CORES 全方位痛症治療中心

Upper Limb

TFCC Injury

Definition

Triangular fibrocartilage complex (TFCC) is a complex structure which is always described as wrist menisci, and located on the ulnar side of the wrist. TFCC is composed of a group of ligament and fibrocartilage. It has two main functions: firstly, to maintain wrist stability in rotational movement; secondly, to transmit and absorb the stress from hand. Acute injury or chronic overuse will cause TFCC injury.

Causes and Risk Factors

Quick and sudden wrist rotation when fall on outstretched arm is a common cause of acute injury, and may even leads to a wrist dislocation. Repetitive wrist and forearm rotation will cause chronic overuse, that creates stress to TFCC, causing tear or even degenerative changes. In addition, inadequate warm-up and poor flexibility of wrist and forearm, is risk factor of TFCC injury too. Sportsmen involved in weight-lifting and racket sports may lead to chronic injury.

Risk Factors

  • Nonunion of wrist fracture
  • Discrepancy between radius and ulna bone, too prominent of ulnar head
  • Always operate modalities (e.g. electrical drill) or athletes participating in sports with repetitive wrist compression (eg: tennis, gymnastics) creating repetitive microtrauma to TFCC

Common Symptoms

  • Pain and weakness on medial wrist joint
  • Rotational movement of forearm and wrist will aggravate the pain
  • Wrist swelling not prominent, but local tenderness in around medial wrist joint
  • When the wrist deviates to medial side, provotes more pain
  • Very few cases may lead to some wrist bone subluxation, causing prominent ulnar bone on dorsum, with reduced strength and range of movement

Management

If injury is not extensive with good joint stability, sports taping may be helpful to support the joint. Patient needs to apply ice therapy for 15-20 minutes for few times a day, and incorporates wrist strengthening in the later stage. NSAIDs or corticosteroid injection were shown efficient in controlling local inflammation, but not advise to do if symptoms are controllable. If the tear is severe, early arthroscopy of the wrist joint and immobilization provides promising results. If TFCC tear is not treated, in a long term wrist instability and loosen ligament may lead to overuse wrist arthritis, causing chronic pain and weakness.

Preventive Measures

  • Learning proper sporting techniques of racket sports
  • Sufficient warm-up of wrist and forearm
  • Strengthening the muscles surrounding wrist joint
  • Avoid from high risk wrist movement (e.g. carry heavy object in awkward angle)

Recommendations

Supraspinatus & Biceps tendinitis

Definition

Supraspinatus and biceps muscles pass through the narrow space under the acromion which is called subacromial space. Both tendon are easily injured and inflamed by various acute or chronic reasons. The most common cause is sudden pull and strain. The tendons can also be trapped and injured by repeated friction inside the narrow subacromial space.

Causes and Risk Factors

  • Poor posture and long-term intensive manual labor
  • Repeated minor shoulder injury or excessive shoulder joint activity
  • Sudden injury caused by lifting a heavy object with awkward position or excessive shoulder activity
  • Degeneration or calcification of tendons

Risk Factors

  • Kyphosis or round shoulder
  • Abnormal acromion structures, resulting in compression of the subacromial space
  • Osteophytic changes of acromioclavicular joint
  • Shoulder joint instability
  • Poor shoulder muscle flexibility

Common Symptoms

  • Local tenderness, sometimes radiating to elbow and forearm
  • Comparable tender spots on the biceps or supraspinatus
  • Joint movement may be limited
  • A “painful arc”, which means the pain triggered when the shoulder is abducted from 60º to 120º Increased pain when lifting heavy objects
  • Pain disturbs sleep

Management

In the acute stage of inflammation, physiotherapy including electrotherapy, ice therapy, acupuncture etc can reduce swelling and active inflammation. Afterwards, manual therapy and exercise restore joint mobility and avoid from muscle atrophy. When the symptoms are relieved, muscle strengthening exercises can be performed, especially strengthen up the rotator cuff, scapular muscles and core muscles. Functional training such as throwing or swinging training is effective for preventing re-injury. In rare cases, surgical intervention is required for ruptured tendon. However regardless of surgery or not, stepwise muscle strengthening and stability training is essential for returning to participate in high impact sports.

