The number one work related injury is no longer low back pain but has been replaced by Cumulative Trauma Disorders (CTD), carpal tunnel being the most common type of CTD. Carpal tunnel syndrome refers to a condition that occurs when the median nerve becomes entrapped by the carpal bones of the wrist and the transverse carpal ligament. Computer usage is the most factor in bringing the symptoms on. Unfortunately this has become one of the most misdiagnosed conditions in recent years. Many people associate any type of wrist pain or numbness in the hand with carpal tunnel syndrome. The median nerve supplies the middle two fingers, never the thumb, index finger or the pinkie. Weakness and altered sensation are the most common symptoms. Treatment in this case involves manipulation of the carpal bones, manually breaking up any adhesions or scar tissue within the transverse carpal ligament using Active Release Technique (A.R.T.) and educating the patient on proper ways to stretch the affected area as well as modifying the work environment to reduce the chances of recurrence.

Most of the CTD's that come into this office are from people using computers without being set up correctly from an ergonomic stand point, not taking mini-breaks often enough (every 20-30 minutes) and not stretching. Most are also not true carpal tunnel syndrome, but an entrapment of the median nerve by the pronator teres muscle in the forearm. This entrapment will mimic most of the signs and symptoms of a true carpal tunnel syndrome. The national average for resolving this condition by a credentialed A.R.T. provider is 6-8 visits. Workers compensation case mangers are increasingly utilizing the services of credentialed ART providers because of the success rate at cost savings compared to the decompression surgical intervention route, and missed time from work. In any case not resolved within thirty days, the patient is sent out for a second opinion with a physiatrist for electro-diagnostic testing (nerve conduction velocity testing). Our philosophy of taking a team approach to healthcare has ensured the successful resolution of many difficult and chronic cases.


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