What is Carpal Tunnel Syndrome?
The carpal tunnel is an area in our wrist on the palm side where tendons that help our fingers grasp and flex run. The bones of the wrist form the floor of the tunnel, while a strong fibrous ligament acts as the roof. Inside the tunnel, along with the tendons, there’s also a nerve, an artery, and a vein. The nerve, called the median nerve, enables movement and sensation in the thumb, index finger, middle finger, and part of the ring finger. Carpal tunnel syndrome occurs when pressure builds up on this nerve for various reasons.
What are the symptoms of Carpal Tunnel Syndrome?
Numbness or a pins-and-needles sensation in the hand, especially around the thumb, index, and middle fingers, is one of the most common symptoms of carpal tunnel syndrome.
Wrist pain is also common, and symptoms often worsen at night. People may wake up feeling like their hand is asleep and need to shake or move it to feel normal again. Many also notice weakness in their hand, making it difficult to grasp objects or causing them to drop things frequently.
What are the causes of Carpal Tunnel Syndrome?
Carpal tunnel syndrome is caused by pressure on the median nerve within the carpal tunnel. The most common causes include:
- Frequent wrist movements, especially bending, straightening, or awkward gripping
- Poor ergonomics from using a computer or performing tasks inefficiently
- Using tools or equipment that cause a lot of vibration
- Swelling and inflammation in the wrist
- Arthritis, whether rheumatoid or osteoarthritis
- Injuries like fractures or sprains
- Changes related to pregnancy
How Do I know If I have Carpal Tunnel Syndrome?
- If you’re experiencing the signs and symptoms of carpal tunnel syndrome mentioned above, a health professional can confirm the diagnosis.
- The gold standard for diagnosing carpal tunnel syndrome is nerve conduction studies, but in many cases, it can be confirmed by healthcare providers, including physiotherapists.
How can physiotherapy help with carpal tunnel syndrome?
- Splinting: Our physiotherapists can prescribe splints to keep your wrist in a neutral position, helping relieve pressure on the nerve. This is particularly important at night when it’s harder to control wrist position.
- Ergonomic Advice: You can reduce symptoms by avoiding certain wrist positions and activities that increase pressure in the tunnel. Getting your computer setup assessed and improved can also make a big difference.
- Wrist and Finger Exercises: Moving your tendons within the tunnel can help relieve pressure on the nerves and reduce swelling.
- Swelling Management: Your physiotherapist can teach you techniques to manage swelling, including the use of heat and cold, as well as some massage techniques. A compression glove might also be beneficial.
- Nerve Gliding Exercises: Nerves can become tight or restricted just like muscles. If your median nerve is restricted, your physiotherapist may show you exercises to help it glide from your neck all the way down to your fingers.
- Strengthening: If your muscles have weakened due to nerve compression, your physiotherapist can guide you through strengthening exercises for your thumb and fingers. This will help prevent dropping things!
- Surgery: A small percentage of people with carpal tunnel syndrome may require surgery. If conservative treatments don’t relieve your symptoms, especially if numbness is constant and weakness is severe, seeking a specialist opinion is recommended. Nerve conduction studies may be performed first to assess the level of nerve compression. If it’s severe, a surgeon might cut the fibrous ligament over the tunnel to relieve pressure. Physiotherapy can support your recovery and rehabilitation if surgery is needed.
What Can I do at home?
Listen to your body and find the activities that aggravate and try to minimize or avoid these activities. If you find activities that give you relief then do these.
- Wear a splint to support your wrist for up to 3-6 weeks. You may find wearing it at night or when it is most irritated is enough.
- If your hand is swollen follow the advice from your physio and keep your hand elevated and keep the fingers moving.
Physiotherapist Jewel OH