Carpal Tunnel Syndrome

Conservative management remains effective in most cases of carpal tunnel syndrome. Generally, therapy should occur up to 3 times a week for up to 8 weeks in order to educate the individual in symptom control and management. After a diagnosis of CTS, reduction of the symptoms and the identification of activities that increase the symptoms, both at home and at work, are the first goals. Individuals should receive therapy from an occupational therapist, a physical therapist, or a hand therapist (Gerritsen, "Conservative Treatment Options").

The first objective of therapy is to reduce pain and swelling, using modalities such as heat and cold (Braddom). The hand and wrist are elevated to reduce swelling and may be positioned in a static resting hand splint to decrease movement in the painful region and to provide proper alignment (Gerritsen, "Splinting vs. Surgery"; Muller; O'Connor). After pain is consistently reduced, activities to increase muscle flexibility, range of motion, strength, and body posture are a second objective. During this stage, the therapist also monitors sensory status and, if deficits are noted, provides sensory reeducation (Muller). Patient education also addresses awareness of body posture during task performance. An ergonomic evaluation may also be beneficial (Wilson).

In order to increase the individual’s overall comfort and function, clinicians and therapists must devise specific plans that will help the individual reduce activities that increase the symptoms in the course of daily activities. In the workplace, modified work is important until symptoms resolve. This needs to be specifically addressed with company representatives if possible. Some have programs with alternative work options.

Additional information may provide insight into the rehabilitation needs of these individuals (Evans).