Health
Pursuit Physiotherapy- Managing and Preventing Carpal Tunnel Syndrome
Management & Prevention of Carpal Tunnel Syndrome
Carpal tunnel syndrome is one of the most commonly diagnosed repetitive strain injuries. It occurs when the median nerve, which is the main nerve that travels down the inside of your forearm to your hand, becomes compressed or irritated as it passes through the carpal tunnel at the wrist. The carpal tunnel is an opening formed by ligaments and bones on the inside of the wrist which allow tendons and nerves to pass through it.
The problem is that this passageway is narrow and can be easily obstructed by local swelling and inflammation, usually from overuse or direct trauma. For example, repetitive work or leisure activities that involve a lot of gripping or use of the flexors (inner forearm muscles) can cause inflammation of the tendons. Similarly, long hours of computer work with improper ergonomics can cause excessive pressure on the inside of the wrist.
The common symptoms of carpal tunnel syndrome are numbness, tingling, or burning sensations in the palm of the hand and fingers, often accompanied by skin sensitivity and grip weakness. As the symptoms worsen people often experience sharp, shooting pain from the inner wrist up the forearm and decreased ability to use the affected hand.
Our treatment strategy is geared towards reducing the pressure on the carpal tunnel area and allowing the median nerve to function properly again. We are able to use a number of different treatment strategies such as:
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Joint mobilization – stiff joints around the carpal tunnel can cause narrowing of the passageway and compression of the median nerve and flexor tendons. Using manual techniques we will loosen stiff joints and work to restore normal mobility and range of motion in the wrist and hand bones, taking pressure off the nervous tissue.
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Soft tissue release – it is important to release tight muscles in the forearm and hand that may be compressing the median nerve and contributing to nerve pain and tightness. We can use a number of techniques to achieve this such as massage, cupping, acupuncture, and IMS.
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Ergonomic correction – we will work with you to determine how to optimize your ergonomic set-up for work or home to minimize strain on your body. A brace may also be recommended to manage symptoms at work or at night. A brace will keep your wrist in a neutral position and prevent the wrist from flexing and compressing the carpal tunnel.
There are also a number of prevention strategies that you can use to reduce your risk of developing carpal tunnel syndrome:
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Optimize your ergonomic set-up – position your keyboard and mouse so that your wrists are neutral and not hyperextended or flexed. Also be aware of your posture and try to keep your neck, shoulders, and back in a straight and relaxed position. Ergonomic equipment may also be useful especially for people who spend long hours at the computer. For more detail see the full blog on correct ergonomics.
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Take regular breaks from repetitive activities – prevent tension and strain from building up in your tissues by planning regular breaks for stretching and changing position.
Seek help from a physiotherapist at the first signs of pain; don’t wait for it to get worse.
Carpal tunnel release surgery is also an option for chronic cases that do not completely resolve with physiotherapy; however it should be seen as a last resort. A course of physiotherapy treatment is always recommended before having an invasive procedure.
**It should be noted that NOT ALL WRIST AND HAND TINGLING IS DIAGNOSED AS CARPAL TUNNEL SYNDROME. Your nervous system is a continuous network of tissue, therefore nerve compression or irritation in other areas of the body such as the neck, back, shoulder, or elbow can contribute to or cause your hand symptoms. Especially if your condition is bilateral (symptoms on both sides), it is likely that body parts other than your wrist and hand require treatment.
As physiotherapists we are trained to comprehensively assess and diagnose your body as a whole and treat all the factors contributing to your pain. We can help ensure you get thorough treatment to eliminate your symptoms as quickly as possible and prevent it from becoming a chronic condition. Don’t try to treat it yourself off the internet! Leave it in the hands of the trained experts.
Aristotle Foundation
The Canadian Medical Association’s inexplicable stance on pediatric gender medicine
By Dr. J. Edward Les
The thalidomide saga is particularly instructive: Canada was the last developed country to pull thalidomide from its shelves — three months during which babies continued to be born in this country with absent or deformed limbs
Physicians have a duty to put forward the best possible evidence, not ideology, based treatments
Late last month, the Canadian Medical Association (CMA) announced that it, along with three Alberta doctors, had filed a constitutional challenge to Alberta’s Bill 26 “to protect the relationship between patients, their families and doctors when it comes to making treatment decisions.”
