I am pleased to participate in frist week of SLC Season 22. This week, I enjoyed a deep details explanation on the topic carpal tunnel syndrome. I welcome you to me explanation and my opinion, please down.
What's carpal tunnel syndrome? Write in your own words after getting knowledge from the lesson post.
Carpel tunnel syndrome is a condition commonly affect the wrist, hand causing tingling, pains in the fingers and numbness.
The syndrome occurs when the tunnel becomes narrowed or the tissue surrounding the flexor tendons swells, putting pressure on the median nerve there by reducing it blood supply.
This usually happens when the median nerve that runs from the forearm into our hand is narrowed or compressed. This condition often affect woman more than men because the tunnel is smaller in women than in men.
Cause of carpal tunnel syndrome.
There are several cause of carpal tunnel syndrome which includes the following:
Repetitive strain injuries or Repetitive motion: An individual who play musical instruments or a typists who use mouse on regular basis might have the swelling or inflammation in the wrist, which may lead to nerve compression.
Medical Conditions: Some medical conditions like Arthritis, Diabetes, Rheumatoid can increase the risk of Carpal Tunnel Syndrome.
Fluid retention: Overweight can also cause fluid retention and inflammation which can result to pressure on the Median Nerve. In some cases it is due to pregnancy or menopause.
Extending or flexing the wrist for long periods of time.Another condition is when the median nerve is larger than the carpal tunnel.
Symptoms of Carpel tunnel syndrome
The patient with definitely have numbness or tingling sensation in his or her fingers. Most especially index, thumb and probably middle finger.
There is also weakness in the hands making it for such individual to perform some certain daily tasks.
Pain is one of the expected symptoms,it always worse at night and in some cases it comes with burning sensation.
Types of Carpal Tunnel Syndrome
There are several types of carpal tunnel syndrome some of the are idiopathic, the cause is unknown or might a combination of environmental and genetic factors.
1 Acute CTS: This types of carpal tunnel syndrome occur suddenly due to the pressure or increase swelling on the median nerve.
Chronic Carpal Tunnel syndrome
The gradual onset of symptoms due to repetitive use. The symptoms last from weeks to months.
Primary Carpal Tunnel syndrome
This type of carpal tunnel syndrome usually occur without any specific medical ailments, which is idiopathic.It is usually as a result of constant hand and Wrist motions.
Secondary Carpal Tunnel Syndrome
As the name implies, this type is usually occur when there is an underlying medical conditions like Diabetes, Arthritis, thyroid disorders, kidney disorders and cyst in the wrist.
How would you diagnose a carpal tunnel syndrome? Any clinical investigation or assessment tests.
Clinical evaluations
- Medical history
When carrying out medical history, the doctor will interact with the patient asking him or her about the sign and symptoms of carpal tunnel syndrome, such as weakness in the hands or wrist,pains, tingling or numbness.
He would also go ahead to ask if you're suffering from any medical condition like thyroid disease, Diabetes that can trigger it. Asking about his or her lifestyle is essential.
- Physical examination
The essence of physical examination is for the doctor to carryout out palpation and inspection of the affected part. He or she will assess the wrist for tenderness, muscle weakness, check hand and fingers sensory change. The doctor will also tap the patient Wrist over the Median Nerve to know if the patient will feel tingling in the Finger which is a symptom of carpal tunnel syndrome.
Diagnostic Test
- Electromyography (EMG)
This test is conducted on a Patient to measure the electrical activity of the muscle or if they is muscle is disfunction.
Nerves conduction studies (NCS) This test help in measuring the speed and strength of electrical signal in the median nerve.lt help in detecting nerve compression or damages.
Ultrasound scan and magnetic resonance imaging: the both provide a detailed images of the wrist fracture or tumour in the median nerve for a doctor to rule out carpal tunnel syndrome.
Special Test.
Tinel's Sign;
In the test, the forearm will be in the resting position and wrist with neutral position. In this test the tapping is done over the nerve. The test will be positive if the patient feels sensation of numbness in the region which is supplied by the median nerve.
Phalen Test:
This particular test is commonly and widely used in diagnosing CTS. To perform this test, the Patient is asked to stretch out their arm in front with their Wrist flexed. The Doctor should uses his hand to press the back of the hand while applying pressure on the Wrist and if sharp pain and tingling is felt, then Carpal Tunnel Syndrome is concluded.
Flick's Test: This test involves the a patient flexing the wrist and he or she quickly extends it . If a patient fell much pain, numbness which means CTS is certain.
Reverse Phalen test:
To perform this test, the doctor asked a Patient to place his arms straight in front with the Wrists extended. The Doctor then uses his hand to gently press the back of the Patient hand while applying pressure to the Wrist. If the symptoms of Carpal Tunnel Syndrome is felt, they we can conclude that it is positive.
We also have carpal compression test, Durkan's test and Median Nerve Compression test.
Try to practice at least 3 exercises that you have learned from the lesson. Share images, gifs or videos while practicing preferably gifs or videos.
Before I start this exercise,I use heat pack on my body, which helps to relax the muscles and reduce stiff as it was instructed.
Stretches for CTS
In thumb stretch,the first thing I do was to Grab my thumb an make a fist. I bend the wrist down ward to feel a stretch in the thumb and wrists.
In carpal stretch, I place my palm flat on the wall with my fingers facing down. I use the left and reach across and pull the thumb back on pull on the palm side forearm. In extensors stretch, make a fist, Reach under pull back on the fist.
Arm prayer stretch
To perform this, I sat down on the chair and then stretched out my arm in front of me and then bring my two palms together like I'm praying. I held on about 5 to 10 minutes before releasing my palms. I continue these exercise two more times, this exercise was my best for the day.
Median Nerve Glides
In practicing this exercise, I stretched out my arm in my front with my Palm facing down and then titled my wrist up, while maintaining my forearm still. I held on for about 10 to 15 minutes before releasing myself.
Share your review after performing these exercises either on yourself, healthy individual or patient
In Median Nerve Glides and the arm prayer stretch, I stretched my hand, I have mild pain on my hand after the exercise and felt relieved. Then for Stretches for CTS , I didn't feel any pain, only felt my fingers stretched and light. I really appreciate how I felt after the exercises. These exercises are useful in the mild to moderate cases of the carpal tunnel syndrome. These can reduce the symptoms and pain relief.
My special thanks goes to for providing a wonderful lecture, I would like to @goodybest, @max-pro, @blessedlife and @yannel to share their entry with us.
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Thank you for understanding the lesson and sharing your assignment; I hope that you will enjoy this week's lesson and try to implement it in your life if you see any such case.
Observations
Task 1 (3/3)
You have shared a great knowledge about carpal tunnel syndrome, its symptoms, cause, and it's types. I appreciate your effort.
Task 2 (3/3)
In the second question, you tell us about how you have to assess a patient by doing physical examination, history taking, special tests and investigations. Excellent.
Task 3 (3.8/4)
You try the CTS stretches, median nerve glides and arm prayer stretch exercises. You did the arm prayer stretch and median nerve glides correctly. But in CTS stretches you have to hold the position for at least 5 to 10 seconds for effective results. Always remember to apply heat pack before performing exercises to relax the muscles and reduce stiffness. I appreciate your efforts.
Overall you made a great attempt to answer all the questions. I appreciate your efforts. But next time try to avoid the above written suggestions. Keep learning and try to implement your knowledge to the people suffering from carpal tunnel syndrome or any type of wrist. Thank you.
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