My Carpal Tunnel symptoms are not isolated to my hand? What does this mean and how does this impact treatment?

While symptoms from carpal tunnel syndrome can radiate up the arm, special consideration for potential alternative diagnoses need to be consider when this is the case. This is especially true if someone’s carpal tunnel pain is also present in the neck, shoulder blade region or upper arm. While electrodiagnostic testing is available for carpal tunnel syndrome, it is far from perfect. More often than not, it is our clinical examination that best guides treatment decisions. On your first visit, we look at several areas that maybe the potential culprit including the neck (cervical spine) and other areas of potential entrapment of the Median Nerve. Our goal with this testing is to find the area most likely contributing to your symptoms so we can target this area accordingly. We take a series of measurements, such as thumb grip, to allow us to re-test following treatment of a given area (i.e., the neck or the wrist). If improvements are made, it is likely treatments will continue to this body region. If we fail to make a meaningful change, treatment will move to the next most likely culprit body area. 

Citations:

1. “Neck Pain Guidelines: Revision 2017: Using the Evidence to Guide Physical Therapist Practice.” Journal of Orthopaedic & Sports Physical Therapy, Vol. 47, No. 7, 2017, pp. 511–512., https://doi.org/10.2519/jospt.2017.0507. 
2. Wainner, Robert S., et al. “Development of a Clinical Prediction Rule for the Diagnosis of Carpal Tunnel Syndrome.” Archives of Physical Medicine and Rehabilitation, Vol. 86, No. 4, 2005, pp. 609–618., https://doi.org/10.1016/j.apmr.2004.11.008. 

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