What If These Treatments Dont Help
In some cases, surgery is needed to make the symptoms go away completely. The surgery involves cutting the ligament that may be pressing on your median nerve. You’ll usually get back the normal use of your wrist and hand within a few weeks to a few months after surgery.
Doing the hand, wrist, and finger exercises that your doctor tells you to do after surgery is very important. Without exercise, your wrist may get stiff, and you may lose some use of your hand.
Pros Of Using Ice To Treat Carpal Tunnel
Clinical Contributors To This Story
Michael Cunningham, M.D. contributes to topics such as Orthopedic Surgery.
Carpal tunnel syndrome is a painful condition that is caused when inflammation puts pressure on the median nerve.
Located on the same side of your hand as your palm, the median nerve delivers sensation to fingers as well as impulses to the muscle leading to the thumb.
When the wrist swells as a result of overuse, it can compress the nerve. In addition to pain, it can cause tingling, weakness or numbness near the thumb.
The common cause of the inflammation in the wrist can be due to an underlying medical condition, such as diabetes, high blood pressure, rheumatoid arthritis or thyroid dysfunction. Obstructed blood flow can also cause inflammation.
CTS can be worsened by repetitive tasks, such as the position you’re in when typing or using a computer mouse. Not doing those activities can relieve symptoms of CTS, but because the activities are required for work, many people cannot afford to take significant breaks.
“There are other ways to relieve carpal tunnel,” says Michael Cunningham, M.D., an orthopedic surgeon affiliated with Bayshore Medical Center. “Some treatments deliver a short-term reprieve, but permanent relief for severe pain usually requires surgery.”
That said, there are a few ways to relieve discomfort from carpal tunnel if it flares up from time to time.
Ice Or Heat For Carpal Tunnel
When Carpal Tunnel pain begins to flare up, you may be wondering, “Should I use Ice or Heat for Carpal Tunnel?” Not every ailment or syndrome requires the same temperate treatment. With this in mind, let’s take a look at the pros and cons of both, and answer your concern: Should I Use Ice or Heat for Carpal Tunnel?
Does Ice Therapy Help Reduce Carpal Tunnel Syndrome
October 15, 2008 by Kathryn Merrow
Carpal tunnel pain can be treated both with ice therapy and with heat.
There are therapists who believe that ice is often the better treatment for carpal tunnel pain. Ice helps relieve pain and inflammation
Ice slows the blood flow while it acts as a pain reducer with no side effects.
Heat, however, increases the blood flow and so relieves pain by relaxing the muscles. Heat is especially useful with long-standing or chronic carpal tunnel pain
Ice, however, is used for carpal tunnel pain that has just started recently, or for a new injury, or for new treatment.
The recommendation to use ice is generally for the first 48 hours, but the inflammatory stage can last up to 5 days. So, it is okay to use ice or cold therapy for the first 5 days after you start using it.
After that, you can alternate between cold therapy and heat therapy.
Some people don’t like to use ice or cold. They find it too uncomfortable.
And, in some cases of carpal tunnel syndrome, ice may not be the best treatment.
People who have impaired blood flow could get worse symptoms by using ice. People with certain vascular diseases that affect the circulation in their hands and arms should not use ice. People with Reynaud’s syndrome, who often have cold hands, should not use ice for their carpal tunnel pain.
How can you use ice or cold therapy for carpal tunnel syndrome?
Where should you use ice therapy for carpal tunnel syndrome?
And, that’s a good thing.
Is There An Alternative To Carpal Tunnel Surgery
Surgical decompression is commonly performed and has traditionally been considered the defnitive treatment for CTS. Conservative treatment options include physical therapy, bracing, steroid injections and alternative medicine. While CTS is often progressive, patients may get better without formal treatment.
Symptoms Of Carpal Tunnel Syndrome
There are a specific set of symptoms that typically occur in people with CTS. Symptoms of CTS may include:
- Pain in your thumb, index and middle fingers
- Numbness or tingling in your hand
- Difficulty grasping items or performing tasks that require dexterity or fine motor skills
- Weakness in your hand or thumb
- Visible atrophy of the muscles around your thumb
If you have any of these symptoms, check in with your doctor right away to get an accurate diagnosis of your condition and to get started on the correct treatment.
Step 1: Get The Right Diagnosis
Reaching out to your doctor is the best first step you can take to find relief. Expect a few possible tests during a doctor’s visit:
- Tinel’s sign: Your doctor taps on the underside of your wrist to test how your nerves respond. Many patients feel what they describe as an electric sensation.
