Practical Relief For Carpal Tunnel Pain And Numbness

Transcript

Welcome And Focus On Carpal Tunnel

SPEAKER_00 0:00

Welcome back to the hand to shoulder solution where pain meets its match. I'm your host, Carl Petito. I'm an occupational therapist and a board certified hand therapist specializing in the rehabilitation of orthopedic conditions affecting the fingertips through the shoulder. Let's talk about exercises that I usually give people to do who have carpal tunnel syndrome. Now, carpal the carpal tunnel is made up of the eight carpal bones within the wrist. So if you look at the heel of your palm right here, that's your carpal tunnel. So the base of the thumb over here at the base of the little finger, that right that that heel of your palm there, that's that's the carpal tunnel right here. Now there's a thick, large nerve that travels through that tunnel. And by the way, the tunnel is the palmer surface is formed by a ligament called the transverse carpal ligament that goes right over the top like that, that forms a roof. If somebody has a surgery, that ligament that forms the roof of the tunnel there gets cut and it releases the pressure off of the nerve. That's why it's called the carpal tunnel release. It's releasing pressure off the nerve. So that's why I'm gonna repeat this muscle multiple times, that's why no one should massage that because pressure on a nerve is never a good thing and it causes numbness and tingling and aching. And the median nerve that goes through the carpal tunnel that innervates or plugs into the thumb, index finger, long finger, and half of the ring finger. So when patients say it's numb and tingling on my thumb side, okay, probably the carpal tunnel could be some other points along, you know, up higher, but I'm taking carpal tunnel. The the small finger side, ulnar nerve, I'm taking inside part of the elbow, also could be points up higher, also could be Guian's canal. There's a lot of details. That's why, if you're having problems, you have to get into your healthcare professional so you can get it an accurate diagnosis, and we can start treatment sooner rather than later. So, back to the carpal tunnel. It's a nerve compression issue. So when you when you cross your leg and your foot goes to sleep, that's not circulation, that's pressure on a nerve. Okay, same thing here. After time goes by, the numbness and tingling after you know months, and as this gets worse, it gets achy, and people wake up and they'll also have what we call a flick sign, or people you just want to shake it out to try to get it to feel better. So, exercises for carpal tunnel syndrome, what's the goal? It's to decrease pressure within the carpal tunnel. And also, I want to I want to floss or glide that thick, heavy nerve that travels through the tunnel. I want that to glide and slide, and nerves can also get very, very tight, and we can restore the length of them. So let's let's say, because the nerves are living tissue, just like a tendon or a ligament. Let's say the nerve is really tight. So now I reach out for things, and every time I reach out for something, the nerve gets yanked on a little bit. Well, that gets on its nerves, so it starts getting irritated and aggravated, it starts getting all numb and tingly. And well, how can we restore the length of the nerves gently? How can we get it to glide or floss through the structures that it passes through to make it healthier, get any fluids that are stuck in there and out? What I have folks do is usually uh floss or glide all of the nerves that come out of the neck and go through the armpit, which is called the brachial plexus, it goes through the axillar armpit area. So I'll have people just I'll they'll say, Well, let's compare one side to the other. Does you know? Let's, for example, I'm having the problem in my right side, I'm symptom-free on my left, and a lot of them uh say, you know what, just reach up, press your palm toward the ceiling. How does that feel? It feels okay, okay. Do the same thing on your other side, and a lot of them will stop here, or they just really can't get it very well, um, and they'll feel like really achy, achy stretch. And I'll have them do this to the point of a light stretch, a light, a very light pull, three seconds, one and two and three, back on slack, again, one and two and three back on slack, again, one and two and three back on slack, three repetitions for three seconds, three times a day, three or four times a day, roughly three, three, and three, three repetitions, three seconds, three times a day, and then focused on the median nerve is out to the side, and the arm comes back, the wrist is bent back, and the fingers out straight until they feel an A pull. And it's interesting if you're having these symptoms right on yourself, how far does the opposite side go? Wow, that's nice and loose, and then and then the involved side, ooh, yeah, I feel that right there. So the same thing: one and two and three, back on slack, one and two and three, back on slack, and then after patients come back in a week or two, guess what? They're looser and they're having uh less symptoms. Uh, another exercise I have folks do is called tendon gliding. So there's two tendons to each finger, and the tendons travel through the carpal tunnel. We want those to move separately, or or we want to differentiate them. So we want them to move separately from each other in any thick, heavy fluid that's stuck in the tunnel. Because remember, we can't just push that out and sweep because now we're putting pressure on the nerve, and that's going to aggravate it more, it's going to make the carpal tunnel syndrome worse. So, what studies have shown is that if you do a hook fist, it's like if you're making a hook, and then it you do a um position like this, and then a position like this, and that. So I have folks do here, here, here, and here, and then full fist. Most recently, it's been found that all that really needs to happen is this, this, and then this, and that provides adequate tendon glide through there. So I have people do about 10 repetitions two or three times a day. First thing in the morning, I'll have folks do a low electric heating pad wrapped around the wrist and hand. Well, heat, if it's inflamed, do we want to it's maybe if the tendons are inflamed, taking up space with inside the tunnel. Why do we want to use heat? Well, we can get away with heat first thing first thing in the morning because the hand has been resting all night. Inflammation will be at its lowest point first thing in the morning, low electric heating pad, 10 to 15 minutes, electric heating pad. So it's a low, steady temperature on a thermostat. We can open the vessels, increase blood flow, and get the circulatory system working nicer in our favor. Then during the day, we're using our hand, aggravating, increasing inflammation, and want to shrink down inflammation. What shrinks cold? So we want to put that under a cold running faucet or barely touch the skin with the ice cube because we again we don't want pressure just only until it's deeply cold. I like the cold running water because it envelops the whole thing 10 to 20 seconds, that's all it takes, and that reduces the inflammation amazingly. It actually works better than an ice pack for 10 to 15 minutes. The ice pack laying on there, you don't want the pressure on there. Then also I go over ergonomic considerations. I use my keyboard on the very edge of the desk, so there's nothing when I'm typing, there's nothing but air on my carpal tunnel. The rest pad that people use in front of the keyboard, resting on it, so now you got pressure on your carpal tunnel. There's more on these tendons that connect the muscles to the bones, there's more friction on those, right? So that's more friction. So they're gonna swallow up all the more and take up more space in the carpal tunnel, and that thick, heavy, median nerve that goes through the carpal tunnel is it lives kind of close to the surface, it's pretty superficial. So now you have pressure on the nerve. So those I would argue all day long, those help predispose people to getting carpal tunnel syndrome. Nobody should rest on the heel of their palm on the carpal tunnel. If anybody wants to rest anywhere, they should rest here, but then I don't I don't want the keyboard too far because now I'm rounding out my shoulders, then I start having neck problems and then other compression syndromes. But if that keyboard is brought back to the edge of the desk, now I have healthy posture, nothing but air is touching my carpal tunnel, and I'm a happy camper. It's just that easy. So share this with people who might be concerned about their hands. Thank you for liking the uh episode and thank you for subscribing to the channel, the Hand to Shoulder Solution, where we are the solution to your pain.