Carpal Tunnel Syndrome
Where is the Carpal Tunnel?
Your carpal tunnel sits of the palm side of your wrist, and is a narrow tunnel that is formed between the bones and ligaments of the wrist/hand. Various tendons, blood vessels and a nerve pass through this space. When this nerve, called the Median Nerve, is compressed or irritated, it is called Carpal Tunnel Syndrome (CTS). In the past it was one of the conditions that got a name RSI or Repetitive Strain Injury.
Symptoms of CTS include;
- Pins and needles, numbness or pain in the thumb, index finger, middle finger, and part of the ring finger
- Swelling of the hand or wrist
- Difficulty determining hot vs cold
- Weakness of the hand/wrist
- Symptoms are often worse at night, especially when sleeping on the affected hand
There are many factors that contribute to CTS, all of which result in an increased pressure inside the tunnel that compresses the Median Nerve.
These causes may include;
- Fracture of the forearm or hand
- Inflammation of the tendons
- Rheumatoid Arthritis
- Work that involves a lot of wrist movements up & down, typing, cooking, vibrations etc.
What can physiotherapy do?
Your physiotherapist will do an assessment of your wrist and your day-to-day tasks that involve the wrist to determine what is causing the CTS. From there, your physio will be able to suggest strategies to reduce inflammation and pain, and change the way you are working to allow the structures to rest. Strengthening exercises will be important to ensure your wrist doesn’t lose strength, so follow the physio’s guidelines and exercise prescription. Additionally, splinting may be required to ensure the wrist doesn’t fall into bad positions.
If you require surgery, physiotherapy will be an important part of your recovery including pain management, scar desensitisation and strengthening exercises.
What else can be done?
If your symptoms are not resolving, you may be referred to your GP for nerve conduction tests or scans. If conservative management is not effective, surgery may be required.