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Physical Therapy Intervention Following Surgical Treatment of Carpal Tunnel Syndrome in an Individual With a History of Postmastectomy Lymphedema

JE Donachy, PT, PhD, is Assistant Professor, Department of Physical Therapy, PO Box 271, Alabama State University, Montgomery, AL 36101 (USA) (jdonachy{at}asunet.alasu.edu). Address all correspondence to Dr Donachy
EL Christian, PT, PhD, is Associate Professor, Department of Physical Therapy, Alabama State University

Background and Purpose. This case report describes the physical therapy examination, intervention, and outcomes for a patient with lymphedema following breast cancer treatment who underwent carpal tunnel release. Case Description. The patient was a 53-year-old woman with right upper-limb lymphedema and symptoms of carpal tunnel syndrome (CTS) in her right hand who underwent a carpal tunnel release. Management of her lymphedema included the use of general anesthesia with reduced tourniquet time in conjunction with physical therapy, which included use of compression bandaging, limb positioning, and exercise. Outcomes. Following surgical release, the patient' s numbness and pain were alleviated. Right-hand grip strength increased following active exercise. Girth of the forearm decreased 1 to 1.5 cm at the 2 most distal measurement sites, and girth of the arm increased 1.5 to 2 cm 6 months after surgery. Discussion. This case supports the option of elective hand surgery for CTS in an individual with chronic lymphedema.

Key Words: Carpal tunnel syndrome • Lymphedema • Physical therapy • Postmastectomy • Surgery

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