岡上肌及肱二頭肌長肌腱炎 Supraspinatus & biceps tendinitis_肩痛成因物理治療運動1
岡上肌及肱二頭肌長肌腱炎 Supraspinatus & biceps tendinitis_肩痛成因物理治療運動2
岡上肌及肱二頭肌長肌腱炎1o
岡上肌及肱二頭肌長肌腱炎2o

Preventive Measures

  • Avoid lifting or dragging heavy objects in bad posture
  • Warm up before exercising, and maintain good muscle strength and flexibility
  • If nature of the work requires raise the arms up for long period of time, such as teacher and painter, one should pay attention to have rest in between work
  • When housewives do cleaning (such as cleaning windows), they should avoid long working hours and change their posture more often
  • Appropriate exercise regime includes stretching and strengthening the muscles around the shoulder joint

Lymphedema after Breast Cancer

Definition

The lymphatic system is a part of our circulatory system, which take an important role in fat absorption and the immune system.

The lymphatic fluid carries harmful substances to the lymph node, where the harmful substances are quarantined and destroyed. The fluid will then return to the blood system. The flow of fluid is led by muscle contraction and blood flow, so it flows slower than the blood at approximately 6-10ml/min.

Lymphedema is the dysfunction of the lymphatic system. The fluid is clogged and cannot return to the blood circulation. This weakens the backflow prevention ability of the lymph nodes. The accumulated fluid infiltrates under the skin from the lymph nodes, causing lymphedema. Lymphedema commonly appears with aches, swelling, numbness, pins, and needles, and heaviness. Patient with lymphedema is also prompted to have cellulitis, active inflammation of skin.

Causes and Risk Factors

Lymphedema is more likely to happen when the lymphatic system is disturbed or overloaded:
- When lymph nodes are removed after breast cancer surgery. A study showed more than 20% of patients who underwent treatment for breast cancer would develop breast cancer-related lymphedema
- When radiotherapy causes fibrosis of the soft tissue and damage to the lymph nodes
- When chemotherapy causes edema all over the body

Risk Factors

Apart from lymphatic system damages and breast cancer-related procedures, bacterial or viral infection, serious injury or obesity may also cause lymphedema.

Common Symptoms

Normally, lymphedema does not cause other physical injuries, but some patients may feel limbs heaviness or aching if too swollen. The pain is mainly caused by the stiff shoulder, tight soft tissues (e.g. axillary cording), surgical scar adhesion, or neurological problems.

Congestive lymph may cause chronic inflammation and thus fibrosis. Bacterial infection of the affected limbs may cause cellulitis, which induces redness, pins and needles, and fever. In this condition, medical treatment will be needed.

Besides, since lymphedema affects patients’ appearance, it may upset their mental health and quality of life. In order to prevent flare-up, patients may need extra considerations on the selection of hygienic, healthcare products and clothes, the intensity of daily activities, and whether they should take long flights.

Management

There are five aspects for the management of lymphedema, namely skin and soft tissue caring, balance of daily activities, exercise therapy, lymphatic drainage, and compression therapy. Physiotherapist will teach patients how to integrate the management into daily habits, such as skincare and wearing compression stockings for better results.

The theory of lymphatic drainage is to drive the excess lymph back to the unaffected lymph ducts. For upper limb, tt normally starts from the trunk, then shoulder, elbow, wrist, and finger. During lymphatic drainage, physiotherapist will gently and slowly massage the skin to stimulate the lymph ducts at the superficial skin structure. More pressure is needed to soften fibrotic areas.