- Visual and physical exam: In the worst cases, your doctor may be able to see the muscle loss at the base of your thumb.
- Phalen’s sign: You’ll put your hands in a position similar to praying and then let them fall forward naturally. This position often triggers symptoms.
- EMG and nerve conduction: Your doctor may recommend this test, which is a more involved way to assess nerve function.
Your doctor will also ask about your overall health because diabetes, rheumatoid arthritis, an overactive thyroid and other conditions often go hand-in-hand with carpal tunnel. Pregnancy and heredity play a part, too.
“On the whole, treatment will target the symptoms of carpal tunnel syndrome,” says Dr. Burg. “But it’s important to know how it fits into the big picture. For example, if you have rheumatoid arthritis, treating it may reduce your carpal tunnel symptoms, too.”
Part 1 Of 2:recovering In The Short Term
How Physical Therapy Treats Carpal Tunnel Syndrome
Physical therapists examine the functioning of the hands and wrists. They may ask the patients to hold different-sized objects in certain positions for a specific time. They also gently feel around the arm and wrist region to find the exact area of pain. These analyses help them provide the patients with an individualized plan that reduces the symptoms of carpal tunnel syndrome and promotes hand pain relief.
1) Therapeutic Exercises
Therapeutic exercises include gentle stretching and strengthening exercises that improve flexibility in the wrist, hand, and finger and provide them with strength and stability. These exercises help to reduce the pressure on the median nerve at the wrist and may include wrist extension stretch, wrist flexion stretch, median nerve glides, tendon glides, wrist curl, hand squeeze, and finger bend.
2) Heat or Cold Therapy
Heat therapy improves blood flow to the area where the patient experiences hand pain and brings an adequate amount of oxygen and nutrients. Patients can immerse their hands in warm water with a temperature ranging from 92 to 100 degrees, gently moving the hand and wrist. They can do this therapy three to four times a day.
Cold therapy decreases circulation and reduces inflammation caused by carpal tunnel syndrome. Patients can ice their wrists or soak them in an ice bath for 10 minutes to 15 minutes. They can do this once or twice per hour. It reduces irritation in the median nerve and promotes hand pain relief.
3) Massage Therapy
Take Breaks From Repetitive Tasks
This is as much a management strategy as it is a preventative one. If you do repetitive tasks regularly, you need to take a break every few minutes to prevent the onset of carpal tunnel syndrome. If you already sustain the injury and can’t avoid doing these tasks, the same applies.
You may not be able to stop doing these repetitive tasks, but you can definitely dedicate a set time for breaks as you go about the work. For instance, if your job involves typing most of the day, you can schedule a break every 20 minutes and use this time to stretch your hands and wrists. Wiggle your fingers too, while you’re at it. Do this for a couple of seconds and rest your hand for a minute before resuming work. This will improve the blood flow to these regions and prevent the condition from worsening.
Will A Tens Unit Help Carpal Tunnel Syndrome
Using a TENS unit to help ease the pain of carpal tunnel has proven to be effective for many people. Carpal tunnel causes swelling around the wrist area, so before turning to TENS treatment, try an application of an ice pack for a few minutes a day to reduce the swelling on your wrist.
TENS works by stopping the nerve signals from reaching the brain so using TENS for carpal tunnel is very effective, and it is a non-invasive treatment for pain. TENS treatments do not hurt and the electrodes can be put on your hand and wrist. It will create a tingling, almost massage-like sensation in the area that the electrodes are placed.
Many TENS units also come with electrical muscle stimulation , which work in tandem with the nerve signal reducing swelling around the median nerve of the wrist.
Tens Placement For Carpal Tunnel Syndrome
As you can see in the above picture you will want to place the first electrode pad in the middle of your palm and place the second electrode pad right beneath the wrist area. Make sure to press firmly to ensure a good connection with the TENS device.
Now flip over your hand and place the first electrode pad on the top of your hand while the second electrode pad is placed below the wrist bone.
If you have small hands and the electrode pad is too big you can trim the electrode pad. Please see my article about how to properly cut an electrode pad.
Want to know where else you can place a TENS unit? Here are some common TENS electrode pad placements:
What You Need To Know Carpal Tunnel Syndrome
Carpal tunnel syndrome is a condition that causes numbness or weakness in your hand. This condition is also called median nerve compression. This is because your median nerve runs the length of your arm, passes through the passage in your wrist called the carpal tunnel and ends in your hand. The median nerve controls your thumb and finger movements with the exception of your pinky.
