by Natedoc808 » Sun Apr 10, 2016 11:37 am
Being a Physical therapist that specializes in hands, I can say without a doubt there is some good info on this thread. However to the OP, you need to make sure you actually have carpal tunnel syndrome and not some other nerve entrapment issue as with carpal tunnel syndrome your pinky finger should not be effected as it is supplied by the ulnar nerve which does not run through the carpal tunnel. If you have pain in the palmar side of your forearm just below the elbow along with pain in the muscles at the base of your thumb at the same time you get your numbness, you are likely experiencing Pronator Teres Syndrome which is entrapment of the median nerve just below the elbow but the numbness will be the same as carpal tunnel syndrome. In carpal tunnel syndrome you should not have pain in the base of the thumb as the branch of the median nerve that supplies that area with sensation splits off before the carpal tunnel. If the pinky is going numb too then you must rule out Cubital tunnel syndrome which is entrapment of the ulnar nerve at the elbow where you hit your funny bone; which is aggravated by persistent and repetitive flexed elbow positions. Another possibility is Thoracic Outlet syndrome which can be common in people with desk jobs or those who participate in sports with a flexion biased movement pattern (motocross) and comes from pressure to the brachial plexus, arteries and veins at the shoulder girdle where all the neuromas ulnar tissue passes from behind the collar bone, through the armpit and into the arm. With people who have multiple nerve pattern involvement this must be ruled out. Last but not least, if you are having multiple nerve pattern involvement, particularly on both sides, your neck must be cleared of a ridiculopathy (nerve root pressure at the spine). All of these scenarios are typically very well addressed with skilled physical therapy focusing on mobilizing the tissue to decrease the tissue tension and restoring circulation to the nerve. Overall fitness and flexibility is critical in combatting all of these scenarios... So stretch out a lot!
Regarding carpal tunnel surgery if it is ruled to be the culprit at work here: 90% of patient I see post CTR doing incredibly well. Of the other 10%, 5% were poor candidates for surgery to begin with due to waiting too long for treatment as the nerve is damaged due to chronic loss of circulation from pressure which is what causes the numbness, or because they had other health problems that limit their healing like diabetes, smoking, heart disease, etc. the remaining 5% who have very poor outcomes simply don't follow instructions: don't go to hand therapy as prescribed, don't do the rehab protocol if they do go to therapy, or go back to forceful repetitive lifting grasping, pulling too much too soon against medical advice.