Preventive Measures

  • Perform lymphatic drainage regularly.
  • Clean the body part and apply moisturizer every day.
  • Do not cut the nails too close to the nail bed.
  • Put on sun cream and prevent possible skin abrasions. When wounded, use disinfectant and cover it appropriately. If the lymph bursts out, compression bandage may be needed.
  • Exercise regularly. Hydrotherapy in warm water can improve lymphatic circulation and reduce swelling.
  • Avoid contracting affected limbs' muscles continuously ( e.g. carrying a heavy handbag)
  • Avoid high-temperature activities such as sauna and steam bath. For the first few days after breast cancer surgery, patients should avoid dangling the affected arm as to prevent swelling. In case of redness, swelling, warmth and pain, please consult your physiotherapist or doctor for assistance.
  • Perform lymphatic drainage regularly.
  • Do not cut the nails too close to the nail bed.

De Quervain’s tenosynovitis

Definition

De Quervain’s tenosynovitis, commonly known as "Mommy thumb" which refers to inflammation of the soft tissue caused by strain on the tendon of thumb near the wrist. For chronic inflammation cases, the tendon sheath will become thicker and the space inside the tendon sheath will be narrowed and restricted the gliding inside. When the patient is using the thumb, will have symptoms like stuck in that position

Causes and Risk Factors

Most of the hand movements use the thumb directly for the action and it is easily strain the thumb’s tendon due to excessive force or incorrect force (such as the wrong way of holding the baby). In addition, when stretching and abduction repeatedly, soft tissue proliferates near the wrist area, compressing the local tendon, causing the tendon to slide irregularly or causing adhesion.

Risk Factors

"Mommy thumb" is often seen in pregnant women in the late trimester or just after childbirth, especially women who lack physical activity before. Suddenly, they need to hold a baby repetitively with a certain weight and do more housework such as washing clothes and twisting towels. It is easy to develop symptoms two to three months after giving birth. For those who need to use their thumb repeatedly at work are susceptible to this disease too, such as computers users, waiters with heavy plates in one hand, hairdressers, gardener, chefs etc.

Common Symptoms

  • On the side of thumb near wrist, there is weakness or persistent pain which is more serious when you wake up in the morning
  • With symptoms such as tightness of the upper limbs, local swelling, etc; and it will extend upwards to the forearm and downwards to the thumb
  • When the wrist and hand are twisted, or the thumb is repeatedly stretched and flexed, the pain will be exacerbated. For example, twisting towels, writing, and other activities that use the thumb with force will be very difficult.
  • If the disease develops, it will cause soft tissue over-grow, and a prominent mass can be felt on the side of the thumb of the wrist.

Management

Minimize unnecessary thumb movements in acute inflammation. Using thumb brace, electrophysical therapy with ice pad, ultrasound, laser, acupuncture, etc. can help reduce pain and swelling. Deep friction massage techniques can effectively reduce symptoms and maintain soft tissue flexibility. If the pain persists and seriously affects life, you can take non-steroidal anti-inflammatory drugs or local small-dose steroid injections. When the symptoms gradually ease, more stretching and muscle training should be done to improve muscle strength and flexibility. In the long run, it is necessary to understand the cause of the injury, improve the method or posture of the usage of thumb, and avoid re-injury.

Preventive Measures

The simplest prevention method is to minimize the excessive usage of thumbs; for example, when holding a child, try to support the child with five fingers, spread the power evenly and avoid the child's weight from being completely supported by the thumb. If you need to use your thumb for a long time at work, the most important thing is to give your thumb more intermittent rest and do some local massage or stretching exercises of the tendon. If necessary, it can be equipped with thumb brace or sports taping to protect the thumb.

