Steemit Learning Challenge-S22W1: Physical Therapy Intervention: Carpal Tunnel Syndrome
First of all I would like to thank Steemit Block who has provided us with the best platform for choosing teachers for us and those teachers who are providing us with homework and this teacher for providing us with the best exercises especially the best. A person who maintains the balance of our health is named @ashkhan Steemit Learning Challenge-S22W1: Physical Therapy Intervention: Carpal Tunnel Syndrome
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What's carpal tunnel syndrome? Write in your own words after getting knowledge from the lesson post.
Readers will be enlightened on what Carpal Tunnel Syndrome entails.
Carpal Tunnel Syndrome (CTS) is a pathologic condition localised to the wrist and hand, manifesting as pain, numbness and weakness. It is a condition experienced when the median nerve, extending between the forearm and palm is compressed at the wrist. One of these nerves has a pathway through a structure known as the carpal tunnel a little tunnel occupied by tendons that allow fingers to move.
If these tendons are enlarged, or if the tunnel is constricted due to inflammation, pressure is applied to the median nerve. This results in metabolic changes and the kind of symptoms typical of CTS. They include a tingling sensation, numbness and burning sensation which are more often felt in the thumb, forefinger and middle finger. If not treated it may lead to gripping power and adversely the persons ability to carry out simple activities such as buttoning a shirt or holding objects.
Factors leading to Carpal Tunnel Syndrome
There are many potential causes of CTS. The straining movements are usually the repetitive ones involving hands in typing, knitting or handling a tool. Also, risk factors for CTS include some medical conditions such as diabetes, rheumatoid arthritis and hypothyroidism. Oestrogen oophas‚ pregnancy, menopausal status, obesity and wrist injuries also play a part.
Diagnosis and Treatment
These acts include medical history and clinical examination and nerve conduction velocity test for instance. Prompt action is necessary in order to avoid unpleasant consequences with regards to the nerves.
Since cystic fibrosis is a progressive ailment, different courses of action depend on the stage at which the patient is diagnosed. Minor symptoms usually can be treated with rest, wearing wrist braces, and taking nonsteroidal anti-inflammatory drugs. Lifestyle changes are also quite beneficial; these include changing hand use, avoiding إدرا and using hand splints, as well as taking a break whenever indulging in repetitive movements. If the situation becomes worse, the doctors may try injecting corticosteroids or perform surgery in order to reduce the pressure on the median nerve.
Carpal Tunnel Syndrome Bane and Prevention
Measures for avoiding CTS include proper wrist position while using the hands, avoiding overuse of the wrist and doing hand stretches. Otherjuries experienced on the wrists include hand tool vibrations and awkward postures; this could be minimized by ergonomic tools and work spaces.
Carpal tunnel syndrome presents certain difficulties which may be minimized or even prevented if the symptoms are identified on time and necessary.Wrap up
How would you diagnose a carpal tunnel syndrome? Any clinical investigation or assessment tests?
Diagnosing Carpal Tunnel Syndrome: Clinical Investigations and Assessment Tests
The diagnosis of Carpal Tunnel Syndrome or CTS includes assessment of the patients complaints, examination and Diagnostic procedures. The goal is to make sure what the condition is, how severe it is and to eliminate any other possibility of wrist and hand pain.
Clinical Evaluation
1. Medical History: The first step the doctor takes is to take history on the signs and symptoms of the patient such as pain, numbness, tingling and weakness in the hand and the wrist. This is all important: The exact length of the episodes, how severe they are, and what kinds of activities seem to bring them on. They will also inquire on other conditions which include diabetes, arthritis or if the patient had previous wrist injuries.
2. Physical Examination:
Inspection: The doctor checks for muscle weakness or atrophy beginning at the base of the hand that is being assessed.
Palpation: They also ask if their wrist is sore or swollen and then examine the patient’s wrist accordingly.
Range of Motion: One will require the patient to flex the wrist and fingers to check if there is are issues of pain or rigidity.
Diagnostic Tests
Several clinical tests and investigations help confirm CTS:
1. Tinel’s Sign: The doctor has the patient bend the wrist and then pat lightly over the median nerve. If conducting an electrical current through the fingers, a positive reaction is the experience of a tingling or “electric shock” sort.
2. Phalen’s Test: The patient is then instructed to clasp his/her hands with wrists flexed at the right angles for one minute. Positive result can be determined by having a tingly or numb feelings in the fingers.
3. Hand Elevation Test: In CTS patients, the exercise as simple as raising the hands above the head for two minutes can induce symptoms in the patient.
4. Electrodiagnostic Studies:
Nerve Conduction Study (NCS): This assess the velocity of electrical impulses across the median nerve. Faulty signals suggest compression.
Electromyography (EMG): This tests the electrical conduction in the muscles confirming diseases of the nerves or muscles.
5. Ultrasound and MRI: The mentioned methods in imaging assist in visualizing the carpal tunnel, determining whether it is inflamed or is narrow.