Bill 26, which became law last December, prohibits doctors in the province from prescribing puberty blockers and hormone therapies for those under 16; it also bans doctors from performing gender-reassignment surgeries on minors (those under 18).
The unprecedented CMA action follows its strongly worded response in February 2024 to Alberta’s (at the time) proposed legislation:
“The CMA is deeply concerned about any government proposal that restricts access to evidence-based medical care, including the Alberta government’s proposed restrictions on gender-affirming treatments for pediatric transgender patients.”
But here’s the problem with that statement, and with the CMA’s position: the evidence supporting the “gender affirmation” model of care — which propels minors onto puberty blockers, cross-gender hormones, and in some cases, surgery — is essentially non-existent. That’s why the United Kingdom’s Conservative government, in the aftermath of the exhaustive four-year-long Cass Review, which laid bare the lack of evidence for that model, and which shone a light on the deeply troubling potential for the model’s irreversible harm to youth, initiated a temporary ban on puberty blockers — a ban made permanent last December by the subsequent Labour government. And that’s why other European jurisdictions like Finland and Sweden, after reviews of gender affirming care practices in their countries, have similarly slammed the brakes on the administration of puberty blockers and cross-gender hormones to minors.
It’s not only the Europeans who have raised concerns. The alarm bells are ringing loudly within our own borders: earlier this year, a group at McMaster University, headed by none other than Dr. Gordon Guyatt, one of the founding gurus of the “evidence-based care” construct that rightfully underpins modern medical practice, issued a pair of exhaustive systematic reviews and meta analyses that cast grave doubts on the wisdom of prescribing these drugs to youth.
And yet, the CMA purports to be “deeply concerned about any government proposal that restricts access to evidence-based medical care,” which begs the obvious question: Where, exactly, is the evidence for the benefits of the “gender affirming” model of care? The answer is that it’s scant at best. Worse, the evidence that does exist, points, on balance, to infliction of harm, rather than provision of benefit.
CMA President Joss Reimer, in the group’s announcement of the organization’s legal action, said:
“Medicine is a calling. Doctors pursue it because they are compelled to care for and promote the well-being of patients. When a government bans specific treatments, it interferes with a doctor’s ability to empower patients to choose the best care possible.”
Indeed, we physicians have a sacred duty to pursue the well-being of our patients. But that means that we should be putting forward the best possible treatments based on actual evidence.
When Dr. Reimer states that a government that bans specific treatments is interfering with medical care, she displays a woeful ignorance of medical history. Because doctors don’t always get things right: look to the sad narratives of frontal lobotomies, the oxycontin crisis, thalidomide, to name a few.
The thalidomide saga is particularly instructive: it illustrates what happens when a government drags its heels on necessary action. Canada was the last developed country to pull thalidomide, given to pregnant women for morning sickness, from its shelves, three months after it had been banned everywhere else — three months during which babies continued to be born in this country with absent or deformed limbs, along with other severe anomalies. It’s a shameful chapter in our medical past, but it pales in comparison to the astonishing intransigence our medical leaders have displayed — and continue to display — on the youth gender care file.
A final note (prompted by thalidomide’s history), to speak to a significant quibble I have with Alberta’s Bill 26 legislation: as much as I admire Premier Danielle Smith’s courage in bringing it forward, the law contains a loophole allowing minors already on puberty blockers and cross-gender hormones to continue to take them. Imagine if, after it was removed from the shelves in 1962, government had allowed pregnant women already on the drug to continue to take thalidomide. Would that have made any sense? Of course not. And the same applies to puberty blockers and cross-gender hormones: they should be banned outright for all youth.
That argument is the kind our medical associations should be making — and would be making, if they weren’t so firmly in the grasp, seemingly, of ideologues who have abandoned evidence-based medical care for our youth.
J. Edward Les is a Calgary pediatrician, a senior fellow with the Aristotle Foundation for Public Policy, and co-author of “Teenagers, Children, and Gender Transition Policy: A Comparison of Transgender Medical Policy for Minors in Canada, the United States, and Europe.”
Health
Last day and last chance to win this dream home! Support the 2025 Red Deer Hospital Lottery before midnight!
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