[1]One of the first blog posts I wrote was: Carpal Tunnel Syndrome (CTS): Is surgery the only option? [2] I was treating a patient at the time who was told by several people that surgery was her only option. She decided to give physical therapy a shot; one last-ditch effort before surgery. Since that time, several of you have inquired about this patient. Did she have surgery or was physical therapy successful?
May 2014: The patient story…
Currently, I am treating someone with CTS symptoms. This is her story and my inspiration for this blog post.
This past winter, my patient was told by two surgeons that she had bilateral (both wrists) carpal tunnel syndrome and her only option was surgery. At that time, she had a 3-week old baby and so she asked if there was something more conservative to try before surgery. Both surgeons responded “no”. She did try chiropractic and acupressure treatments, but did not have any symptom relief. With surgery finally scheduled this summer, her sister recommended physical therapy to ensure she had explored all conservative options before her date with the operating room.
Her symptoms began in her 7th month of pregnancy and continued to worsen over time. She had the classic signs of CTS: burning that changed to numbness of the thumb, index and middle finger, night pain and weakness of her hands for all fine motor tasks (putting in earrings, writing, opening a water bottle). She had swelling in her wrists, but more importantly, her forearm muscles felt like ROCKS! They were so tight and painful. Her thumbs were weak, but she had good strength of her index and middle finger. Her cervical spine was evaluated, but was not a contributing factor.
Her PT diagnosis: Carpal Tunnel Syndrome AND Pronator Teres Syndrome
The craziest part of her story is that she was told by one surgeon that she should get carpal tunnel surgery on both wrists, but if the symptoms were coming from her forearm they wouldn’t know until they do the surgery. Well, that just seems silly. Why would you cut a structure in the wrist if it’s not actually causing the problem?
We got to work immediately. She was educated to continue to wear her splints at night and add in her PT home exercise program. After two weeks of manual therapy, exercise progressions for stretching, strengthening, fine motor coordination and icing, she reported 50% improvement in her symptoms. Her best statement: “They’re starting to feel like hands again.”
We’re not out of the woods yet, but she has currently postponed her surgery because she can now put on earrings and open water bottles, tasks she has not been able to do for over 6 months.
October 2014: Patient follow-up 6 months later…
[3]She did not have to have surgery! She was officially discharged from physical therapy in July 2014 and continues to do her exercises. This excerpt is from an email sent yesterday.
Basically everything feels easier. I can put on earrings, open bottles, and use my hands fully. I have sensation back and feeling good! 🙂
I have regained function and feeling (i.e. touch) throughout my hands and fingers. My middle fingers are still tingly most of the time, although it is worse in the morning and gets better throughout the day. When they are doing well it’s more of a tight feeling then a tingly one. On bad days, my ring and pointer fingers are tingly as well but it’s more of an annoyance; it doesn’t interfere with my function anymore. I can tell when my body is off or particularly tight because both hands will fall asleep. However, if I stretch they will go back to the new normal.
Because of the severity of her symptoms, she was educated that it might take an entire year for her symptoms to completely resolve. But, the most important piece is that she continues to gain sensation and function in both of her hands.
If you have carpal tunnel syndrome or symptoms similar to those described above, try physical therapy. It just might work!
If you want to read my original blog post to learn more about CTS, click here [2].
© 2014 and Beyond. ALL BLOG CONTENT at duncansportspt.com by Lori Duncan PT
ABOUT THE AUTHOR
Lori Duncan, DPT, MTC, CPT is a respected Physical Therapist, Manual Therapist and Pilates instructor in Lafayette, CO. Lori is passionate about preventive physical therapy and education and is a nationally recognized presenter. She can be reached at [email protected]. You can also follow Duncan Sports Therapy + Wellness on Facebook [4] & Instagram [5] for more free tips and information.