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Carpal Tunnel Syndrome

Definition
Wrist- croppedThe carpal tunnel is a narrow, rigid passageway of ligament and bones at the base of the hand which houses the median nerve and tendons. Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist. This can be caused by thickening from irritated tendons through overuse, or from a more traumatic cause which results in swelling that narrows the tunnel and causes the median nerve to be compressed. Compression of the nerve can even result from fluid retention during pregnancy.

Signs and Symptoms

  • Numbness, burning and pins and needles in fingers and hand, especially thumb, index and middle finger
  • Weakness in the hand and wrist.
  • Difficulty with doing up buttons and opening jars etc.
  • Often first presents as numbness or tingling at night or on waking in the morning

Management
Your Physiotherapist at Advantage Healthcare and Physiotherapy will perform a thorough examination to determine the cause and severity of the injury. Treatment of carpal tunnel will include correcting the fault that caused the injury, reducing local pain and inflammation and a suitable exercise program as part of your rehabilitation.
If conservative management fails to make an improvement, your physiotherapist will send you for review, and possible further investigation under the care of your GP. This may include nerve conduction studies and a cortisone injection. Really persistent cases may require surgical intervention.

De Quervain's Tenosynovitis

Definition
De Quervain's tenosynovitis is a painful inflammation of the tendons located on the thumb side of the wrist. These tendons are responsible for straightening the thumb and the pain is caused by inflammation of the synovial sheath that the tendons pass through as they cross the wrist into the hand.

Signs and Symptoms

  • Local tenderness and swelling on the base of the thumb
  • As the condition progresses the tendons may creak as they move through the tunnel (crepitus)
  • Left un-treated the pain may spread into the hand and up along the arm

Management
Physiotherapy treatment, at Advantage Healthcare and Physiotherapy, includes splinting, local electro-therapeutic modalities, acupuncture, stretches and a graduated strengthening program.

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