Carpal

Tunnel
Syndrome
T H E VA M A L A R A / P N A D A R A J A
4263201001
KPJUC, NILAI
WHAT IS CARPAL
TUNNEL
SYNDROME
A condition that affects the hand
and wrist. It is caused by the
compression of the median nerve as
it passes through the carpal tunnel,
a narrow passageway in the wrist
formed by the carpal bones and a
ligament called the transverse
carpal ligament.
CAUSES AND SIGN & SYMPTOMS
CAUSE SIGN & SYMPTOMS

Rapid finger movements Numbness

Tingling
Forceful gripping of objects with fingers
Pain
Repetitive wrist movement
Stiffness
Prolonged awkward wrist movement and
Weakness of hand and thumb
prolonged firm grip on the palm
Reduced muscle mass in thumb

Difficulty in holding or pinching items.

Occupational Therapy Assessment
Semmes-Weinstein monofilament testing (SWMT)

Jamar dynamometer and pinch gauge

Problem Nerve compression at wrist.

Aim To immobilization wrist movement and avoid prevent further damage.

Treatment Splinting-wrist splint

Model / FOR Rehabilitative

Methods 1. Wrist in neutral position to 15 degrees of extension.

2. The straps of the splint should be done up over the back of the arm

Precautions 1. The thermoplastic should not be too hot.

2. Ask the patient to sit while moulding the splint
3. Check for the hand regularly to prevent blood circulation problem
4. .The splint should not restrict any finger movements.
5. Educate patient on splint care
Problem Numbness at hand.

Aim To normalize sensation

Treatment Sensory re-education

Model / FOR Sensory integration

Methods 1. Roll Velcro covered roller in palm for 5 minutes.

Precautions Pt sitting in good posture

Problem Poor pinch strength and endurance

Aim To improve pinch strength and endurance

Treatment Pinch tree activity

Model / FOR Biomechanical

Methods 1. Ask client to pinch clips like holding key and clip on rod.
2. Start with yellow following with red and green.
3. Ask client to clip back at the initial place.

Precautions 1. Do not use broken clips

2. Place the rod closer to client to avoid overstretching of arm.
Problem Poor grip strength and endurance

Aim To improve grip strength and endurance

Treatment Digi flex hand exercises

Model / FOR Biomechanical

Methods 1. Asl client to hold the digi flex with gross grasp position , thumb against black rubber
and finger against finger key.
2. Ask client to grasp the digi flex and release for 10 times with interval of 10 seconds.

Precautions 1. Discontinue if patient have unusual swelling, skin discolouration.

Problem Pain at wrist due to repititive wrist movement

Aim To reduce wrist movement

Treatment Conservation of energy technique

Model / FOR Rehabilitative

Methods 1. Plan and prioritizing the day around to complete most important tasks
2. Delegate tasks
3. Provide Client splint to resist repititive wrist movement
4. Therapist modify difficult task.

Precautions 1. Educate patient to complete ADLs and IADLs while wearing provided splint.
REFERENCES
1. https://healthnews.com/health-conditions/neurological-disorders/occupational-therapy-for-car
pal-tunnel-syndrome/

2. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/carpal-tunnel-
syndrome-why-go-to-occupational-therapy

3. Occupational Therapy for Carpal Tunnel Syndrome , Department of Rehabilitation

Occupational therapy.

4. https://www.brighamandwomens.org/assets/BWH/patients-and-families/rehabilitation-
services/pdfs/wrist-carpal-tunnel-syndrome-ot.pdf