Ep 42: Self-Diagnosis Guide: Is Your Wrist Pain Carpal Tunnel Syndrome? Tingling and numbness and what to do.

Carl Petito, an occupational therapist and certified hand therapist, explains what carpal tunnel syndrome is and how to test yourself for it at home. He details the anatomical structures involved and why prompt medical attention is crucial for preventing long-term nerve damage.

• The carpal tunnel is formed by eight carpal bones connected by ligaments, containing nine tendons and the median nerve
• Carpal tunnel syndrome occurs when the median nerve is compressed, causing numbness in the thumb, index, middle finger, and half the ring finger
• Contrary to popular belief, wrist pads for typing can actually cause carpal tunnel syndrome by putting pressure on the nerve
• Self-tests include Phalen's maneuver (holding wrists bent for 30 seconds), Tinel's sign (tapping the heel of the palm), and manual occlusion test
• Early intervention is critical as nerve tissue is "unforgiving" – the longer symptoms persist, the harder they are to treat
• Nerve conduction studies provide definitive diagnosis, but see a healthcare provider if experiencing persistent symptoms

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Chapters

• 0:00 Introduction to Carpal Tunnel Syndrome
• 1:00 Anatomy of the Carpal Tunnel
• 2:00 Self-Testing Methods Explained
• 3:30 Why Early Treatment Matters
• 6:10 Episode Closing and Call to Action

Transcript

Speaker 1: 0:00

Welcome back to the Hand to Shoulder Solution giving pain the middle finger. I'm Carl Petito. I'm an occupational therapist and a certified hand therapist. I specialize in the rehabilitation of orthopedic conditions affecting the fingertips through the shoulder. I want to talk to you today about carpal tunnel syndrome, how to test yourself.

Speaker 1: 0:17

There's a lot of folks, you know they're at home with symptoms and they're wondering is it carpal tunnel syndrome? What can I do? How do do I know? Should I go to the doctor or what? You know what's going on? So here's a few things. We all have a carpal tunnel, so the carpal tunnel is literally a tunnel that is made up of the carpal bones there's eight carpal bones, c-a-r-p--l, and that they are assembled by ligaments and they form a tunnel right here in the palmar surface of your wrist and this is the area where the tendons you can see them on my wrist connect the muscles to the skeleton, so they travel through this carpal tunnel. There's two tendons to every finger and one tendon to the thumb, so there's nine pretty good-sized tendons that travel through the carpal tunnel, along with the median nerve, and I'm going to show these structures to you on the anatomic model in a few moments.

Speaker 1: 1:15

Carpal tunnel syndrome is a problem of the nerve being compressed, so the nerve is being squeezed. You know, when you cross your leg and your foot goes to sleep, that's pressure on a nerve, that's. That's not a circulatory problem, it's not blood flow, it's pressure on the nerve. So when there's pressure on this nerve, it's called the median, m, e, d, I A N nerve that plugs into or innervates the thumb, the index finger, the long finger and half the ring finger. So when you have numbness and tingling on the thumb side, it's the median nerve. Now I want to make note that it can be compressed in different areas upstream, even at your neck.

Speaker 1: 1:54

But we're talking about carpal tunnel syndrome today. So let's take a look at the nerve, and in the wrist there's two nerves. So we talked, I mentioned the median nerve that goes through the carpal tunnel and in the wrist there's two nerves. So we talked, I mentioned the median nerve that goes through the carpal tunnel and when you look at this yellow cord here, that's the median nerve and that plugs into the again the thumb, index finger, long finger and half the ring finger On the pinky side. If you're having only numbness and tingling on only the pinky finger or the pinky side of the ring finger. That is not carpal tunnel syndrome, that's something else and we'll talk about that in other videos.

Speaker 1: 2:29

But there's when this travels through the carpal tunnel along with the other tendons. You know there's there's a lot of structures in this very tiny area. So if, for example, there's pressure on your wrist when you're typing and maybe you're leaning on the desk or leaning on a carpal tunnel pad that is designed for typing with, that will increase friction and will cause the tendons to start to swell up. So if the tendons swell up, that takes up space within the tunnel and it starts to squeeze the choke off the nerve. So a quick note those carpal tunnel pads to use with typing, they cause carpal tunnel syndrome because we don't want any pressure on the nerve. The problem with the carpal tunnel syndrome, remember, is pressure on the nerve. So the ideally, you know, as I mentioned in other videos, the keyboard should be on the very edge of the desk. But you know, if a person is sleeping like this, or they're sleeping like this, and that nerve is being pressured or choked off or pinched in there, that's going to start to make this go to sleep. This whole thumb side, it's going to go to sleep and it's going to become achy and it's going to become tingly.

Speaker 1: 3:45

So what are a couple of quick tests you can do for yourself at home? So the most common, commonly known one is called phalanx maneuver, so you can push your wrist into a fully bent position toward your palm and just hold that position for 30 seconds. If any time within that 30 second period you start having a lot of numbness and tingling on the thumb side of your hand, that's a positive phalence P-H-A-L-E-N-S test. Okay, now there's also something called Tenels. So if you look at the heel of your palm, that's your carpal tunnel, and if you tap there and you have a zinger and it just goes and you feel almost like a little electrical zinger on the thumb side you're when you tap on that, that's a positive tunnel sign.

Speaker 1: 4:30

Now see the pinky side of of the of the wrist, and then here's that, that yellow cord, that's the ulnar nerve on the on the pinky side. We talked about it a few minutes ago. If you accidentally tap over here and then that that gives you a zinger, that's that's not the carpal tunnel. But back to things you can do at home. So we talked about phalans, we talked about the tonnels to tap on that. Also, if you just not a, not a ton of pressure, but just put firm pressure in the heel of your palm, more on the thumb side, and you hold that there. We call that a manual occlusion test. So it's occluding and we're putting a little bit of light pressure and if that lights up your symptoms on the thumb side, wow, you know, um, you probably have carpal tunnel syndrome.

Speaker 1: 5:17

So again, the really the only way to get to the bottom of it is with, ideally with a nerve conduction study. I and I do things in the office. I checked the tightness of the nerves, different nerves, we go through the whole thing, we do a much more thorough exam. But if, if these are positive or any of these are positive, and if you're having symptoms of numbness and tingling and aching on the thumb side or anywhere in your wrist or hand or your arm, you have to get into your doctor because what happens is over time.

Speaker 1: 5:49

The longer this goes on, the harder it is to get rid of and any problems with the nerve. The nerve tissue is very unforgiving and the longer it goes on, the longer it takes to get rid of the symptoms. So be proactive. You know, my goodness, it's your body. Just get in and be seen by a health care provider sooner rather than later. Hey, thanks a lot for liking the videos. It really supports us. It brings a lot of information to people who can use this and it empowers folks because they're learning about their bodies. So please share the videos, subscribe to the channel, and I really greatly appreciate your support. Thank you.