How Long Should You Do Physical Therapy For Carpal Tunnel Syndrome
Most physical therapy episodes of care for CTS last about four to six weeks. Your time may be shorter or longer depending on the severity of your condition and on any comorbid factors. Working closely with your therapist can ensure you have a realistic expectation of the length of your specific episode of care.
Can A Tens Unit Make Pain Worse
When you use a TENS machine, at first the sensation will subside a little and you can turn the settings up a little for the rest of the time you use the machine. However, if you use the machine on too high a setting it can cause some over-stimulation which can make the pain feel worse.
Too high a setting can also cause some skin burns, so always start your electric settings low and work your way very slowly up. Also don’t leave the pads on your skin for too long. The adhesive can be irritating to some people’s skin and the units are not meant to be used for long periods of time, at a time.
Read How High Can I Set My TENS Unit
Anatomy Of The Carpal Tunnel
Understanding the anatomy of the carpal tunnel can help you understand why you feel certain symptoms and why specific treatments can help your condition.
The carpal tunnel is formed by your wrist bones, called carpals, and the transverse ligament that crosses over these bones on the palm-side of your hand. This creates an anatomical tunnel where specific structures pass through to get to your hands and fingers. Your have 2 carpal tunnels; one in each wrist.
There are 9 tendons that cross through your wrist under the carpal tunnel. The tendons arise from muscles in your forearms and work to flex your fingers and thumb. Your median nerve crosses through the carpal tunnel along with these tendons. The median nerve delivers sensory and motor information to your thumb and first two fingers. You ring finger may also be slightly innervated by your median nerve.
When your median nerve becomes compressed within the carpal tunnel, symptoms of CTS may result. So how does your nerve become compressed, and what activities may cause carpal tunnel syndrome?
Taking Pain Meds Corticosteroid Injections And Wrist Splints Have Me Feeling Like A Drug Addict
I have Carpal Tunnel and I just seen my Orthopedic Surgeon who gave me a very painful shot of Corticosteroid, which hurt for 3 days after, and I am STILL having tingling and numbness in hand, thumb and index finger. My right is the worst. I have it in both hands. Right is my dominate hand. I am a writer and painter. I have had a nerve conductivity study. The surgeon said he is going to give me another Corticosteroid Injection in three months. That is not going to happen.
Then he said, he will recommend surgery in 6 months. I have friends and family that have had surgery and they were not happy with it. I have read that it comes back even after a surgery. I saw that the Carpal Solution Treatment is covered under insurance? Is that legit? I would love for someone to call me and discuss this treatment with me.
I am desperate. I am tired of all the pain meds the Doctors prescribe.
They recommended a wrist splint and have me taking Nuerontin, Lodine and even Vicodin. They also have me taking muscle relaxers. I am starting to feel like a drug addict. I know these things are not good for me.
I want to be HEALED from Carpal Tunnel – not just cover-up my Carpal Tunnel Symptoms with pain meds. The wrist splint does not seem to be doing anything to improve my hand’s condition.
Tracie, Florence, Mississippi
Carpal Tunnel Syndrome: Anatomy Causes And Treatment
May 11, 2020
If you have pain in your hand, fingers, or thumb, you may be suffering from a condition called carpal tunnel syndrome, or CTS. The American College of Rheumatology reports that carpal tunnel syndrome affects 4 to 10 million Americans each year, with peak incidence occurring in women in their mid 50’s. When carpal tunnel syndrome strikes, you should learn the steps you need to take to understand the condition and to get started on the correct treatment right away.
Questions To Ask Your Doctor
- How do you know that carpal tunnel syndrome is causing my symptoms?
- What can I do to relieve my pain?
- Are there any special exercises I can do to strengthen my hand and wrist?
- What is the best treatment option? Will I need surgery?
- How long will it take to recover?
- Is it likely that I’ll experience this problem again, either in this hand/arm or in my other hand/arm?
Part 2 Of 2:recovering In The Long Term
Keep Your Wrists Neutral
You can also take steps to keep your wrists in a neutral position. You could wear braces or use a keyboard pad. You should also make sure that your workstation is set up correctly to keep your forearms, wrists, and hands in a straight line. In general, if you have carpal tunnel syndrome, you should be aware of your hands’ position, as over-extending or flexing can trigger your symptoms.
