My Biggest Carpal Tunnel Pet Peeve!

Hoang's World | Helping Occupational Therapist Become Experts

Carpal Tunnel Pet Peeve
[00:00:43] Hey its Hoang here. I am going to talk about carpal tunnel, right? I want to talk about carpal tunnel. I don't know why this is a pet peeve of mine, but I want to talk to you about carpal tunnel because man, every time I see it in the group, it drives me crazy. So I [00:01:00] see these posts all over the place and. So we deal with this kind of issue when patients call us about carpal tunnel.
[00:01:08] So as, as occupational therapists, as hand therapists, we have a tendency to think like, oh, carpal tunnel, uh, you know, brace, uh, or surgery. So why. Why is it that when it comes to carpal tunnel syndrome, it's either brace or surgery, right? Y Y Y is, you know, um, oh, I think I have carpal tunnel. Oh, put a brace on, do tendon glides and there is a more to carpal tunnel than wearing a brace and getting surgery.
[00:01:46] I swear to God more. I've been a hand therapist. The more I've been working with the carpal tunnel, there is so much more to carpal tunnel than wearing a brace. As occupational therapists. As a [00:02:00] hand therapist, we have more. Ability than just saying put on a brace. Right. So I see in this group, um, Hey, I have, you know, seen in like mom groups all over the place and in other therapy groups all over the place, it's like, oh, I have so and so who, who has numbness and tingling in their fingers?
[00:02:23] And every day they wake up and they have numbness and T. It's carpal tunnel. So, um, what, what should I do about it? Right. Oh, everyone's like put on a brace, wear the brace, take drugs, do tendon glides. There's so much more as therapists. We have the ability to evaluate. And evaluating is asking very specific questions, you know, what's going on because they're with carpal tunnel, just like everything else.
[00:02:50] There's a rule in and a rule out. Okay. So let's rule out other problems and this rule in carpal tunnel. So. What I would like to see [00:03:00] more of it's just like, Hey, you know, if you think you have a couple of tunnel, why don't you reach out to an experienced occupational therapist or a S uh, a hand therapist in your community, blah blah, a certified hand therapist in your community that really can help you get to the bottom of what's going on.
[00:03:16] Bracing is actually really good and it can be used for a short period of time. This is a. Temporary thing. Right. And then too, you know, as OTs, as occupational therapists, we have new skills, a yes. Tell you that there's something specific about the brace, because it's not just putting on any old breeze.
[00:03:39] It's about getting the right kind of brace and wearing it the right way. Right wearing the right way. The schedule is very important at night only. Do you know how many people come into my clinic and tell me, they've been told to where it breaks and they wear that fucking brace all the goddamn time and they have other problems, then Joe's carpal tunnel.
[00:03:58] So there's a little [00:04:00] bit more to it. And what we need to do is we need to dive in a little, extra dive into a little extra so that we can talk more about just bracing. Okay. How we add. As occupational therapist is really huge. You want to get, do you want a job? This is how we get a job. This is how we keep our job is by helping people very specifically, not just being like a Google.
[00:04:24] Right? So people are looking on Google and they're like, oh, brace, oh, injection. Oh, pills. Yes. I know. But as occupational therapists, we can help them so much more than just modifications. Right. I don't know about you, but if. Twenties, thirties, forties, fifties, and sixties and seventies. I don't want to modify for my whole fucking life to just be racist.
[00:04:46] I'm sorry. I'm cursing a little bit because I'm very passionate about this, but there's more than that, but you want a rule in, you want a rule in and, um, ah, rolling. And rule [00:05:00] out other problems. There's a lot of times people come with carpal tunnel issues and it's coming from neck shoulder coming all the way down their arm and into the wrist and into their hands.
[00:05:09] Right. So there's a hand intrinsic tightness issue or is it shoulder and neck problem? Right. And is it just carp? Is it just the media. Or could we have potentially some owner nerve types of issues or radio narc types issues that like they're all over the place with. Right? So we got a rule in and rule out and sometimes you got to rule out and rule out tendonitis types of issues.
[00:05:32] Right? So there's so much more to it than just telling someone to wear a brace. Now, surgery is very important, has a place in hand therapy, but I don't know about. But I don't rush to surgery if I don't have to. Now, obviously you're working with someone and they have atrophy, you know? Um, yeah. Yeah. And it's some surgery, right.
[00:05:56] Because once you start having atrophy, um, there's a problem. [00:06:00] So, I mean, Sometimes you have to see, like, is it a bilateral type of thing? Is it, um, what's their past medical history. I've worked with people before who have had carpal tunnel surgery on one hand, gotten complicated, uh, surgery. Like they, they got a little bit more complicated than just the, oh yeah.
[00:06:18] Take off your dressing and you can start moving. No problem. Right. They end up with other problems. And it was because we weren't very effective in ruling things out and rolling things in. And they have gone to places where they're doing certain things that are not effective to helping them with carpal tunnel.
[00:06:36] So they don't think that therapy works. And then what happens is they go and they have surgery, they get really sick and they're like, holy crap. Like I, um, I don't want surgery. To my other hand, we had this exact woman who came in, she had surgery to her left. Bilateral carpal tunnel. So use her left hand because your left hand was worse than her right hand.
[00:06:55] She was at a driver and, um, she came in and she [00:07:00] was like, oh my God. If, if this is what my hand looks like after surgery, I don't want surgery to my other hand, but I don't know how I'm going to work. And I was like, listen, she didn't have insurance. She came and she was. And I was like, listen, let me help you with this hand.
[00:07:13] Once I help you with this, I'm going to show you everything you need to do this hand. And that way you can try to avoid carpal tunnel surgery onto the other hand. And let me tell you, it has been, um, years, years since this happened, we fixed her hand and, um, I spent the last couple of sessions on her other hand, as well as stretching her out, teaching her how to effectively stretch on her own.
[00:07:37] And by the end of those sessions, she didn't need any surgery to other hand until this day, she still has not had surgery to her right hand. And she has no symptoms because she had so many issues coming next shoulder all the way down to her hands and her fingers. I mean, the woman was tight everywhere.
[00:07:55] So I think that it's so much more, when we talk about carpal tunnel [00:08:00] then saying, oh, like you, you just have to do this and that, like, you just have to do bracing and 10, 10 guides. That's why our patients are confused. I'm going to tell you, that's why our patients are confused because they are online.
[00:08:14] They're reading that all they need to do is wear a brace and go get physical therapy. Right. But what they should be doing is going to an expertise, right? That's you and occupational therapist is expert in helping people with carpal tunnel, um, types of injuries. Um, so that's my little rant of the day. I want to encourage you to think a little bit outside the box and it's not always.
[00:08:42] Like just do bracing. Let's do 10 and glides. There's so much more to it. And it's going to allow you to be more effective and when you're more effective and you help people solve the problem that they have. Which is if they want to [00:09:00] come to you to avoid surgery, there's so many things that you can do as a therapist to help them rule out and help them fix their carpal tunnel issues so that they don't have to go and have surgery if they don't want to.
[00:09:15] And they don't have to live in pain and they don't have to wear a brace for years and years and years. All right. So I just hope that this helps you kind of dive in a little bit. So much more too, but dive in a little bit, think outside the box and, um, be more effective for the patients that you serve.
[00:09:34] All right. Thanks for listening. I will see you soon.