I am @shadow04
From #bangladesh🇧🇩
How are you all? Hope everyone is well. Alhamdulillah, I am also very well. Today I appeared in the ongoing Steemit Learning Challenge- S22W1: Physical Therapy Intervention: Carpal Tunnel Syndrome for joining the contest.At the beginning of the contest I would like to thank @ashkhan ma'am for giving us such a beautiful contest.
Carpal tunnel syndrome is a problem in the body where multiple factors cause compression on our median nerve and it runs through a narrow passageway called the carpal tunnel to the wrist. As a result, it causes pain in our wrists, fingers, numbness and other problems.
There are many reasons for carpal tunnel syndrome but some of the main reasons are mentioned below:-
• This is the most common cause of Carpal tunnel syndrome. which leads to our wrist through a narrow passageway called the carpal tunnel.
• Carpal tunnel syndrome is caused by doing the same work continuously, i.e. repetitive work that puts pressure on the wrist (eg typing) or working with objects that vibrate all the time. These activities cause nerve damage and muscle weakness.
• Lifting a heavy object or any other injury to the wrist creates a damaging effect on our median nerve.
• This problem is more noticeable in women due to hormonal changes at different times in women's life due to certain reasons.
• The risk of carpal tunnel syndrome increases if the wrists are kept away from work due to diabetics, arthritis existing for a long time in our body.
• If our carpal tunnel is smaller in shape than the median nerve.
Some of the main causes of Carpal Tunnel Syndrome are mentioned below:-
1.Numbness & tingling sensation.
• Numbness and tingling sensations are experienced due to nerve compression in the thumb, index and middle fingers.
2. Pain
• Hands, wrists and fingers feel quite painful. And especially at night time this pain is intense.
3.Muscle weakness
• This problem is mainly aggravated by doing a task repetitively, during which we feel discomfort even while typing.
4. Pain when doing normal activities
• Slight but sharp pain in the hand during activities that require movement of the wrist.
There are basically four types of carpal tunnel syndrome. They are mentioned below:-
1. Acute CTS
• An injury to the wrist can cause sudden onset of symptoms of Carpal Tunnel Syndrome.
2. Chronic CTS
• Repeating the same task over a long period of time causes this problem. Eg:- Typing.
3. Primary CTS
• This type of CTS usually occurs without any specific medical problem. This problem is mainly caused by doing any work that puts pressure on the wrist for a long time.
4.Secondary Carpal Tunnel Syndrome
• This type of CTS is usually due to various medical conditions. For example :- Pregnancy, Diabetes, Thyroid etc.
In the modern medical system, doctors use several methods to diagnose Carpal Tunnel Syndrome. They are mentioned below:-
1.Physical Examination
• Thorough full body examination by an experienced physician.
2.EMG
• Measuring the electrical activity of muscles.
3. Nerve Conduction Study (NCS)
• Measuring muscle strength and speed.
1.Medical history.
• In this case the doctor will first tell the patient about his problems in detail or he will ask some questions. For example, since when did this pain start, is there any specific reason for the pain, i.e., does the pain start after doing any particular activity, how intense is the pain and how long does the pain last, etc.
2. Lifestyle
• The doctor can also ask questions such as what kind of lifestyle the patient follows, what is his job, what kind of pressure is created on the wrist in those jobs.
• In physical examination, doctors can better understand the patient's wrist problems by performing several tests on the patient's hands and wrists.
Some special tests are done as clinical test for Carpal Tunnel Syndrome in Physiotherapy. eg :/
1. Phalen's Test
• This test is done to diagnose problems caused by pressure on the median nerve in the hand.
In this case, the patient has to keep the palms of both hands together as recommended by the doctor, leaving the elbows as much as possible.
2. Flicks Test
• In this case, the patient should try to reduce the pain or discomfort before seeking medical attention. Usually patients refer to the relief of their problems by flicking their hands, so it is called the Flicks Test.
3.Reverse Phalen's Test
• In this case, keeping the palms of the hands together, the wrists should be extended in opposite directions as per the advice of the doctor.
4.Tinel's Sign
• It is used to identify presence of nerve regeneration or nerve compression. In this case, doctors tap the patient's fingers along the median nerve, and if there is compression of the nerve, the patient expresses a tingling sensation.
Median Nerve Compression
• Compression or compression of the median nerve at the wrist.
Wrist Rotations
•For this first I my my two hands Stretched forward, then first put the thumbs of both hands on the palms and then make a fist through the remaining four fingers and rotate the wrist first several times to the right and then several times to the left.
Then I clench my right hand into a fist and hold the right hand with my left hand and then roll the entire fist with the wrist. However, I took care to keep the hand still.
Then I closed the fingers of both hands together and rolled the wrists leaving a gap between the two hands.
Arm Prayer Stretch
• For this first I sit on a chair and then put the palms together like a prayer and extend both elbows as far as possible. After staying like this for 15-20 seconds I again lift the nose along with the palms together and again take it to the chest position and stay for some time.
Stretches for CTS
• I first touched the thumb of my right hand to the palm then made a fist with the other four fingers and stretched the fist up and down until I felt no tension in the palm.
Then I placed the palm of the right hand downwards against the wall and kept all the fingers bare and then with the help of the four fingers of the left hand pulled the thumb of the right hand back slightly and stood still for some time.
For this, first I stretched my right hand forward and touched the thumb to the palm, then I made a fist with the remaining four fingers and held the lower part of the fist with the left hand and stressed it downwards and touched the left hand with the right hand and remained silent for some time.
Median Nerve Glides
• For this I kept my right arm straight, palm facing up while standing straight. Then I moved my neck from right to left and from left to right.
Wrist Rotations When I rotated my fists while doing this, my wrists and the bones around my wrists massaged them and I felt great too. During the Arm Prayer Stretch, my arms were almost at a right angle, and I felt a lot of nervous calmness in my arms, which really inspired me to do the regular Arm Prayer Stretch, and I decided to practice it regularly. However, while doing the Median Nerve Glides, my I was feeling a lot of pain in the back of my shoulder due to the weight of the body bearing on the right arm. But after exercise the pain was cured by massaging with ice pack and my younger brother.
Each of the exercises mentioned above really calmed me down a lot After just one day of practicing it, my hands and wrists seem to be much lighter and easier to handle.
- Thanks by,,
- @shadow04
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, its cause, and its types. You explained all the things very well. I appreciate your effort.
Task 2 (2.9/3)
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. I will add one point you have to take history first and then perform physical examination. Excellent.
Task 3 (3.6/4)
You try the CTS stretches, median nerve glides, wrist rotations and arm prayer stretch exercises. You did the CTS stretches, wrist rotations, median nerve glides and arm prayer stretch correctly. 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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