Carpal Tunnel Syndrome Treatment
If carpal tunnel syndrome is caused by a medical problem , your doctor should treat that problem first. Your doctor may ask you to rest your wrist or change how you use your hand. He or she may also ask you to wear a splint on your wrist. The splint keeps your wrist from moving but lets your hand do most of what it normally does. A splint can help ease the pain of carpal tunnel syndrome, especially at night.
Putting ice on your wrist to reduce swelling, massaging the area, and doing stretching exercises may also help. An over-the-counter non-steroidal anti-inflammatory drug can relieve swelling and pain. These medicines include aspirin, ibuprofen , and naproxen . In more severe cases, your doctor might inject your wrist with a corticosteroid, which reduces inflammation and pain.
Acquire Physical Therapy Treatment For Carpal Tunnel Syndrome
Physical Therapy Treatment for Carpal Tunnel Syndrome –Have you ever experienced an irritating pain in your hands and fingers? Or have you heard of someone you know who has been struggling with such irritation in their hands for several months? It could be a condition called carpal tunnel syndrome. It is a common condition and is one of the nerve entrapment neuropathy disorders.
Carpal tunnel syndrome primarily affects the wrist and palm, leading to pain and numbness, limiting one’s ability to carry out daily activities with ease. Physical therapy is an effective treatment that helps in reducing the symptoms of this condition and promotes hand pain relief.
How To Recover After Carpal Tunnel Release Surgery
This article was medically reviewed by Eric Christensen, DPT. Eric Christensen is a Physical Therapist based in Chandler, Arizona. With over a decade of experience, Eric works in both orthopedic and neurological fields and specializes in custom orthotic prescription and casting, vestibular reprogramming, and manual therapy. He holds a Bachelor’s degree in Exercise Science with a focus in Sports Medicine from Colorado State University and a Doctor of Physical Therapy from Regis University. In practice, Eric takes a developmental approach to rehabilitation utilizing the Selective Functional Movement Assessment. He uses functional movement patterning and manual therapy to return patients to prior levels of function. This article has been viewed 26,963 times.
Carpal tunnel release surgery is done as a last-resort treatment for carpal tunnel syndrome that has failed to improve via more conservative methods. Surgery can lead to great improvement or a cure of the condition. However, there are also risks associated and a lengthy recovery time. Recovery usually takes several weeks to several months; it requires dedication to a physiotherapy program to help strengthen and heal your wrist and hand following surgery.XTrustworthy SourceJohns Hopkins MedicineOfficial resource database of the world-leading Johns Hopkins HospitalGo to source
When To Use Heat
Heat therapy’s ability to increase blood flow and loosen muscles makes it a good choice to use before physical activity. It can also increase the effectiveness of carpal tunnel exercises if used before hand and make muscles more pliable for massage techniques. Otherwise, use heat therapy sparingly when treating carpal tunnel syndrome to avoid unwanted side effects.
Tips for Using Heat Therapy
Heat therapy should be used in moderation when treating carpal tunnel syndrome as the increased blood flow and exacerbate inflammation. Be sure to follow these guidelines when using heat therapy:
- Never apply heat therapy to a wrist that is visibly red or swollen.
- Apply for 20 to 60 minutes per session, depending on the severity of your symptoms.
- Don’t use heat therapy on a new wound or recent pull.
- To avoid skin irritation or burns, avoid heat therapy while sleeping.
- Try using simple self massage techniques with heat.
Cons Of Using Heat To Treat Carpal Tunnel
Too much heat can increase swelling within the carpal canal and lead to increased pressure on the median nerve worsening your symptoms.
Too much heat and the nerve may engorge or get swollen and the pressure in the canal rises.
With either temperature treatment for Carpal Tunnel, it is important to avoid extreme temperatures. It’s normal for your skin to look a little pinker after using cold or heat. Before resuming temperature treatment, let your skin return to its normal color and temperature.
If you see any of the following signs after treatment, call your doctor. The following are signs that the temperature was too extreme:
- Purple, dark red, spotty red or white color on skin
Benefits Of Using A Tens Unit
TENS units are non-invasive pain relief which can reduce the need to partake in consuming\ pain medications which can be addictive to many people. The units are small and portable and can be carried in one’s pocket or purse to use at will. The unit can be used as frequently as you need and with its portability, quick pain relief is at your fingertips.