Recommendations

Adhesive Capsulitis (Frozen Shoulder)

Definition

Frozen shoulder is caused by inflammation of shoulder joint capsule and surrounding tissues. Middle-aged people and Women have a higher incidence. Because inflammation and pain induce shoulder muscles guarding and tightness, which affect the normal movements. In a vicious cycle, the soft tissues become tighter, which causes even more pain in movement and even gradual onset of joint displacement. In severe case, one cannot lift the arm above 90 degree and have intense pain and stiffness.

Causes and Risk Factors

The actual underlying cause of adhesive capsulitis is unknown, but history of trauma, long term overuse (wrong lifting posture) and very tight shoulder muscles limiting normal shoulder mobility may increase the incidence of frozen shoulder. Moreover, the inflammatory process often progress very slow. If patients didn’t treat it properly, the shoulder joint may still actively inflame even after a year.

Risk Factors

Stroke, cervical pathology, breast cancer or previous upper limb fractures or trauma which may affect shoulder muscle strength and normal movements

Common Symptoms

The most obvious symptoms are shoulder pain and stiffness. The pain greatly disturbs sleep and daily activities like combing hair, dressing or scratches your back.
Frozen shoulder can be divided into three stages:
(1) Acute Pain Period: Shoulder pain is very intense that often disturb sleep. The anti-inflammatory drug may not help so much. Sometimes the pain diffuses across the whole shoulder and scapula region. One may not be easy to point the tender spot accurately.
(2) Freezing period: In this subacute stage, patient may start to feel the shoulder gradually becomes stiff in certain directions and angles, but the pain mildly decrease.
(3) Rehab period: The freezing of the shoulder gradually resolves, the joint mobility and pain are also improved. At this stage, the shoulder undergoes a very long recovering period; however if the problems are not properly treated, there will be many complications and limitation in daily activities.

Management

The treatment principle of frozen shoulder is to take corresponding treatment measures for different periods of frozen shoulder:
1. Early phrase of rehab
Using acupuncture, ultrasound, electrophysical therapy, hot and cold therapy or any other physiotherapy treatment to relieve the pain, so as to improve the blood circulation and reduce local inflammation.
2. Frozen Period of rehab
Pain is often caused by joint dysfunction, and the treatment aim during this period focuses on restoring joint function. The mobilization exercise can reduce joint stiffness, increases the range of shoulder movement, and restore normal joint function.
3. Remodeling phrase of rehab
The main purpose is to alleviate the residual symptoms and to continue functional training and muscle strengthening. Also, it is essential to restore normal functions of previously atrophic muscles to achieve comprehensive rehabilitation and prevent recurrence.

Preventive Measures

  • Avoid concentrating or reusing the same shoulder when working or doing housework. Try to use your shoulder alternately
  • Strengthen the shoulder stabilizing muscles and improve posture
  • Maintain good flexibility and strength of the soft tissues around shoulder.

Recommendations

Shoulder Impingement Syndrome

Definition

Shoulder joint has the largest range of motion in our body. The stability of a moving shoulder joint is mainly supported by the rotator cuff muscles. As the space between humerus bone and acromion is very narrow, poor posture resulting in compensatory movements, tendons are squeezed and impacted by the shoulder humeral head, causing inflammation and related pain, called shoulder impingement syndrome.

Causes and Risk Factors

When lifting the arm, shoulder tendons and soft tissues located underneath the acromion are easily jammed. If any excessive pulling or repeated vigorous lifting with upper arm at internal rotated position, the soft tissues inside the sub-acromial space can be injured or triggered chronic inflammation. If the inflamed tendon is not properly recovered, the body subconsciously avoids touching the painful structures, which produces compensatory actions such as kyphosis or round shoulder. Unfortunately, these compensatory actions often exacerbate the vicious cycle of tendon and soft tissue compression.

Risk Factors

Poor postures such as kyphosis and protracted shoulder are the most common risk factor. Swimmers and athletes that often require lifting up arms (such as tennis, throwing sports, etc.) will repeatedly impact and stimulate the affected structures. In addition, their pectoral muscles and anterior deltoid muscles are more developed and tighter than the rotator cuff muscles which may make humerus more internal rotated and anterior tilted when lifting arms, making the space between the acromion narrower and causing inflammation.

