|
The Light At The End
Of The Tunnel
By
Victoria L. Magown, CMTPT, LMT and
George S. Pellegrino, LMT, CMTPT
The deadline for Linda's project was rapidly approaching.
Typing feverishly at her keyboard in spite of pain in her hands,
wrists and arms, she knew people were counting on her to get this
project done on schedule. Working at a computer day after day,
made this pain a common occurrence. "Carpal Tunnel Syndrome?",
she mused. For some people this story is all too familiar.
Many people know the term Carpal Tunnel Syndrome or CTS.
How often have you seen people rubbing their hands to get rid of
their pain? When they notice you observing them, their explanation
is "Carpal Tunnel!" Have you had hand pain and wondered, "Do
I have Carpal Tunnel Syndrome"?
Most people use this term to explain pain in their hands without
fully understanding what the term means. The pain of CTS is
caused by compression of the median nerve in the tunnel through the
carpal bones. "Carpals" are the bones of the wrist and the
tunnel is the space between the bones and the flat, broad ligament
that crosses over the top.
In Linda's case, the initiating cause was "Repetitive Motion Injury",
currently defined as "injury to tissues due to repeated trauma, usually
associated with writing, painting, typing or use of vibrating tools
or hand tools. More specifically, CTS may be, but is not always,
caused by repetitive motion of the wrist."
Although Linda had many of the signs of CTS, there can be other
causes. As early as 1951, an industrial disease call Occupational
Myalgia, referred to injuries specific to muscles involved in the
use of another modern miracle, the typewriter. Not much has
changed.
Carpal Tunnel Syndrome is characterized by pain, numbness and/or
tingling on the palm side of the hand over the thumb, palm, index
and middle fingers. Pain can extend into the forearm and upper
arm.
Trigger Points (TrPs) in muscles can cause these patterns of pain.
TrPs are a hypersensitive focus of pain in a muscle that restricts
range of motion and refers pain in a predictable pattern usually
away from the site of the Trigger Point. They can be laid down
in muscles through direct trauma or repetitive motion.
Take for instance the palmaris longus (Illustration A). TrPs in
this muscle can cause a painful, prickly sensation in the palm of
the hand, wrist and forearm. Linda also had pain in her thumb
caused by two muscles in the palm of the hand, the adductor and opponens
pollicis (Illustration B). These muscles can mimic CTS and
need to be considered before surgery.
Another muscle that developed TrPs as a result of her occupation
was the brachialis (Illustration C). Upper arm pain from this
muscle was part of Linda's symptoms, which she never connected to
the pain in her thumb. It was involved as the result of keeping
the forearms bent at a keyboard for hours at a time.
The pronator teres (Illustration D), a muscle that turns the palm
downward as in typing, not only causes wrist and thumb pain, but
compresses the very nerve responsible for CTS, the median nerve.
The tunnel of the carpals is not the only location at which this
nerve can be compressed.
Appropriate treatment by the Certified Myofascial Trigger Point
Therapists at MyoRehab eliminated Linda's pain. A specific
Home Exercise Program and modifications to her workstation prevent
the return of her symptoms.
Are you looking for "The Light At The End Of The Tunnel"?
Do you suspect Carpal Tunnel Syndrome?
Give us a call at MyoRehab.
|
