Figure 19: Work Trigger Points within Flexors
Figure 20: Locate Trigger Points within Hands
RECOMMENDATIONS TO PROVIDE CLIENTS
Recommending exercises and activities for a client to perform between massage therapy sessions is a necessary part of client- therapist communication. Here are ten recommended items to suggest to clients to augment their self-care regiments and carpal tunnel recovery care. Be mindful of how much torqueing and bending an activity creates on the wrist joints. Excessive flexion (bending) and rotation (torqueing) of the wrist can create injury to the anatomical structures of the carpal tunnel region, thereby undoing much of the progress made in massage therapy treatments, as well as further exacerbating an already-weakened region. 1. Employ stretching as often as possible. A general recommendation is to stretch every day for at least 10 minutes. If pain is present when an activity or an exercise is performed, pausing to stretch can prevent injury and allow restricted tissue to free and ease pressure from the median nerve. Topical agents (such as analgesic creams, gels, and rubs) can bring temporary relief to carpal tunnel-related pain. There are three main ingredients of these agents: counterirritants such as menthol and camphor, which create a burning or cooling sensation to mask pain; salicylates, which relieve pain in the same manner as aspirin; and capsaicin, which creates a warming sensation to ease nerve pain. 2. Self-massage techniques to bring temporary relief to carpal tunnel related pain. Pressing with moderate pressure (never deep enough to cause pain) into the thenar (thumb pad) or hypothenar (pinky pad) muscles can ease pressure within these muscle groups. Massaging into the anterior antebrachium (front side of forearm) can take pressure off of the major muscle group, causing compression upon the median nerve. 3. Elevate the hands and wrists whenever possible if there is fluid retention coupled within the usual carpal tunnel Conclusion Surveying the research conducted on carpal tunnel syndrome indicates that this condition greatly affects the general population. It manifests itself in a wide variety of characteristics; massage therapy efforts may aid the carpal tunnel patient. Age, the repetitive nature of one’s occupation, and sleep positions hold strong correlations to the development of carpal tunnel syndrome. Orthopedic assessment testing may provide a therapist with a clearer clinical picture of their patient’s References Ashworth, N. (2018). Medscape. Carpal Tunnel Syndrome Treatment & Management. Retrieved from https://emedicine.medscape.com/article/327330-treatment Biel, A. (2015). Trail Guide to Movement, Books of Discovery, Boulder, CO Butler, S., (2016). Self-Care for RSI. Carpal Tunnel Syndrome Self Care. Retrieved from https://www.selfcare4rsi.com/carpal-tunnel-syndrome-self-care.html Hindawi. (2014). The Negative Effect of Carpal Tunnel Syndrome on Sleep Quality. Retrieved from https://www.hindawi.com/journals/sd/2014/962746/ John Hopkins University. (2018). Carpal Tunnel Release. Retrieved from https://www. hopkinsmedicine.org/healthlibrary/test_procedures/orthopaedic/carpal_tunnel_ release_135,29
symptoms, especially in the case of bone fractures, neurological disease, and pregnancy. 4. Keeping the body warmer will likely keep forearm and hand muscles looser, easing the compression of the median nerve. The body constricts tissues when it is cold, which only furthers exacerbates the compression factor of the median nerve. 5. Relax the hands and wrists often. We often never realize how much tension we are holding in our hands and wrists when performing basic daily tasks such as driving, writing, using our phones, typing on a keyboard, or gripping objects. Softening our hands and wrists during these activities can release muscular tension that contributes to the compression of the median nerve. 6. Take frequent breaks during a work shift. Carpal tunnel syndrome is often referred to as a repetitive-stress syndrome . Taking breaks allows muscles involved with compression of the median nerve to relax and avoid excessive inflammation. A 10-minute break per each 50-minute period of work is a general recommendation. With severe cases that involve a lot of pain, breaks up to 20 to 30 minutes per a 30 to 40-minute work load of is recommended. 7. Wearing splints will keep the anatomical structures of the wrist and hand in healthy alignment, easing restrictions and compressions of the median nerve. Carpal tunnel symptoms may worsen at night, thereby making it necessary to splint one’s wrists while sleeping. Splinting during the day may be necessary if one’s occupation involves dexterous hand motions, such as typing and writing. 8. If one’s forearms become achy, running cold tap water over the muscles or immersing the forearms in cold water for 30 seconds will help relieve inflammation. carpal tunnel case. Bodywork suggestions presented in this course will provide great relief and enhance treatment plans. Recommending self-care efforts to the carpal tunnel patient will augment therapy. Information presented is never intended to replace advice from a qualified medical professional. Please honor all requests of the physician and practitioners in the care of one’s health condition. National Institute of Neurological Disorders & Strokes. (2018). Carpal Tunnel Syndrome Fact Sheet. Retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/ Fact-Sheets/Carpal-Tunnel-Syndrome-Fact-Sheet Netter, F. (1997). Atlas of Human Anatomy, Novartis Publishing, East Hanover, NJ TSPT. (2018). Special tests for wrist / hand. Retrieved from https://www. thestudentphysicaltherapist.com/ Turner T. & Connelly, K. (2018). Drug Side Effects & Medical Complications. Retrieved from https://www.drugwatch.com/side-effects/ Washington State Department of Labor & Industries. (2018). Economic burden of carpal tunnel syndrome. Retrieved from http://www.lni.wa.gov
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