Carpal Tunnel Syndrome

Carpal tunnel syndrome

Pathogenesis

In the last 20 years carpal tunnel syndrome has been adversely effecting human population, due to excessive use of computers that demands the constant repeated motion in a forearm and hand flexor muscles. Being relatively small structure, carpal tunnel formed by 4 carpal bones and breached by transverse carpal ligament that run between these bones. Nine flexor muscle tendons as well median nerve are located inside the carpal tunnel. Inflammation of tendons is the result of excessive physical overload-strain of flexors muscles/tendons. It is important to mention that inflammation inside the carpal tunnel could also be the result of the direct trauma or edema of forearm and hand (for example in cases of thoracic outlet syndrome, pregnancy). Inflammation is expressed as swelling that occupies space inside of the carpal tunnel and thus causes compression of the median nerve. In this case patients suffer from pain due to inflammation of tendons, ligaments as well because of median nerve neuralgia and other symptoms related to physiological insufficiency of median nerve. Patients experience pain and numbness at the palmar surfaces of the first, second and third fingers as well at the half of the 4th finger. Additionally patients have difficulties to flex these fingers and medially rotate the thumb and can develop a significant weakness.
As far as massage therapist is concerned, it is very important to understand that in cases of inflammation, pain is the result of significantly decreased blood supply, accumulation of excessive amount of extracellular fluid inside the carpal tunnel area, tension in muscles and the development of trigger points.
The following is a step by step protocol directed to treat the mentioned above causes of pain. Our capability to directly affect veins blood and lymph drainage, to increase arterial blood supply, to block pain analyzing system, to eliminate trigger points and other reflex zones abnormalities make our method of treatment unique, simple and powerful.

Massage Steps

• Start from mandatory introductory protocol on neck and upper back. Place the back of your client’s hand in your own palm. Using the muscles of the thumb (thenar), under pressure, massage in a circular motion three to four times each of your clients’ fingers (including the thumb).
• Once again use the thenar muscles of your thumb and massage (under pressure) all areas of the palm including the wrist, in a circular motion three to five minutes.
• Under pressure, with both thumbs (you can use thumb on thumb pressure) from the bottom up only, 3 to 5 times massage all channels between tendons on palm side of hand.
• Place your clients hand palm down. Using your index finger and thumb, under pressure, 3 to 5 times massage in a circular motion lateral sides of each finger separately (From the bottom up only).
• Under pressure use your thumbs to massage between each inter-tendon channel separately.
• Turn a client’s hand and forearm so that the thumb side points to the ceiling. Perform for 3 to 5 minutes petrissage #3 from the wrist up on all areas of the forearm.
• All trigger points must be palpated, discovered, and eliminated by application of ischemic compression.