Carpal Tunnel Syndrome (CTS) is a condition where there is excessive pressure on the median nerve. This can be caused by swelling in the carpal tunnel and/or thickening of the transverse carpal ligament, which forms the roof of the carpal tunnel. There may be different factors causing this condition. You should consult a physician or health care provider to determine the cause or causes. Symptoms of Carpal Tunnel Syndrome (CTS) include pain, numbness or tingling in the thumb, index, middle and part of the ring finger. This image depicts the location of the problem in the carpal tunnel. Click on the image to see a larger view.

Most wrist braces treat Carpal Tunnel Syndrome (CTS) and Repetitive Strain Injuries (RSI) by simply immobilizing the wrist at a fixed angle. My experience as a physical therapist treating thousands of patients has taught me that the majority of people will not find these types of braces comfortable or practical to work with. By immobilizing the wrist the wearer will usually start developing elbow or shoulder pain due to compensating for lack of motion at the wrist! They also can't be worn while playing sports or while doing most arts and crafts activities. See how the Tunnel Tech® Wrist Brace treats CTS and RSI by clicking here: How it Works.

Physical therapy treatment for CTS and RSI may include the following procedures and/or modalities: Ultrasound, hot or cold packs, Electrical Stimulation, Iontophoresis (transmission of medication through the skin using direct electrical current), therapeutic massage, joint mobilization/manipulation, myofascial release techniques, therapeutic exercise and ergonomic modifications. The initial evaluation in physical therapy should include a review of the history of the individual's symptoms, including identifying anything that brings on or worsens symptoms as well as anything that fully or partially relieves symptoms. Range of motion, flexibility, strength and general posture are just some of the things that should be evaluated by the physical therapist. Generally treatments should be 2-3 times per week. The duration of treatment can be quite variable depending on the severity of symptoms, whether they are chronic or acute, and if there are other musculoskeletal factors that would cause the individual to respond to treatment more slowly.

Some tests that your doctor or physical therapist might conduct include the following:

Tinel's sign: The doctor or therapist will tap along the forearm and wrist over the median nerve. A positive test is when the patient experiences pain, tingling or numbness over the wrist and/or into the median nerve distribution in the hand.

Phalen's test: The doctor or therapist will ask you to raise your arms and put the backside of your hands together so the fingers point towards the floor. This causes your wrists to fully flex and may compress the median nerve and reproduce your symptoms. The test position is usually held for 60 seconds or until symptoms are reproduced, whichever occurs first.  

Some studies suggest that Phalen's test is more specific for the diagnosis of Carpal Tunnel Syndrome than the Tinel's sign.

CTS & RSI News:

Five factors have been identified that can predict your response to conservative treatement (splinting and medication):

• Age greater than 50 years
• Symptoms lasting more than 10 months
• Constant numbness and tingling
• Stenosing flexor tenosynovitis
• Positive Phalen's test in less than 30 seconds

If four or five of the above apply, conservative treatment is not likely to address the problem (Kaplan, et al, Journal of Hand Surgery, 15B)

For an interesting new treatment approach to RSI called mirror therapy click here: http://www.newscientist.com/article.ns?id=dn8246  or copy and paste this link into your browser window.