Common Symptoms

  • Soreness around the shoulder, sometimes radiate to the back of the shoulder and forearm, obvious tenderness on top of shoulder
  • Increased pain when raising the arms to a certain angle
  • Suffering from redness, swelling, heat and pain after activity, in severe cases the muscle strength of the cuff muscles weakens or the shoulder joint becomes stiff

Management

During the acute phase, rest and avoid from pain-provoking activity. Apply ice to the affected area to reduce pain and inflammation. In severe cases, anti-inflammatory and pain-relieving drugs should be taken as prescribed by doctor. In terms of physiotherapy, manual therapy, acupuncture, and electrophysical therapy can help reduce inflammation and relax muscles. When inflammation begins to subside, patients need to stretch to keep their shoulder joints moving under normal biomechanical conditions. Targeted shoulder strength training, such as stabilization of the rotator cuff muscles and endurance training is also very important. If shoulder muscles are balanced, it can effectively control normal shoulder movements and reduce chance of poor movements and shoulder impingement.

肩撞擊綜合症 Shoulder impingement syndrome_肩膊痛成因物理治療運動1
肩撞擊綜合症 Shoulder impingement syndrome_肩膊痛成因物理治療運動2

Recommendations

Glenohumeral Instability

Definition

Glenohumeral instability means the shoulder is often easily displaced or even fully dislocated. Shoulder dislocation refers to the humerus bone moves out of the normal position. It is commonly dislocated forward or downward which squeezes and pulls the surrounding tissue causing injury and pain. If fully dislocated, the joint will temporarily lose mobility. The younger the first full dislocation of the shoulder, the higher the chance of recurrence afterward. If the labrum is torn, the shoulder stability will be affected, which results in a higher chance of recurrent dislocation.

Causes and Risk Factors

Shoulder dislocation usually occurs in shoulder abduction, external rotation, and extension. Sometimes fall on the hand or elbow will cause the humeral head to displace and result in dislocation. There are many reasons for chronic glenohumeral instability, one of which is insufficient rehabilitation. The cause of pain in young patients is mainly a labral tear or a biceps tear when dislocated. The pain of older patients is often caused by torn rotator cuff muscles.

肩關節脫位 Glenohumeral instability_肩痛成因物理治療1

Risk Factors

  • People with congenital joint instability: such as Marfan Syndrome
  • Participate in contact sports: It is unavoidable that there will be collisions with others during exercise.

Common Symptoms

  • Feeling your shoulders dislocated, getting stuck, or even unable to move
  • Patients may repeatedly experience shoulder joint subluxation or even dislocation at a certain position, such as basketball shooting, volleyball smash, backstroke strokes, etc. Some may even feel unstable or subluxation when holding handlebars on a bus encountering an emergency brake.
  • Paralysis of the upper limbs
  • Shoulder appearance may change

Management

Under the guidance of a physiotherapist, a gradual and comprehensive rehabilitation to train up the shoulder muscle strength and proprioception to improve the stability of the shoulder joint is important. However, sometimes the torn shoulder joint tissue caused by injury is not easy to heal by itself. It may be necessary to receive surgical repair of the torn ligament and tighten the loose joint capsule.

After the operation, a shoulder sling is used to protect for 2 to 4 weeks with gradually onset of passive joint mobilization, Muscle training begins only after 8 to 9 weeks after operation, and daily activities can be resumed after 12 weeks. Patients can usually return to contact sports safely at 4 to 6 months post-operation with proper rehabilitation.