Differential Diagnosis
Other conditions for example arthritis, cervical radiculopathy or tendonitis can produce symptoms similar to those of CTS. Consequently, a detail scan is essential in identifying the right problems.
Through clinical assessments and tests, CTS can be diagnosed and further treatments can be recommended to avoid compromise of the nerve.
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.
Exercises to Help Reduce Symptoms of Carpal Tunnel
Stretches soothe CTS and make a difference through flexibility, nerve displacement and straightforward strengthening of the wrist. Here are three effective exercises: There are three techniques namely Wrist Rotations, Arm Prayer Stretch, and Median Nerve Glides.
1. Wrist Rotations
It increases circulation around the wrist bones and keeps the area flexible or the joint of the wrist.
How to Perform:
- Stand or sit comfortably and raise the arm in from of you horizontally.
- Place your first in a therapeutic, or open, position with the thumb faced downward.
- Twirl your wrist clockwise and counter clockwise.
- Take 10 full turns right and 10 full turns left.
Benefits:
Improves circulation of blood in the wrist and hand.
Reduction of the stiffness and increased mobility.
2. Arm Prayer Stretch
This stretch aims at the muscles and tendons of the wrist and forearm.
How to Perform:
- Stand sa prominence with your hands cupped together in front of the lower chest area.
- Gradually bring down your hands to your waste but the palms should remain clenched together.
- Pulse when you sense just a mild tension appearing in your wrists and forearms.
- Forty repetitions of this exercise are to be completed with the lift taking between 20-30 seconds before then getting back into the starting position. Repeat 3–5 times.
Benefits:
Affecting the muscles and tendons in the forearm and wrist exercising the fingers and uncrossed wrists.
Reduces stress due to strain in joints and muscles from usage of certain parts of the body.
3. Median Nerve Glides
This exercise is effectively used for increasing the flexibility of the median nerve with a view of reducing pressure on nerve within the carpal tunnel.
How to Perform:
- Stand with your arm straight out from the side of your body, parallel to the floor, with your wrist upwards.
- Tilt your wrist upwards, in an opposite direction to which your fingers are pointing at the moment, so it looks like your fingers are pointing towards the ceiling.
- Slowly open the fingers and the thumb moving them backward.
- You can make the stretch deeper by making a slight bend at the elbow.
- To proceed, pause for 5 seconds, and then release the pressure. Perform 5–10 repetitions.
Benefits:
Decreases rubbing of median nerve.
Enhances nerve flexibility and helps to eliminate other symptoms such as tingling and numbness.
Graphics to support for a better comprehension
These exercises are best explained by including videos or animated GIFs. If you need help in the making of illustrations for these exercises feel free to let me know.
Share your review after performing these exercises either on yourself, healthy individual or patient.
Check up after completing the Wrist exercises
I applied Wrist Rotations, Arm Prayer Stretch, and Median Nerve Glides to a normal, noccomplaining subject in order to assess the comfort of the stretches. Here's my review based on the observations:
1. Wrist Rotations
This exercise was basic and did not take a very long time to complete. The participant felt comfortable after each of the rotations done which was reflected in the enhanced flexibility notably in the wrist joint. The circular movement helped in rotary Flexion-extension of wrist and was really beneficial in reducing mild stiffness. The exercise is gentle; therefore it is ideal for people who have restricted mobility, and it is ideal for warm up prior to engaging in other exercises.
2. Arm Prayer Stretch
The participant at first reported some difficulty when performing this stretch, though the difficulty was reduced with the correct positioning of the body. The movement engaged the wrists and forearms up to a deep level which was regarded as the best feeling after the exercise. Due to the nature of the movements involved in this exercise, it would greatly help in those feeling pain in the wrist and forearm because of excessive use of the hands. That way however it is recommended that those with severe wrist ache should consider taking small steps so as to avoid any strain on the wrist.
3. Median Nerve Glides
The participant applauded this exercise for this sort of call being direct to the median nerve. They said they felt a numbness during the stretch, although this is expected when stretching the nerve. There were no feelings of discomfort as the movement was achieved with out any jerk. This exercise is therefore most suitable for persons who may have mild cases of the Carpal Tunnel Syndrome because nerve flexibility improves in this case once compression is reduced.
Overall Impression
These exercise regimes are not complicated and can suit any time of the day. It is even more important that they are not only therapeutic for those who have wrist discomfort, but can also be utilised in preventative care for wrists. The above mentioned exercises may be of crucial value for everyone, primarily since practice of these exercises leads to flexibility enhancement, prevention of nerve compression, and growing strength of the wrist muscles.
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Regard for me @shabbir86
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 (2.6/3)
You have shared a great knowledge about carpal tunnel syndrome, its symptoms, cause, but didn't add it's types. There are 4 types that I explained in the lesson. Acute, chronic, primary and secondary. It would be better to explain them. 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 (4/4)
You try the wrist rotations, median nerve glides and arm prayer stretch exercises. You did the wrist rotations, median nerve glides, 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.