Carpal Tunnel Syndrome
The carpal tunnel is a passage formed by the wrist (or carpal) bones, ligaments connecting the bones and the transverse carpal ligament, which makes the ‘roof’ of the tunnel.
The median nerve is one of the main nerves of the upper limb. It runs from the neck, down the arm and into the hand via the carpal tunnel (along with the flexor tendons of the forearm muscles). It supplies feeling to the thumb and all of the fingers apart from the little finger and part of the ring finger. The median nerve also supplies most of the muscles in the hand.
Carpal tunnel syndrome occurs when there is pressure or compression of the median nerve as it passes through the carpal tunnel, and can result in pain, numbness, tingling or weakness.
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The carpal tunnel is generally narrow and fairly rigid, therefore any increase in pressure in the area may compress the median nerve. Overuse of the forearm flexor muscles, often due to repetitive tasks can cause swelling and irritation. The swelling of the tendons can cause further narrowing of the carpal tunnel and compression of the median nerve (carpal tunnel syndrome). Rarely, carpal tunnel syndrome develops suddenly due to a traumatic injury, such as falling onto a hand. Many factors can increase a person’s risk of developing carpal tunnel syndrome. These include:
- Activities such as typing on a keyboard, sewing or knitting
- Occupations involving repetitive use of vibrating hand tools or tools such as a screwdriver
- Participation in sports involving gripping or frequent wrist movement such as gymnastics, golf, cycling or racquet sports
- Pregnant women
- Diseases such as diabetes, arthritis, thyroid problems or gout
- A tumour, infection or cyst in the region
Persons presenting with Carpal Tunnel Syndrome will have a very typical presentation including one or multiple of:
- Burning pain, numbness or tingling in the thumb and next 2 or 3 fingers of one or both hands
- Increased pain in the morning or night
- Loss of strength or wasting away of the muscles around the thumb and hand
- Reduced coordination in one or both hands
- Difficulty with tasks such as gripping or carrying
Our Physiotherapists are skilled at performing a range of orthopaedic tests to confirm the diagnosis of carpal tunnel syndrome.
Most individuals respond well to Physiotherapy treatment which may include:
- Sufficient rest from aggravating activities and modification of specific activities to avoid repeat episodes.
- Bracing or splinting the wrist.
- Pain relief and anti-inflammatory medication as recommended by a doctor or pharmacist
- Physiotherapy- massage, ultrasound, ice therapy, joint mobilisations and stretches
- Range of movement exercises, stretching and strengthening
Occasionally, referral for additional nerve conduction tests and orthopaedic opinion is required. Your Physiotherapist can facilitate the arranging of these tests.