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  • Q&A with Australian Health Practitioners

    How do you treat mild to moderate carpal tunnel syndrome?

    Hi I have evidence of mild to moderate median nerve entrapment in the right carpal tunnel how can this be treated and is there a way of preventing it getting worse.
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    Well Now Health Solutions offers high quality occupational therapy services to the adult population in Gympie and the surrounding regions. Our occupational therapy services aim … View Profile

    Hi Anne

    There are a few ways in which you can relieve the symptoms of CTS without the need for surgery.  These include the use of splints, rest, injections and stretches and medications.  You might find a combination of these will be the most effective.

    As an occupational therapist, I commonly prescribe splints as one way to treat the symptoms as it allows the wrist to be rested even when the arm is being used in daily activities.  Splints that support the wrist in a neutral or slightly extended position, but allow the fingers to work, are efficient and effective.  They can be used during the day and at night to maintain the wrist in a comfortable position.

    Avoiding/reducing activities that overuse the wrist or place a lot of pressure on the wrist is another way of treating the problem.  If you are frequently involved in activities that cause compression on the median nerve through constant wrist flexion or excessive extension, then the use of a splint can help, but also look at having frequent rest breaks from the activity and do some stretches.

    Remember, you can't ‘push through’ carpal tunnel so seeing a health professional, such as an occupational therapist and doctor, will help you find relief for those symptoms.

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    Dr Chan obtained his medical degree from the University of Sydney. In 1998, he was awarded the Zimmer Research Fellowship at the Jo Miller Laboratory … View Profile

    Anne

    I agree entirely with Tina. Having carpal tunnel syndrome does not mean you need to have surgery. I will usually refer patients with carpal tunnel syndrome to a hand therapist for non-operative treatment (avoidance of aggrevating activities, night splint, nerve gliding exercises) prior to considering surgery.

    What constitutes mild to moderate carpal tunnel syndrome? I assess severity from the symptoms that a patient describes, more than what is reported on nerve conduction studies that patiens often come to me with.

    I suggest surgery if:

    • symptoms are constant (present 24 hours per day) - this implies severe nerve compression and can have implications on nerve recovery
    • symptoms cause significant sleep disturbance despite wearing a night splint
    • symptoms interfere with function (ie what you need to do or want to do)
    • you do not wish to continue using splints to control your symptoms

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