Therapy can prevent, delay carpal tunnel syndrome

BOULDER ? Hour after hour, day after day, pounding a keyboard can take its toll.

The result can be carpal tunnel syndrome, a disorder that pinches a nerve and causes the hand to become sore, weak or even numb.

Carpal tunnel syndrome is the most common cumulative trauma disorder, which account for about 60 percent of all occupational illnesses, according to the Bureau of Labor Statistics.

Carpal tunnel is caused by the compression of a nerve where it passes through the wrist into the hand. Everyday tasks such as writing, typing and holding small objects are impossible to do comfortably.

“Early on, if we can relieve nerve compression, we can prevent (carpal tunnel) surgery,´ said Sally Buczek, registered occupational therapist, certified hand therapist at Healthsouth and board member of the American Society of Hand Therapists.

By getting employees back to work sooner, employers can minimize workers compensation insurance costs and boost morale. Certified hand therapists helped develop a therapy that can prevent or indefinitely delay carpal tunnel surgery. The less invasive technique can keep people working or shorten recovery times.

The therapy includes splinting to prevent further compression, consultation to see what is causing nerve compression, and preventative exercises. This treatment costs between $120 and $140 per hour.

Employee-benefit plans cover hand therapy if occupational or physical therapy is covered said Ann Hooson, a hand therapist at Centura Health-Avista Therapy Clinic in Louisville. Employers are required by law to pay for treatment of workplace injuries, including carpal tunnel syndrome, through workers compensation insurance.

An ongoing study by the American Society of Hand Therapists — Non-surgical Management of People with Carpal Tunnel Syndrome — seeks to measure therapy treatment. Heat or ultrasound can promote blood supply and healing around the nerve, Buczek said. Medication helps shrink swollen tissue. Prevention is the best cure; the American Society of Hand Therapists stresses taking action before the condition develops.

“The therapy is good,” Buczek said, “because we’re preventing nerve compression at that time and in the future by educating the patient.”

Overuse or improper use of the hands causes carpal tunnel syndrome. An at-risk job includes repetitive activity, such as typing or using a 10-key pad for extended periods of time.

“If you’re at an at-risk job, we can go to your office and educate on prevention,” Buczek said.

The best prevention for carpal tunnel is an ergonomically correct working space, she said. After therapy, it is crucial to change the office environment appropriately. She said, “Even if we take pressure off the nerve and you go back to the same task that compressed it, the nerve will do it again.”

Led by therapist Bonnie Olivett from the University of Denver, the non-profit American Society of Hand Therapists was incorporated 24 years ago to provide specialized treatment to hand injury patients and establishing training and guidelines for hand therapists.

To become a certified hand therapist, a candidate must be a physical or occupational therapist for five years, perform 2,000 certified hours of hand care, and then pass an exam.

An average certified hand therapist in the Denver-metro area can make about $79,000 per year, Buczek said. Additional training is “kind of a marketing tool for the health-care facility. We can target a specific referral set like hand surgeons.”

Michelle Osgood, registered occupational therapist and certified hand therapist, said interest in hand injury prevention is a big change. “Employers are a lot more aware now than even 10 years ago,” she said, “as far as the causes, symptoms and remedies for (hand injuries).”

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