Carpal tunnel syndrome is the most common peripheral neuropathy. CTS occurs when the median nerve is impinged beneath the transverse carpal ligament, which holds the carpals in position where the wrist meets the palm of the hand. The carpal tunnel contains nine flexor tendons that are responsible for the fingers ability to flex, and provides sensation to the radial three digits and half of the fourth digit. CTS causes parethesias, thenar clumsiness, and weakness in lumbricals one and three (Clark, Shaw Wilgis, Aiello, Eckhaus, & Eddington, 1998: p. 223). This syndrome is caused by health conditions such as: obesity, arthritis, diabetes, hypothyroidism, pregnancy, and wrist fractures. CTS can also be caused by activities that put pressure on
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The most common tests are the Phalen’s test and Tinel’s percussion test. During a Phalen’s test, the patient’s elbows are resting on a flat surface while holding their forearms vertically. The patient then lets their wrists fall together into flexion for at least one minute. This position increases the pressure in the carpal tunnel and has the effect of pinching the median nerve. The reverse Phalen’s test is done when the patient’s wrist and fingers are in full extension for two minutes. This test significantly increases pressure in the carpal tunnel. A positive Phalen’s test occurs when the patient experiences parethesias. A Tinel’s sign is when light percussion is placed on the median nerve. A positive Tinel’s sign occurs when a tingling sensation results (Urbano, …show more content…
Ultrasound is used to provide deep heat to the structures of the hand by producing friction to increase functional use. This modality aids in relieving pain. The frequency will most likely be set at 3.3 MHz because the higher the frequency, the less the penetration. The intensity will most likely be set at 0.5 W/cm2 since we are doing a small area. Phonophoresis is the use of ultrasound to enhance the delivery of corticosteroids. Iontophoresis is a method of delivering medication into tissue by using the force of electrical current. Dexamethasone is a corticosteroid frequently used with iontophoresis and phonophoresis that reduce inflammation. This specific corticosteroid has a negative charge, and when placed on a negatively charged electrode, the electrical force pushes the medication into the desired area. The electrodes will be placed to enable the electrical current to pass through the area where the pain is felt. Cryotherapy, or cold therapy, can be used if the syndrome has caused swelling; although, contrast baths are more commonly used. The cold water causes vasoconstriction and the hot water causes vasodilation, which forces circulation. The contrast baths are used for treating pain, swelling, and
The most common tests are the Phalen’s test and Tinel’s percussion test. During a Phalen’s test, the patient’s elbows are resting on a flat surface while holding their forearms vertically. The patient then lets their wrists fall together into flexion for at least one minute. This position increases the pressure in the carpal tunnel and has the effect of pinching the median nerve. The reverse Phalen’s test is done when the patient’s wrist and fingers are in full extension for two minutes. This test significantly increases pressure in the carpal tunnel. A positive Phalen’s test occurs when the patient experiences parethesias. A Tinel’s sign is when light percussion is placed on the median nerve. A positive Tinel’s sign occurs when a tingling sensation results (Urbano, …show more content…
Ultrasound is used to provide deep heat to the structures of the hand by producing friction to increase functional use. This modality aids in relieving pain. The frequency will most likely be set at 3.3 MHz because the higher the frequency, the less the penetration. The intensity will most likely be set at 0.5 W/cm2 since we are doing a small area. Phonophoresis is the use of ultrasound to enhance the delivery of corticosteroids. Iontophoresis is a method of delivering medication into tissue by using the force of electrical current. Dexamethasone is a corticosteroid frequently used with iontophoresis and phonophoresis that reduce inflammation. This specific corticosteroid has a negative charge, and when placed on a negatively charged electrode, the electrical force pushes the medication into the desired area. The electrodes will be placed to enable the electrical current to pass through the area where the pain is felt. Cryotherapy, or cold therapy, can be used if the syndrome has caused swelling; although, contrast baths are more commonly used. The cold water causes vasoconstriction and the hot water causes vasodilation, which forces circulation. The contrast baths are used for treating pain, swelling, and