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The Carpal Tunnel Syndrome

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At first, the pain starts in your wrist and then extends into your hand. It’s called carpal tunnel syndrome and usually includes burning, numbness, and sometimes even tingling sensations that extend up the arm and beyond. Simple tasks such as flexing your fingers or curling your wrist inward are now a struggle as tightening muscles put pressure on the median nerve. Before long daily activities such as typing on the computer or cooking become a challenge. What’s worse is if left untreated the condition will only deteriorate eventually causing permanent damage to the underlying muscles.

Carpal tunnel syndrome isn’t in your head, but it can certainly start there. Something as simple as how you hold your head at work can cause a “multiple crush,” an issue that creates catching spots in the elbow, neck, or shoulder.  In that sense, wrist pain could be the end result of something bigger that affects your whole body.

That’s why it’s important to visit a pt Health physiotherapist. When you visit pt Health, you’ll receive a thorough assessment which addresses the source of your problem long before you are given any exercises, pain relief, or bracing options.  This type of treatment plan ultimately saves you cost and time because you aren’t left to shop for a brace which may ultimately compromise the nerve.

The good news? There’s something you can do about it. Introducing the pt Health Carpal Tunnel Treatment Program.


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Treatment Plan

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Carpal Tunnel Syndrome is the most frequently diagnosed form of nerve entrapment, i and for this reason it’s important to consider preventative techniques to reduce the rate of occurrence.  But no matter how hard you try to flex and stretch sometimes the median nerve insists on acting up. This is especially true for persons with metabolic diseases such as diabetes and arthritis, which have a tendency to compress the nerves. Even pregnancy can cause carpal tunnel because of the increase retention of fluid in expectant mothers.

Your Assessment

When you visit pt Health, we’ll get you right in so your therapist can assess your condition. But before treatment even starts, your provider will want to know if the pain is localized to the wrist as nerve compression can start higher up in the body. For example, they may ask you to stand tall, balance, and even walk to assess your gait which helps detect muscle and nerve weaknesses.  From there your therapist can demonstrate gliding exercises, nerve flossing, traction, and stretches to relieve strain on the muscles which constrict the carpal tunnel and press on the median nerve.

Non-Surgical Pain Relief

There is no medication involved in your physiotherapy for carpal tunnel, but your therapist will certainly work with you to decrease your discomfort using a wide range of therapeutic modalities. And since many carpal tunnel conditions are work place related, your therapist may also suggest plans for ergonomic settings at work and home in order to prevent strain.

The goal with physiotherapy is to avoid long term damage and surgical intervention. If you do require surgery however, rest assured physiotherapy is still the next step to getting the tendons, nerves, and muscles healing properly.

Exercises

Once your therapist has addressed the basis of your discomfort, they will work with you to ease tightening muscles which put strain on the median nerve. But don’t be surprised if these stretches involve more than just the hands. As you may recall, nerves travel from the top of the head and radiate, so by the time they reach your wrist the pain could have a cause that with origins elsewhere.

Wrist Braces & Splints

One of the most helpful treatments to curing carpal tunnel is fitting the patient with a resting or nighttime splint which keeps the wrist in a neutral position. The reason for a splint is that many people get into a position which unknowingly compromises the median nerve during rest.

The best part of pt Health is we have access to an assortment of braces. So when you visit with your physiotherapist, they are able to source a splint that keeps your wrist in the right position for healing. This is especially important because you want to be sure to select a device that does not further compromise your pain. Braces have many different fits and your therapist wants you in one that doesn’t put greater pressure on your nerves.

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Marilene’s Story

Wrist Pain Has this Mom and Teacher Seeking Treatment

Marilene is a busy mom of three and full time school teacher. She talks with her hands, and uses them to teach her students, drive a car, help her kids with homework, and walk the dog. She can’t imagine not having them to get her through the day. So while at work one day this year, it came as a big surprise as the once dull pain in her wrist starting getting worse. Grading papers, writing assignments on the board, holding a book – all of these activities only made things worse.

The Assessment: Carpal Tunnel Syndrome

Marilene knew she had to get help so she saw her doctor who did an x-ray and assured her that nothing was broken, but that she probably was suffering from carpal tunnel syndrome, the most common nerve entrapment condition diagnosed in patients. “But, I haven’t injured myself. It’s not like I walk on my hands!” She said to him. “That’s not the problem, but repetitive motions like the activities I’m sure you do every day at school and at home could be the culprit,” her doctor told her.

