Carpal Tunnel Syndrome

Carpal tunnel syndrome is an entrapment neuropathy of the median nerve, which runs from the forearm into the hand. The median nerve controls sensations to the palm side of the thumb and fingers, as well as impulses to some small muscles in the hand that allow the fingers to move. The carpal tunnel is a narrow, rigid passageway of ligament and bones at the base of the hand that houses the median nerve and tendons. When tendons swell, the tunnel narrows and the median nerve becomes compressed. This compression causes patients to experience a number of symptoms, including:

• Tingling and numbness in the fingers.
• Aching in the hand and forearm which can radiate to the shoulder and back.
• Clumsiness or weak grip.

Symptoms of Carpal Tunnel Syndrome
Symptoms usually start gradually, with frequent burning, tingling, or itching numbness in the palm of the hand and the fingers, especially the thumb and the index and middle fingers. Some carpal tunnel sufferers say their fingers feel useless and swollen, even though little or no swelling is apparent. Symptoms often first appear in one or both hands during the night but as symptoms worsen, people might feel tingling during the day. Decreased grip strength may make it difficult to form a fist, grasp small objects or perform other manual tasks.

Causes of Carpal Tunnel Syndrome
Some people are genetically predisposed to carpal tunnel syndrome because they have smaller carpal tunnels. For this reason, women are three time more likely than men to develop carpal tunnel syndrome. Other contributing factors include trauma to the wrist, fluid retention, hypothyroidism, work stress, rheumatoid arthritis or the development of a cyst or tumor in the canal. Repetitive motions can cause bursitis and tendonitis and are sometimes mistaken for carpal tunnel syndrome - there is no scientific data to prove that repetitive motions alone cause carpal tunnel syndrome.

Diagnosing Carpal Tunnel Syndrome
Dr. Anselmi will conduct a thorough physical examination of the hands, arms, shoulders and neck to determine if your symptoms are indicative of carpal tunnel syndrome. He will examine your wrists for tenderness, swelling, warmth and discoloration; test each finger for sensation; and inspect the muscles at the base of the hand for strength and signs of atrophy. If necessary, routine laboratory tests and X-rays can reveal diabetes, arthritis and fractures. If Dr. Anselmi determines that you are in fact suffering from carpal tunnel syndrome, he will recommend a customized plan of treatment to address it.

Treatment of Carpal Tunnel Syndrome
Dr. Anselmi uses Active Release Techniques (ART?) in the treatment of Carpal Tunnel Syndrome. It is noninvasive, very safe with a 90% success rate. At the beginning of each appointment, Dr. Anselmi evaluates the texture, tightness and movement of muscles, fascia, tendons, ligaments and nerves in the affected area. He treats any abnormalities with a combination of precisely directed tension and very specific patient movements that helps relieve the symptoms of numbness, tingling, burning, and aching. Active Release Techniques® Treatments can be uncomfortable during the movement phases of the treatment as the scar tissue or adhesions "break up". This is temporary and subsides almost immediately after the treatment. Treatments are about 8-15 minutes per area treated and vary in number from 2 to 10 visits typically. In addition, Dr. Anselmi's patients are given arm, wrist and hand stretches to complement the treatment and prevent further damage from occuring.