Carpal Tunnel Syndrome: Clinical Application

Carpal tunnel syndrome (CTS) causes irritation or compression of the median nerve within the carpal tunnel at the wrist. CTS is caused by factors including bony abnormalities, neuropathic conditions, inflammatory conditions, and most commonly, cumulative trauma. The trauma involves excessive repetition, force, bending, vibration, and impact activities performed at home or at work. As a result, the median nerve becomes irritated and intermittent sensory deficits occur initially leading to motor dysfunction with advanced disease. Once CTS is diagnosed, the first line of defense is conservative treatment which may result in operative care if unsuccessful. Modified activity and early postoperative hand therapy is the key to a good prognosis, although no treatment is a reliable cure. CTS is a growing epidemic with increasing treatment cost demands due to the growing use of computers which lead to repetitive motion. Physical therapists must stay current on the causes, diagnosis, treatment, and prevention of CTS to reduce the incidence. The focus of this paper remains on the therapist\u27s role in treating CTS conservatively and postoperatively utilizing various clinical techniques with emphasis on preventing CTS using ergonomics in the workplace