Generally speaking, patients seek out the expertise of a registered massage therapist when joint and muscle pain interferes with their daily routine. However, it is quite often those daily repetitive tasks that can cause muscles to constrict and joints to stiffen in the first place. Thus, regular massage therapy provides relief from the cumulative and cyclical stresses of everyday life, helping to keep more serious conditions at bay.
One of those more serious conditions is carpal tunnel - a syndrome that develops slowly, progressing from pesky irritation to near paralysis with seemingly innocuous movements of the wrist. Massage therapy has been found quite effective in reducing pain, restoring range of motion, and eliminating the need for surgery in carpal tunnel patients. However, MTs must be well-informed in order to effectively assess and treat patients exhibiting the telltale signs of this debilitating condition - a process that begins with understanding precisely how carpal tunnel effects the wrist and hand.
Massage therapy training includes an in-depth study of the musculoskeletal system, so practising MTs should be well-acquainted with the structures of the wrist and hand. Carpal tunnel syndrome develops when the median nerve that runs from the forearm into the palm of the hand, becomes compressed. The carpal tunnel houses the median nerve, which controls sensation to the palm side of the thumb and fingers (except the little finger) as well as various small muscles in the hand.
Repetitive actions, like typing on a computer or playing a musical instrument, can cause tendons in the wrist to inflame and thicken - which in turn narrows the carpal tunnel. As a result, the median nerve is compressed, causing weakness and numbness in the wrist and a shooting pain that may radiate up the patient’s arm. Because the syndrome is common, and seen often by MTs, practitioners might be quick to arrive at a diagnosis. However, careful assessment is necessary to determine whether factors in addition to carpal tunnel syndrome (CTS) are contributing to patient pain and immobility.
In addition to taking a full health history and conducting an interview, MTs may carry out evaluative tests like Phalen’s or Tinel’s to confirm that CTS in indeed the problem. This is especially useful when the patient arrives without a diagnosis from their health care provider. Also, since there are a number of other structures in the wrist that may contribute to nerve compression, MTs will often perform additional examinations in order to rule out other potential sources of reported pain. Rather than assuming carpal tunnel as the cause, MTs take a broad and informed view of the patient’s condition before developing and administering a treatment plan.
Treatment for carpal tunnel does not usually begin and end at the wrist. Putting to work the full range of techniques learned at massage therapy college, MTs will often combine a concentration on the wrist with other full-body approaches. Generally, MTs will use detailed deep tissue techniques to release tension and adhesions along the full arm and shoulder, neck and upper back. They will look for obstructions along the entire length of the median nerve which is housed in the carpal tunnel. Although clients often experience some relief after their first session, it typically takes several visits to achieve prolonged relief - and continuous care is, of course, the very best protection against relapse.
How do you approach the treatment of carpal tunnel?