I'm going to try to answer some of the most common questions I get, and explain how massage, stretching and jointy mobilisation can help.
What is CTS?
The median nerve does not affect the little finger, so if you are feeling sensations in your little finger it is not a symptom of CTS, it could be bursitis or tendonitis.
How did I get CTS?
1. Any activity that can cause inflammation of the tendons in the Carpal Tunnel can cause CTS symptoms. Contrary to what people think, CTS is mostly a congenital disoder. The carpal tunnel is just smaller on some people, which causes more problems.
2. People with conditions such as diabetes, rhumatoid arthritus, pituitary gland issues and Hypothyroidism can be affected because they make the body's nerves more susceptible to compression.
3. Incorrect wrist angles is another common cause. For example prolonged and incorrect use of the computer mouse. Cyclists often get CTS because of prolonged holding on to the handebars at an angle that put pressure of the nerve, and the shocks of uneven terrain on the wrist. Massage therapists often complain of CTS due to extensive palm and finger work on clients at the wrong wrist angle. People in the cleaning, sewing and manufacturing industries are also affected.
4. Fluid retention during pregnancy or menopause - the oedema can put pressure on the median nerve.
What tests can be done to indicate presense of CTS?
1. Tinel test - doctor or therapist taps on the medial nerve - The test is positive when tingling in the fingers or a resultant shock-like sensation occors.
2. Phalen/Wrist Flexion test
How do I treat CTS? Can I get rid of it?
1. If necessary treatment of the underlying conditions first - in the case of diabetes or arthritis
2. Coolpacks can help reduce swelling in the clase of acute CTS
3. Rest of the wrist, including splinting
4. Massage - for client with CTS, local massage over the wrist is contraindicted however there are massage treatments that can be used to alleviate pain: elevate the arms and do some lymphatic drainage; moist heat to the area can help soften and allow stretching of the area; passive movements of the wrist, elbow and finger joints improve joint range of motion; massage to the neck, shoulder, chest and arms is essential; a massage client can help identify risk factors such as improper arm-wrist angles and excessive flexion or extention.
5. Acupuncture and chiropractor have been known to help
6. Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and other nonprescription pain relievers, can ease symptoms that have been present for a short time or have been caused by strenuous activity.
7. Surgery is an option if the symptoms persist after 6 months and all other forms of treatment have been eliminated. It is a very common procedure that severs the carpal ligament to release pressure on the median nerve. However full recovery can take months.
1. Regular massage of forearms, arms and neck
2. Keeping wrists neutral while working (using a splint if necessary)
Some exercises that may help:
- warm up hands by vigorously rubbing hands and fingers together
- press palms together at chest level with fingertips pointed upwards. Quickly rotate forward until fingers are pointed downwards towards the toes. Then reverse the action. This motion should be quick and vigorous.
- wrist circles
- Ball squeeze - place a tennis or golf ball in your hand and wrap your fingers around it. Squeeze hard for 10 seconds. Repeat 10 times. This will strengthen the tendons muscles and ligaments in the hand.
I hope this helped clear things up!
For any questions on CTS and how massage or other therapies can help please contact me on firstname.lastname@example.org or 0422480163.
1. Moseby's Pathology for Massage Therapists - Salvo, Anderson