How It Works

REPETITIVE STRESS INJURY

Wrist pain is a com­mon and costly occu­pa­tional prob­lem affect­ing thou­sands of peo­ple every year. Women report 70% of all occu­pa­tional carpal tun­nel syn­drome injuries, (Booth-Jones, Ses­tito, Alter­man, Har­ri­son, & Flat­tery, 2004). Repet­i­tive stress injuries to the hand and wrist have six com­mon forms, with carpal tun­nel syn­drome being the most preva­lent.  The wrist is com­prised of two fore­arm bones, the ulna and the radius, and in the space at the end of them, eight wrist bones.  (See illustration)

The com­mon fea­ture of many repet­i­tive stress injury or wrist pain is loss of joint space — a nar­row­ing and com­pres­sion of the wrist com­part­ment. This is the carpal com­part­ment; it has eight “carpal or wrist” bones in it. All joints (syn­ovial) in the body should have a fluid (syn­ovial fluid) between the car­ti­lage sur­faces. The tight­en­ing and short­en­ing of the mus­cles and ten­dons cross­ing the joints squeeze or com­press the bones together lim­it­ing or elim­i­nat­ing the fluid bar­rier (syn­ovial fluid) result­ing in fric­tion and ero­sion. Loss of joint space and ero­sion of the joint car­ti­lage is osteoarthri­tis. Carpal tun­nels are the lit­tle groves between the bones and lig­a­ments in the wrist. We have 19 tun­nels in our wrists. They con­tain the nerves, arter­ies, veins and ten­dons that oper­ate the fin­gers and hands. What could cause the nor­mal rela­tions of the bones, ten­dons and nerves to alter suf­fi­ciently to result in this painful com­pres­sion of wrist space?

A com­mon fea­ture of patients com­plain­ing of wrist pain is addi­tional ten­der­ness and pain in the fore­arm and elbow. The mus­cles that move the fin­gers and hand start above the elbow (see illus­tra­tion).  Mis­align­ment of the elbow joints results in a defen­sive tight­en­ing of the mus­cles that oper­ate the wrist and hand, which then causes dis­tress and pain.  Activ­ity, espe­cially repet­i­tive move­ment, makes the dis­tress worse.  This indi­cates that thick­en­ing and short­en­ing of these tis­sues could be part of the syndrome.

It has been shown that these ten­dons increase in mass with exer­cise, i.e. stress. This con­di­tion could cause carpal collapse, the nar­row­ing of the space between the base of the radius bone to the base of the third metacarpal, and loss of joint space in the hand and fin­gers as well, could be a con­se­quence of con­trac­tion of the flexor-extensor groups. The flexor-extensor mus­cle groups are the fin­ger bend­ing and fin­ger open­ing mus­cles that start at the elbow. Over time, repet­i­tive motion may cause the ten­dons and lig­a­ments to become deformed cre­at­ing wrist pain as well as pain in the fore­arm and elbow. Symp­toms may also include a burn­ing and/or tin­gling sen­sa­tion in the fin­gers and thumb, numb­ness in the hand, and inflam­ma­tion of the hand and forearm.

Spinal reha­bil­i­ta­tion uses the two main com­po­nents of time and weight to cor­rect the defor­ma­tions of ten­dons and lig­a­ments. Per­sis­tent pas­sive stretch is used to reform lig­a­ments and rehy­drate discs. Stud­ies done on inter­ver­te­bral discs, the space that lies between adja­cent ver­te­brate in the spine, and spinal lig­a­ments indi­cate that, to over­come the nat­ural elas­tic defor­ma­tion of these tis­sues, a con­stant stretch­ing force for 12 –15 min­utes must be achieved. Increase in length of these tis­sues occurs only after the nat­ural flex­i­bil­ity of the tis­sues has been reached (Woo, ’82). The steep­est part of the change curve (length graphed against time) is 20 to 25 min­utes after the begin­ning the ses­sion, and there is lit­tle change after that.

A sim­i­lar approach may be used on the fore­arm and mus­cu­lar, ten­do­nous struc­tures of the hand and fin­gers. A clin­i­cal study was done to deter­mine the amount of weight and time that was nec­es­sary to pro­vide elon­ga­tion of the fore­arm mus­cles with­out harm.

The con­cept of a pas­sive per­sis­tent stretch as a means of increas­ing carpal space and reliev­ing repet­i­tive stress injury is not dis­cussed in research lit­er­a­ture. Pain in the fore­arm and elbow is a com­monly asso­ci­ated symp­tom with repet­i­tive stress injury, but is not men­tioned in most ref­er­ences. The flex­ors and exten­sors of the hand and wrist orig­i­nate in the elbow region and the tight­en­ing and short­en­ing of these mus­cles with activ­ity is a rea­son­able expec­ta­tion. Com­pres­sion of the carpal region results from this tight­en­ing, and can be the source of pain and other symp­toms in some of those diag­nosed with repet­i­tive stress injury.

The Relief Glove is a FDA approved med­ical device that can be used daily for 20 min­utes for relief and man­age­ment of symp­toms result­ing from carpal tun­nel syn­drome and/or repet­i­tive stress injury. The pas­sive per­sis­tent stretch cre­ated by the Glove length­ens ten­dons and lig­a­ments restor­ing space in the carpal tun­nel and reliev­ing symp­toms. Con­sis­tent and reg­u­lar use of the Relief Glove results in a pos­i­tive out­come. The treat­ment time is 12 weeks or less. After the ini­tial pos­i­tive results, clients con­tinue to use the Relief Glove to man­age their symp­toms. The Relief Glove pro­vides a ther­apy allow­ing clients to go on with their reg­u­lar daily activ­i­ties while man­ag­ing their carpal tun­nel syn­drome and/or repet­i­tive stress injury. When patients re-injure them­selves, they tend to have a pos­i­tive response to inter­mit­tent use of the Relief Glove.  It can be used more often, with less cost, then fre­quent phys­i­cal ther­apy or chi­ro­prac­tic office vis­its would require.

As with any fit­ness or reha­bil­i­ta­tion pro­gram requir­ing long-term use of a device, it is essen­tial that the client uses the Relief Glove as directed to achieve a pos­i­tive results and man­age their symptoms.