Preventive Measures

It is not easy to prevent dislocation of the shoulder joint because it is an instinctive reaction of the body to support the ground when falling. But the following are some effective methods:
Warm up and exercise more to strengthen shoulder muscles and stabilize shoulder joints
Wear appropriate protective equipment when participating in sports
Pay attention to safety and avoid falling as much as possible

Recommendations

Medial Epicondylitis

Definition

The medical name of a golfer’s elbow is medial epicondylitis, which refers to the inflammation caused by strain on the tendons located near the medial elbow. Racket enthusiasts and people with a sudden increase in handloading may suffer from this problem.

Causes and Risk Factors

The medical name of a golfer’s elbow is medial epicondylitis, which refers to the inflammation caused by strain on the tendons located near the medial elbow. Racket enthusiasts and people with a sudden increase in handloading may suffer from this problem.

Risk Factors

  • Forceful Grasping, playing golf, the movements of racket sports will excessively pull the muscle and joints and may accumulate tears.
  • Wrist and elbow muscles weakness.
  • Works require repetitive movement of wrist and fingers, such as long duration of desk work, cleaning and gardening are prone to develop golfer's elbow.

Common Symptoms

  • Initial symptoms include local pain and tenderness on the inner side of the elbow
  • Weakness when holding something or making a firm grip
  • Abnormal forearm fatigue after continuous work
  • When the wrist or forearm is loaded, such as taking heavyweights, bending the wrist, holding something firmly, etc., the pain will be aggravated.
  • In severe cases, the pain can extend from the inner side of the elbow to the forearm, with stiffness over the patient's wrist.

Management

Combining both medication and physiotherapy, most inflammation can be resolved within weeks. Stretching of the muscles near the elbow and loosening soft tissues can effectively relax the inflamed and tight tissues. Laser, ultrasound, and acupuncture can help reduce pain and control inflammation.

Using tape for the elbow can facilitate the return-to-sport process and reduce injuries in unavoidable actions.

Although steroid injection reduces pain quickly, it is not recommended to be used in the early stage of inflammation because it has negative effects such as early tendon degeneration.
腕管綜合症 Carpal Tunnel Syndrome_手痛成因物理治療運動1
腕管綜合症 Carpal Tunnel Syndrome_手痛成因物理治療運動2
golfers1

Preventive Measures

It is not difficult to subside inflammation, but improving daily habits or exercise skills is the cure. For example, switch to an ergonomic keyboard, arrange a break or reduce the number of repetitive flexion of the wrist, and improve the batting technique. In addition, after the tendon is inflamed, its load-bearing capacity is greatly reduced. It is necessary to gradually train the strength of the wrist flexor muscles in order to reduce the chance of recurrence.

Recommendations

Lateral Epicondylitis (Tennis Elbow)

Definition

The medical term of tennis elbow is lateral epicondylitis, which refers to the inflammation caused by excessive strain on the tendons located near the lateral elbow. Racket enthusiasts and people with sudden increase hand loading may suffer from this problem.

Causes and Risk Factors

Tennis elbow is an overuse pain disorder. Repeated or excessive exertion of the wrists and fingers extensor muscles are the major cause. Initially, this usually does not induce noticeable discomfort, and most tears can heal by resting. However, if the unhealed muscle and tendon are pulled excessively again, the damage will be accumulated. A vicious cycle will cause tendon degeneration, muscle weakening, and increase the chance of recurrence of inflammation in the future.

Risk Factors

  • The backhand movements of racket sports will excessively pull the muscle and joints and may accumulate many slight tears.
  • Wrist and elbow muscles weakness.
  • Prolong computer work or housework with poor posture

Common Symptoms

  • Initial symptoms include localized pain and tenderness on the lateral elbow.
  • Abnormal forearm fatigue after continuous work
  • Pain aggravated when wrist or forearm are loaded, such as taking heavyweights, twisting towels, picking up teapots, etc.
  • In severe cases, pain can extend from the outside of the elbow to the forearm and cause wrist stiffness. Sometimes nerve can be irritated and cause long-term numbness on the outside of the elbow.

