Carpal Tunnel - PTAEducation

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Carpal tunnel syndrome is a common condition causing pain, numbness, and tingling in the hand and fingers due to pressure on the median nerve in the wrist.

This pressure often results from swelling or irritation within the carpal tunnel, a narrow passage in the wrist that houses tendons and the median nerve.

The roof of the carpal tunnel is comprised of the flexor retinaculum.

There are ten carpal bones comprise the floor of the tunnel.

There are contents of the tunnel include:

Four flexor digitorum profundus tendons

Four flexor digitorum superficialis tendons

Flexor pollicis longus tendon

Median nerve

Thoracic Outlet Syndrome is a condition where nerves or blood vessels in the space between your first rib and clavicle are compressed.

This compression can lead to pain, numbness, tingling, and other symptoms in the arm, forearm, and hand.

Types of TOS include:

Neurogenic

Compression of the nerves, most commonly the brachial plexus, leading to pain, numbness, and tingling.

Arterial TOS

.Compression of the arteries, potentially causing pain, numbness, ischemia, or clot formation.

Venous TOS

Compression of the veins, potentially leading to swelling, discoloration, and blood clots.

Etiology

Anatomical factors

Cervical rib

Other bony abnormalities

Repetitive motions

Repetitive overhead movements.

Poor posture

Trauma

Neoplasm

Symptoms

Pain

Tingling, or numbness, paresthesias

Weakness

Coldness or pallor

Edema

Diagnosis

Physical exam

Nerve Conduction Studies

Medical Imaging

Interventions

Physical Therapy (ROM, strengthening, etc.)

NSAIDs

Lifestyle/behavior modification

Decompression Surgery

Pain radiating along the sciatic nerve from the lower back down the lower extremity, typically caused by:

Herniated disc (90% of cases no) at L4-L5/L5-S1 Lumbar Spinal Stenosis

Degenerative Disc Disease

Piriformis Syndrome

Symptoms

Sharp, shooting, or burning pain.

Numbness, tingling, or "pins and needles".

Muscle weakness in the leg or foot.

Symptoms that worsen with sitting, coughing, or sneezing.

Management

NSAIDs (ibuprofen, naproxen) to reduce inflammation.

Physical therapy that includes specific exercises, physical agents, and postural activities to reduce nerve compression and manage pain.

Steroid injections to reduce inflammation.

In rare cases surgery may be required if symptoms are severe, persistent, or caused by significant nerve compression.

Carpal Tunnel Syndrome

Thoracic Outlet Syndrome

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