-surgical care. Treatment will include, along with restoring motion to the joints affected by the condition, advice on sleep (such as the use of a wrist splint at night), job/work station modifications (include working with your employer), teaching of exercises so you can help yourself in the treatment process, and other education approaches to help you avoid future episodes of CTS.

Because of the gradual onset of symptoms including finger numbness, wrist pain and/or loss of joint motion, the elbow, shoulder and neck often become affected and require treatment and exercise in order to obtain a good result. One exercise for stretching the forearm is performed by placing the palm of your hand on a wall in front of you (fingers pointing downward) while keeping your elbow straight. Then, reach over with your opposite hand, grasp your thumb and pull it back until you feel a “good stretch” in your forearm. Other exercises to the shoulder and neck may be appropriate and can be discussed. Most importantly, don’t wait too long after symptoms start! The faster you present to our office, the better the outcome of treatment will be.

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