Treating carpal tunnel syndrome, week 4

Treatment is going well. I finished the fourth session tonight (it's been one hour of massage every Tuesday for four weeks now), and there is noticeable improvement. As mentioned before, I've been mapping sensation loss: once before the massage; once after the third; a last one planned for the end (treatment #5 or #6). Directly following the massage, all sensation is back in the hand. However, I'm more interested in long-term change. Here's some relevant results.

Before treatment
palm side:
- thumb almost 100% numb, ranging down close to the wrist
- index finger numb clear down past the knuckle
- middle finger numb down to palm
- ring finger numb down to palm

dorsal side (back of hand):
- thumb numb 'til just above the second knuckle
- index finger numb more than halfway down hand
- middle finger numb more than halfway down hand

Before treatment #3
palm side:
- thumb numbness starts below first knuckle and ends around the wrist
- index finger numbness no change
- middle finger numbness just down to above second knuckle
- ring finger no sensation loss!

dorsal side:
- thumb only has two small spots where sensation is not felt!
- index finger sensation loss stops above first knuckle
- middle finger sensation loss stops below first knuckle

The sensation tends to be much improved for a day or two, then slowly decline back toward paresthesia (numbness & tingling). There's been a rather perplexing change this week, however. Numbness is very frequent, but more importantly, the speed at which this happens has drastically increased. So while it's going numb quite frequently again, the entire process of starting to go numb, being numb, and recovering, is only taking about 30 seconds.

Previously it would take several minutes just to go numb, and stay numb for much longer depending on what she was doing and if she was able to rest her wrist. Very strange results, and I honestly don't know what could be happening physiologically here. I am very interested to see how week four goes.

There are several special tests in bodywork that test areas for nerve compression - my client had positive results for all the carpal tunnel impingement tests. However, she also had a recreation of symptoms when testing for nerve compression at the brachial plexus (clavicle aka collar bone). This strongly suggests that not only is the median nerve of the wrist cramped in the carpal tunnel, but also further up the arm/shoulder/neck. I think it is crucial for massage therapists treating such conditions to do a thorough investigation of all the places the nerve impingement could be happening.