months or longer if needed based on the operative procedure. Refer to Section H.7.f Smoking Cessation Medications and Treatment for further details. g. Operative trigger digit release. h. Post-operative i. An individualized rehabilitation program based upon communication between the surgeon and the therapist using therapies as outlined in Section H Therapeutic Procedures Non-operative. In all cases, – communication between the physician and therapist is important to the timing of exercise progressions. Treatment may include the following: splinting, elevating the hand post-operatively, and active therapy with or without passive therapy. Digital motion per surgeon’s instructions will avoid scar formation. ii. Return to work and restrictions after surgery may be made by an attending physician experienced in occupational medicine in consultation with the surgeon or by the surgeon. Usually no heavy lifting or forceful activity for 2 4 weeks post-operatively (). – G. SPECIFIC PERIPHERAL NERVE DIAGNOSIS, TESTING &TREATMENT PROCEDURES 1. CARPAL TUNNEL SYNDROME a. The median nerve is vulnerable to compression and injury in the region of the wrist and palm. In this area, the nerve is bound by the wrist bones and the transverse carpal ligament. The most common site of compression is at the proximal edge of the flexor retinaculum (an area near the crease of the wrist). Stenosing tenosynovitis may occur proximal and distal to the carpal tunnel area. There is often a myofascial component in the patient's presentation. This should be considered when proceeding with the diagnostic testing and therapeutic intervention. The following elements are commonly associated with carpal tunnel syndrome:
months or longer if needed based on the operative procedure. Refer to Section H.7.f Smoking Cessation Medications and Treatment for further details. g. Operative trigger digit release. h. Post-operative i. An individualized rehabilitation program based upon communication between the surgeon and the therapist using therapies as outlined in Section H Therapeutic Procedures – Non-operative. In all cases, communication between the physician and therapist is important to the timing of exercise progressions. Treatment may include the following: splinting, elevating the hand post-operatively, and active therapy with or without passive therapy. Digital motion per surgeon’s instructions will avoid scar formation. ii. Return to work and restrictions after surgery may be made by an attending physician experienced in occupational medicine in consultation with the surgeon or by the surgeon. Usually no heavy lifting or forceful activity for 2 – 4 weeks post-operatively (). G. SPECIFIC PERIPHERAL NERVE DIAGNOSIS, TESTING &TREATMENT PROCEDURES 1. CARPAL TUNNEL SYNDROME a. The median nerve is vulnerable to compression and injury in the region of the wrist and palm. In this area, the nerve is bound by the wrist bones and the transverse carpal ligament. The most common site of compression is at the proximal edge of the flexor retinaculum (an area near the crease of the wrist). Stenosing tenosynovitis may occur proximal and distal to the carpal tunnel area. There is often a myofascial component in the patient's presentation. This should be considered when proceeding with the diagnostic testing and therapeutic intervention. The following elements are commonly associated with carpal tunnel syndrome:
Ex5_CTC_InText_Biblio_4.docx