Handy Advice for Carpal Tunnel Syndrome
In this article, a well-known physical therapist reviews the latest findings on carpal tunnel syndrome (CTS). Her focus is on nonsurgical treatment. She discusses the use of splinting, cortisone injections, and exercise.

The use of heat, laser, magnets, and yoga are also presented. Patients and therapists are told how to decide when surgery is the best option. Details are offered on what to expect after surgery.

Dr. Michlovitz reminds therapists that CTS can be caused by diseases such as diabetes, arthritis, and hypothyroidism. She points out that splinting should put the wrist in a neutral position. This is a fairly new finding after years of splinting the wrist in slight extension.

Patients with mild to moderate symptoms of CTS can do well with a program of splinting and exercises. The patient and therapist work together to find activities and positions the patient should avoid. This might include long periods of gripping or awkward positions of the wrist and hand.

Surgery is an option when symptoms are severe and don't respond to therapy. Patients who have mild symptoms but with muscle loss and muscle weakness might also need to consider surgery.
Susan L. Michlovitz, PT, PhD, CHT. Conservative Interventions for Carpal Tunnel Syndrome. In Journal of Orthopaedic & Sports Physical Therapy. October 2004. Vol. 34. No. 10. Pp. 589-600.