What do carpal tunnel, tennis elbow, and golfer’s elbow all have in common?
They can all be treated with conservative management under the care of an occupational therapist. Does this mean that surgery can always be avoided? Unfortunately no, but it does significantly reduce the likelihood for surgical intervention and it also promotes education on addressing underlying causes of symptoms to reduce future recurrence. Continue reading to learn about common treatment approaches and modalities utilized to treat these common disorders.
Carpal tunnel syndrome is a common condition that is associated with pain, decreased strength, numbness and tingling, and limitations with range of motion. CTS is the result of compression of the median nerve as it passes through the sheath in the wrist known as the carpal tunnel. The numbness and tingling that is typically felt affects the thumb, index, middle finger, and at times the ring finger also. Individuals who perform repetitive hand based activities (receptionists, cashiers, hair dressers, etc) tend to be more at risk for CTS. Women who are pregnant may also experience CTS symptoms secondary to hormonal changes that cause swelling.
Occupational therapy can assist to address and mediate symptoms by evaluating a patients current level of function, determine contributing factors to symptoms such as sleep position, job requirements, and potential nerve involvement other than at the carpal tunnel. Modalities and/or treatment approaches typically used include resting and stretching, custom splints for temporary immobilization and/or support, infrared light therapy (Anodyne), electrical stimulation, ultrasound, Kinesio Taping, gentle strengthening, body mechanics and work retraining, nutritional modifications, and soft tissue mobilization.
Tennis/golfer’s elbow, technically known as lateral or medial epicondylitis are conditions associated with the elbow, specifically the attachment sites for the extensor and flexor muscles of the wrist. Similar to CTS, these disorders are often caused by overuse or repetitive tasks. Symptoms typically include pain, stiffness, weakness, and numbness/tingling in the elbow and/or forearm. Commonly an individual will purchase an elbow wrap or brace and although these prefabricated braces may offer temporary relief from symptoms, they are not addressing or correcting the underlying issues.
An occupational therapist can utilize the aforementioned treatment approaches and modalities associated with CTS for the tennis/golfer’s elbow to allow a person to reduce symptoms and return to normal functioning. An example of a typical plan of care following evaluation would include providing the patient with specific forearm stretches to perform throughout the day, soft tissue mobilization and/or instrument assisted soft tissue mobilization, use of infrared light therapy, kinesio taping (the Kinesio Taping Method is a definitive rehabilitative taping technique that is designed to facilitate the body’s natural healing process while providing support and stability to muscles and joints without restricting the body’s range of motion as well as providing extended soft tissue manipulation to prolong the benefits of manual therapy administered within the clinical setting.), and education on body mechanics/ergonomics for home and work activities. A patient may be appropriate for a custom fabricated splint to temporarily immobilize the wrist to allow for rest and healing to the affected tissues. Once painful and numbness/tingling symptoms dissipate, a patient may be progressed to gentle strengthening and practicing functional activities. The patient is involved in the treatment process from start to finish and works with the therapist to create appropriate goals.
In conclusion let there be a call to action. If you are waking up with pain in your wrist or elbow, numbness shooting down or through your arms and hands, or feel like you can’t quite do the tasks you usually do without your hands bothering you — don’t wait, come get an occupational therapy evaluation at The Idaho Pain Clinic and get the help you need. Our occupational therapy services include the above-mentioned treatments including infrared light therapy, in-house ability to custom cast and create splints, soft tissue mobilizations, taping techniques and the issue of corrective home exercises and modifications. Ignoring your symptoms for these conditions could lead to nerve damage and the need for surgery. Occupational therapy is a noninvasive treatment option with positive results for treating these conditions. Talk to your physician today and ask for referral so you can get the treatment and relief you deserve.
Liz Morris can be reached at Idaho Pain Clinic, 208-263-9757.