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Thread: Carpal Tunnel Treatment for Para in a Manual Chair

  1. #1

    Carpal Tunnel Treatment for Para in a Manual Chair

    Hey Everyone!

    I was wondering if anyone had any experience with Carpal Tunnel Syndrome as a para and could recommend any non-surgery treatments that have worked for them in the past. Starting in the middle of last week, my hands have been going numb at night while I sleep. It has really wrecked my ability to sleep, so I am exhausted. I have now found that doing some activities (holding a phone for a while or basically holding anything in my hands) also cause my hands to go numb. I also get shooting nerve pain if i try to pull something hard (like a heavy door shut).

    I did a bunch of research, started doing wrist stretches every couple hours, and wear wrist braces at night, but has anyone else found something that works better? One of the primary things the internet has suggested is to rest your wrists so they have time for the swelling to recede, but that is not really an option for a manual chair using para.

    As a bit of background, I am a T9/T10 complete para who is married, but I do not rely on my wife for anything movement wise. She wouldn't be able to help transfers and I travel for work fairly often, so I wouldn't have any help on the road either.

    The numb hands have not really impeded my ability to do anything other than sleep, but I worry about the lasting effects of everything. Please let me know if you have any experience with this and any treatments you found successful.

    Thanks!
    -Shawn

  2. #2
    My carpal tunnel has mostly been attributed to tendinitis. I never found wrist braces helpful. What’s worked best for me is rocktape (ime, a stickier longer lasting kinesio tape alternate brand, both around the wrist and across the wrist from the back of the hand down the forearm), topical anti-inflammatories and getting the carpal tunnel itself stretched out. Also, I have twice been told by MDs that I had carpal tunnel and then had PTs insist and treat my elbows, which resolved the symptoms entirely.

  3. #3
    I would strongly suggest that you see an OT who is expert in both SCi and CTS for exercises and advice on modification of some of your high risk activities. Such things as changing the position of your hand for transfers, or using a different push rim for your manual chair may be indicated. Night bracing is a good idea as well, as many people put their wrist/hand into positions and under stresses that worsen CTS unknowingly in their sleep.

    CTS is fairly common in manual wheelchair users, and crutch and cane walkers. If you want to avoid surgery, you may also need to consider changing to power assist or full powered wheelchair mobility.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  4. #4
    I developed severe bi-lateral CT 19 years ago which got so bad over the course of one year that my hands became clawed and eventually I lost 80% of grip. It also ended a twenty year career as data entry specialist. I had to sleep upright as the night pain was like boiling fire balls under my hands and wrists. I struggled to do simple things like brush my teeth and it eventually wreaked havoc on my shoulders. I took a whole month off from work to resolve it which didn't help but my CT got too far along by that point. Simply resting wasn't the answer. After that month off, my company set me up to work from home so I didn't need to dress, much less all the transfers in and out of the car. I was scheduled for surgery then came into contact with a chiropractor who treated CT via traction and adjustments as well as cold laser therapy and within six months I was free and clear.

    It's been 17 years and I have had no recurrences. I'd like to add that I had nerve conduction studies done twice during the two years it crippled my hands and the specialists both confirmed I would have permanent nerve damage. Happily they were wrong but that gives you an idea of how severe it was. My worker's comp insurance covered the chiropractic care, by the way, which only added up to around $3000. I was grateful to avoid bi-lateral surgery. As KLD suggested, definitely connect with an OT.
    Wishing you the best as I understand how truly awful and life-changing it can be.

  5. #5
    KT tape, brush your teeth etc with the other hand, get a Smart drive, use voice commands on your computer and phone, ice. Then there is the old joke: Doc it hurts when I do this... don't do that.

  6. #6
    I agree with KLD that you should see an experienced OT.

    My Dad is a 75 year old para and his hands starting going numb while walking on his crutches. He would also wake up with numb hands.

    The OT will give you some exercises and treatments, ideally will re-evaluate the braces to make sure they fit correctly and may re-evaluate how you push your chair, your keyboard, and any other device you use regularly with your hands.

    My Dad still sleeps with braces at night on his wrists, but is doing great.

    Call your physiatrist and get a prescription today for OT.

  7. #7
    Thank you all for the input. I'll seek out an SCI smart OT.

  8. #8
    Hey toast get checked by a chiropractor. My arms and hands will go numb when I get a nerve pinched in my shoulder. With us doing so much with our arms things can get messed up in our shoulders.. sometimes it takes a few visits to get my full range back. Especially since you said it just started and it gets bad at night. I have been seeing my guy for many years .the last 4 in a chair. My lower back gets tightened up from sitting and he also helps that. Surprised by how it affected me since it was below my break. I also do massage every 2 weeks for neck and shoulders. But she also does work on my glutes and releases them.

  9. #9
    Toastguard, what is the pattern of your hand pain and numbness. CTS primarily effects the pinkie, ring, and middle finger. Compression of the radial nerve effects mostly the thumb and index finger. Thoracic outlet syndrome would most likely effect the entire hand and arm.

    EMG is also used to diagnose the type of nerve compression disorder that is going on.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  10. #10
    Quote Originally Posted by baldfatdad View Post
    Then there is the old joke: Doc it hurts when I do this... don't do that.
    Joke is true. My CTS went away completely after changing my keyboard position and taking frequent breaks. It also helped my shoulders. Basically, the keyboard was so high that I was shrugging my shoulders and/or bending my wrists backwards 8 hours per day.

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