Carpal Tunnel Syndrome
Also called median nerve compression, carpal tunnel syndrome (CTS) occurs when compression of the median nerve in the wrist causes pain and numbness. The carpal tunnel is a narrow passageway in the wrist with just enough room for the tendons and nerves that pass through it. When the tendons become swollen, there is less space for the median nerve, so it can become compressed. Find out more about its causes, symptoms and treatment below.
Please note that every patient is different so symptoms can vary. You may experience a combination of the following or just one:
- Tingling or numbness in your fingers or your palm that feels like pins and needles
- Nerve pain in your wrist or hand, which can spread up your arm
- Swollen fingers
- Weakness in your hands, making it hard to grip things
The most common causes of carpal tunnel syndrome are the following:
- Wrist or arm injury
- Overuse (e.g. typing, using vibrating tools)
- Abnormal growth of the hands
- A cyst or tumour in the carpal tunnel
- Kidney disease with dialysis
- Fluid retention during pregnancy or menopause
- Rheumatoid arthritis & other joint or connective tissue disorders
Please Note – Carpal tunnel syndrome can sometimes develop without an obvious cause. However, working in an occupation that requires repetitive use of hand muscles is a key risk factor.
The following recommendations for treatment of Carpal Tunnel syndrome are targeted towards individuals with only minor changes in sensation or motor control/movement in the wrist and hand. Consult with your physiotherapist prior to commencing any of the below treatments.
Sliders, Gliders and Tensioners
Physiotherapist-lead nerve mobilization techniques can be performed to help ensure that the median nerve is moving freely throughout its course within the carpal tunnel. These particular techniques involve gently sliding, gliding or tensioning the median nerve to assist with alleviating symptoms and improving overall hand and wrist function.
Avoiding positions which you find to be most provocative can also play a major role in improving pain and dysfunction associated with CTS. Repetitive tasks (such as prolonged typing on the computer) and sustained poor postures are likely to aggravate your symptoms. An assessment of your workplace environment is also likely to be beneficial as this can identify the most relevant contributing factors- something which is particularly important for individual’s with office jobs!
Functional Hand and Wrist Exercises
Pain-free functional exercises should be incorporated into your treatment regime in order to improve symptoms, increase range of motion and allow you to regain full control of your wrist, hand and upper limb as a whole. This may involve something as simple as practicing opening a jar, turning a door knob or rolling up a towel. These functional exercises are particularly important following a period of immobilization as simple day-to-day tasks can be quite troublesome.
In more severe cases, a splint or brace can be used to help reduce the amount of pressure or swelling within the carpal tunnel, therefore reducing the impact on the median nerve and assist with alleviating your symptoms. This also provides the wrist a form of support and ensures the wrist is able to achieve a pain-free range of movement- allowing you to get through your day with minimal pain!
Depending on your overall health and lifestyle factors, carpal tunnel syndrome can disappear in a few months or a few years. Some patients may experience problems throughout the course of their lives. In this case, managing the symptoms would be the key along with extra preventative measures that reduce and stop further problems occurring.
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