Carpal Tunnel Syndrome

 

What Is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is a condition where one of the nerves that supplies the hand gets compressed at the wrist, giving symptoms of numbness and tingling on the thumb side of the hand, with or without hand pain. There are 3 main nerves that come from the neck and travel down the arm into the hand, giving us sensation and muscle power in the hand. These nerves are called:

  • the median nerve

  • the radial nerve

  • the ulnar nerve

It is the median nerve that is involved in Carpal Tunnel Syndrome. As it passes through the wrist, the median nerve travels through the carpal tunnel - so called as it is a tunnel formed by the carpal bones of the hand and a band of connective tissue. Alongside the nerve there are several tendons and blood vessels that also pass through the carpal tunnel, so any excessive pressure put on the nerve by any of the adjacent structures can create the symptoms of Carpal Tunnel Syndrome.

What Will Happen If Carpal Tunnel Is Not Treated?

Occasionally Carpal Tunnel Syndrome can resolve with rest if whatever is creating excessive pressure in the carpal tunnel settles down and the nerve gets some breathing space. For example, fluid retention in the limbs during pregnancy can create more pressure in the carpal tunnel causing nerve irritation, but after the birth this can resolve as the fluid normalises again. In many other cases however, the Carpal Tunnel Syndrome will remain and sometimes worsen if left untreated.

How Can I Relieve Carpal Tunnel Pain?

Some at-home techniques to relieve Carpal Tunnel Syndrome include wearing a wrist brace overnight to keep the carpal tunnel open to reduce nerve compression, and stretching the tendons on the underside of the wrist to reduce the pressure in the carpal tunnel. This can be done by holding your affected arm out straight and using the other hand to pull the wrist and fingers back so that you feel the stretch in the underside of the affected wrist.

How Do We Treat Carpal Tunnel Syndrome?

At The Physiotherapy Place, our main aims of treatment for Carpal Tunnel Syndrome are to reduce the nerve irritation and to increase the space in the carpal tunnel. Some treatment techniques include:

  • nerve flossing exercises to mobilise the nerve

  • acupuncture to settle the nerve down

  • manual mobilisation to increase space in the carpal tunnel

  • soft tissue release of the adjacent muscles and tendons.

What Exercise Can I Do For Carpal Tunnel Syndrome?

A simple exercise for Carpal Tunnel Syndrome is one which stretches the tendons in the carpal tunnel in order to take pressure off the nerve. This can be done by holding your arm out straight and using the other hand to pull the affected hand and fingers back to feel the stretch in the underside of the wrist. Hold for 30 seconds and try to do regularly throughout the day.

How Long Does It Last?

If untreated, Carpal Tunnel Syndrome can last for a long time. As long as the nerve is getting compressed, symptoms will persist. If treated effectively, the nerve can be settled down in a matter of weeks. Occasionally if the problem is not resolving, decompression surgery may be required.

What To Avoid When You Have Carpal Tunnel Syndrome?

Try to avoid sleeping with your wrists bent as this may aggravate the nerve - this is where a night splint to keep the wrist straight may be useful. Overusing the hand may also cause more compression in the carpal tunnel so this can aggravate symptoms.

What Will A Physiotherapist Do?

A physio will work to decompress the carpal tunnel and release the nerve. This will involve a combination of mobilisation, stretching, soft tissue release and acupuncture. Correcting the factors that created the nerve compression in the first place is also key to a successful recovery.