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Pursuit Physiotherapy- Managing and Preventing Carpal Tunnel Syndrome

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  • 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:

    • 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.

    • 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.

    • 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:

    • 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.

    • 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.

    Read more from Todayville.


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    ‘Just like Iron Man’: Calgary surgeon undergoes experimental spinal surgery

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  • CALGARY — Dr. Richi Gill’s life changed in an instant.

    The 38-year-old surgeon, who helped develop Calgary’s bariatric surgery program, was involved in a freak accident on a boogie board during a family vacation in Hawaii one year ago.

    “The wave pushed me down instead of forward in pretty shallow waters. My head hit the ground and ended up breaking my neck,” Gill said following a recent physiotherapy session.

    “I don’t have any movement or sensation below that injury level. I do have some use of my arms but not my hands.”

    Gill described how he embarked on strenuous rehabilitation at Calgary’s Synaptic Spinal Cord Injury and Neuro Rehabilitation Centre, then headed to Thailand in October for experimental surgery.

    An epidural stimulation implant was placed in his lower back. With the use of a small device like a remote control, the implant sends electrical currents to Gill’s spinal cord to stimulate nerves and move his limbs, bypassing the traditional brain-to-spinal-cord pathways.

    The implant can be programmed to stimulate certain nerves mapped out by surgeons and therapists.

    Gill said his middle of three children, Akaash, thinks the implant is cool.

    “He’s very much like, ‘This is just like Iron Man! … We need the suit,” Gill said.

    “He’s only seven so I think he might think there’s a suit that’s out there somewhere.”

    The smile doesn’t fade from Gill’s face as, strapped into a harness, physiotherapists slowly help him walk with the use of a machine on wheels. Gill isn’t able to move his legs on his own, but by concentrating he is able to make his hip muscles flex and help himself along.

    “Right now, realistically, assisted stepping is where I’m at and being able to stand with assistance. Will I be able to walk on my own? It’s a possibility. My main focus is just trying to improve day by day and we’ll see where that gets me.

    “It’s definitely fatiguing because each time you try to take a step you have to really focus and concentrate to get that signal to the right spot.”

    Gill spent $100,000 for the surgery and travel, since they weren’t covered by health care or insurance. He plans to return to Thailand later this year to have a second stimulator placed higher up on his spine.

    His career as a surgeon is over, he said, but he hopes the operations in Thailand will help him regain some hand function and his overall quality of life.

    The spinal surgery is also performed in a few other countries such as the United States and Switzerland, but it’s much cheaper in Thailand.

    Only a half dozen people in Canada have had it done abroad and the number worldwide is about 30, said Dr. Aaron Phillips with the Cumming School of Medicine at the University of Calgary.

    So few procedures having been done makes it harder to get approval from Health Canada or the Food and Drug Administration in the United States, he said.

    Phillips has been involved in assessing the procedure for the last nine years.

    “I’m just really overcautious about selling these things too early. And, although I am extremely excited about the potential of this therapy, it still needs to pass rigorous tests first,” he said.

    “We don’t know if this will work the same way in everyone. We’re still dealing with very small numbers, although the initial findings are promising.”

    Ryan Straschnitzki of Airdrie, Alta., the Humboldt Broncos player who was paralyzed from the chest down when the Saskatchewan team’s bus crashed last April, has become friends with Gill through the Synaptic clinic.

    Gill has inspired the 19-year-old with his positivity.

    “He’s able to do things he couldn’t do before. It’s amazing,” said Straschnitzki.

    The executive director of Synaptic has seen a marked change in Gill’s abilities and has visited the medical facility in Thailand.

    “Given the nature of Richi’s injury, there was no sensory and no volitional movement below his level injuries. This has allowed Richi to regain some of that function and to be able to command voluntary movement below his level of injury,” says Uyen Nguyen.

    “This is not a cure. But from what we can see, this appears to be the most promising procedure for people with spinal cord injuries.”

    — Follow @BillGraveland on Twitter

     

    Bill Graveland, The Canadian Press


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    Alberta

    As Hair Massacure Returns for Another Year, Here’s A Moving Look at How it Began

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  • On February 22, 2019, thousands of heads will be shaved in honour of the journey of sick children losing their hair due to chemotherapy.

    People will gather once again at the Toyota Mayfield Ice Palace at West Edmonton Mall to collectively shave their heads, raising money in support of Albertans facing cancer.

    The Hair Massacure is founded, supported and organized by The MacDonald Family, in honour of their daughter Kali, a childhood cancer survivor.

    The MacDonald family partners once again with the Children’s Wish Foundation of Canada and supports Terry Fox Profyle, a Pediatric cancer research project.

    With the support of their partners, the family plans to scale Hair Massacure to the national level with the support of the Children’s Wish Foundation, continuing to raise funding for pediatric cancer research and for children with life threatening illnesses.

    Children’s Wish Foundation of Canada

    Children’s Wish Foundation of Canada is a 100% Canadian charity that grants the single-most heartfelt wishes of Canadian children diagnosed with life-threatening illnesses. Every wish is as unique as the child making it.  In Alberta and the NWT, we grant a Wish every three days and approve around 180 new Wishes each year. Wish referrals can be made by anyone who has a child in their lives between the ages of 3-17 and meets the medical criteria. Become a supporter of the largest Wish granting organization in Canada today!

    Terry Fox Profyle

    For the first time in Canadian history, more than 30 pediatric cancer research and funding organizations have joined forces through Terry Fox PROFYLE, a pan-Canadian project to give children, adolescents and young adults who are out of conventional treatment options another chance to beat their cancer. Short for PRecision Oncology For Young peopLE, the Terry Fox Research Institute (TFRI) and these research and funding partners are working and fundraising together under a unique partnership that to date is providing a total of $16.4 million to molecularly profile the tumours of these patients, no matter where they live in Canada. For example, if Terry Fox had been diagnosed with cancer today, he would have been eligible for PROFYLE when the tumour returned and spread to his lungs. A $5-million investment by TFRI is the catalyst bringing together top scientists and clinicians, research centres, cancer charities and foundations at children’s hospitals across the country to create new hope for young people who need it the most.

    Video produced by Storyteller Productions .


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