Wrist & Hand (Orthopedic)
Posture: including scapulae position Rule out cervical involvement: ROM, compression Special Tests: Phalen's, median nerve compression, Tinel's test ROM MMT : hand held dynamometer Joint mobility Palpation Carpal Tunnel Hand numbness and pain in the median nerve distribution, which may present in the entire hand. Pain can occasionally go up to the shoulder. Symptoms usually worse at night. When the wrist is out of neutral, the carpal tunnel pressure increases. They may have difficulty picking up small objects or c/o dropping items. Increased risk if you have diabetes, obesity, female gender, previous diagnosis of carpal tunnel syndrome, RA, thyroid disease, previous MSK problems. Occupational factors that increase risk: vibration exposure, forceful exertion of hand and wrist, repetitive use of hand/wrist, jobs with non-neutral wrist position. Interventions : night splint, day and night splint if night splint alone is ineffective, transverse carpal ligament mobilization (refer t