Management

Combining both medication and physiotherapy, most inflammation can be resolved within weeks. Stretching of the muscles near the elbow and loosening soft tissues can effectively relax the inflamed and tight tissues. Laser, ultrasound, and acupuncture can help reduce pain and control inflammation.

Using tape for the elbow can facilitate the return-to-sport process and reduce injuries in unavoidable actions.

Although steroid injection reduces pain quickly, it is not recommended to be used in the early stage of inflammation because it has negative effects such as early tendon degeneration.

Recent studies have pointed out that elbow joint subluxation, nerve compression, or prolong swelling of tendon may cause delayed cure for more than half a year. Special manual therapy for the nerve or joint subluxation is needed for complete recovery.

腕管綜合症 Carpal Tunnel Syndrome_手痛成因物理治療運動1
腕管綜合症 Carpal Tunnel Syndrome_手痛成因物理治療運動2

Preventive Measures

It is not difficult to subside inflammation but improving daily habits or exercise skills is the cure. For example, use a better ergonomic keyboard, arrange a break or reduce the number of repetitive extensions of the wrist, and improve the batting technique. In addition, after the tendon is inflamed, its load-bearing capacity is greatly reduced. It is necessary to gradually train the strength of the wrist extensor muscles to reduce the chance of recurrence.

Recommendations

Carpal Tunnel Syndrome

Definition

The carpal tunnel contains nine tendons and a median nerve. It extends from the forearm to the palm. It is one of the three nerves in charge of the sensory and muscular strength of the hand. Carpal tunnel syndrome refers to the problem of the compressed median nerve in the "crowded" carpal tunnel and affecting its nerve function.

Causes and Risk Factors

Carpal tunnel syndrome mostly results from swelling of the wrist tendons, which compresses the median nerve in the carpal tunnel, causing pain and numbness. Housewives, people who have been using computer mouse and keyboards in the office for a long time, patients with rheumatoid diseases, patients with diabetes and patients with wrist fracture are more likely to develop this disease.

Risk Factors

Excessive wrist overuse at work, such as lifting objects, using the keyboard and mouse for a long time. Other causes include local inflammation due to accidental injury or infection, gouty arthritis, and pregnancy.

Common Symptoms

腕管綜合症 Carpal Tunnel Syndrome_手痛成因物理治療 肌肉萎縮
  • Numbness and tingling of thumb, index finger, middle finger and ring finger, especially at night
  • Swollen wrists and sometimes even can’t make a full hand grip
  • Late stage will also cause thumb muscle atrophy, affecting thumb function

Management

Most patients have resolved inflammation within a few weeks with rest, ice and electrophysical therapy. Stretching of the wrist and forearm muscles and soft tissue release can effectively relax the inflamed and taut tissues. Ultrasound and acupuncture can help reduce pain and control inflammation. Reduce repeated wrist movements at work. After the situation improves, progressive forearm strengthening can reduce the chance of recurrence in the future.

If the above treatments do not improve the condition, the patient may need to undergo surgery to relieve the pressure on the affected nerve. Other conditions, such as chronic pain and muscle atrophy, or suspected a structural compression, may also suggest surgery. The stitches can be removed about one week after the surgery. The prognosis of surgery is usually satisfactory that the numbness may be reduced immediately and feel easier to exert force.

腕管綜合症 Carpal Tunnel Syndrome_手痛成因物理治療運動1
腕管綜合症 Carpal Tunnel Syndrome_手痛成因物理治療運動2

Preventive Measures

Rest should be taken at regular intervals and wrist stretches should be done every half hour to reduce the chance of overuse. Avoid prolonged writing and typing, and stop any activities that cause numbness of the fingers, such as excessive flexion of the wrist. Place your hands in the middle position as comfortably as possible while working. Avoid pressing or placing your wrist on a hard surface. Use a mouse pad or keyboard pad to protect your wrist and hands.

Recommendations

Shopping Cart