Marilene’s couldn’t imagine getting through the whole school year not being able to write her lessons down. And what if the pain got worse? So she reached out to Darren, a physiotherapist with pt Health who assessed her condition and confirmed her diagnosis. She laughed when he had her do some exercises to strengthen one side of her body. But he noticed she tended to favor one side of her neck and shoulder and identified this region as the source of her wrist problem. From there, they worked on relieving the pain in her wrist and fingers.

A Plan for Physiotherapy

Following a regime of physio, massage therapy, exercise, and suggestions for making her workspace more ergonomically correct, Marilene was finally on her way to feeling her best again. She no longer hunched over her computer, and even starts her day by doing warm up exercises with her class. “Stand tall she tells her second graders, take a deep breath, and flex.”

“Life is so much better now that my carpal tunnel has gone away. I can gladly say I am pain free, never required surgery, and feel like myself again,” she said.

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Physiotherapy & Wrist Bracing Go Together at pt Health

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While physiotherapy is necessary to alleviate carpal tunnel pain, build strength, and improve functionality, therapy alone is not always enough to fully treat a patient with carpal tunnel syndrome. Often a wrist brace is needed to help keep the median nerve protected. For some patients the condition will inevitably return without proper bracing.

Get the Right Fit at pt Health

At pt Health, we offer a variety of top brand bracing and splints that are comfortable to wear and sleep with. Our bracing is very affordable and often covered by most insurance plans. You’ll notice our wide selection when you visit one of our clinics, and can be sure we have one that fits your needs. What’s more your therapist may custom fit a brace to fit your exact needs. For example, there may be a few degrees of wrist extension required, or a particular size needed.

Ultimately, the brace is meant to keep the wrist in a neutral position where carpal tunnel pressure is at a minimum. A good quality wrist brace or splint will help ensure the median nerve is not adversely compromised.

We offer the following wrist brace brands:

  • Procare
  • Med Spec
  • Bio Skin
  • Breg
  • Mueller
  • Imak
  • Thuasne
  • Thermoactive

Coverage Options

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At pt Health, we know that sorting out insurance paperwork can be time-consuming and confusing. We want your focus to be on getting well and staying well. With that in mind, we do our best to help you navigate through the necessary forms. We speak with your insurance providers and we’ll answer any questions you may have about your coverage.

pt Health services are covered by most health care insurance plans.  In most cases, if you are using your extended health care carrier or work plan, we do not require you to pay for your therapy sessions up front.* Instead, we bill your insurance company on your behalf.
If you have extended health care benefits that cover therapy, most auto insurance companies require that your claim be placed through your extended health plan first. Any remaining balances for services are then covered by your auto insurance plan. On your first visit, you may be asked to provide information about your extended health plan. If you do not have extended health care benefits that cover therapy, your treatments may be billed directly through your auto insurance company. For residents of British Columbia, ICBC covers a partial amount of treatment visits. Patients will be asked to co-pay the difference at each visit. If a patient has extended health care benefits, it is possible to claim the difference back.

Although each clinic’s approach to intake, assessment and therapy do vary, generally speaking your physiotherapist will ask a series of questions that will help better describe all of your symptoms in detail. Your physiotherapist can then carry out your assessment. The physiotherapist will examine you physically and discuss the findings, the cause of the problem, and suggest a solution that can effectively treat your health problem.
OHIP covered physiotherapy services must be provided by a designated OHIP physiotherapy clinic. OHIP covers physiotherapy treatments, but does not cover the cost of an initial assessment. To qualify for OHIP coverage, you must have a medial doctor’s referral, be 19 years or younger, be 65 years or older, or be receiving benefits under the Ontario Disability Support Program or Family Works. If you have been admitted overnight in hospital for a condition that now requires physiotherapy, you are also eligible.
Some pt Health clinics will be able to bill Blue Cross direction for physiotherapy and massage therapy treatments if you are a member of:

  • RCMP
  • DND
  • Canadian Forces
  • Veterans Affairs

For any treatments that are only partially covered, you may be asked to co-pay the difference at each visit.

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