Carpal Tunnel Syndrome Causes, Symptoms & Treatment

What Is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a painful condition caused by pressure on the median nerve as it runs through the carpal tunnel of the wrist. The carpal tunnel is a narrow passageway formed by a ring of ligaments and bones at the base of the hand.  The median nerve passes through the tunnel, and can become compressed at the wrist when the pressure inside the tunnel becomes too high.  This can be due to swelling or thickening of inflamed tendons, which narrows the tunnel, and can occur after a traumatic injury, with repetitive hand movements, arthritis, or swelling during pregnancy.  The median nerve provides sensation to the thumb, index, middle and half of the ring finger, on the palm side of the hand.  It also controls muscles at the base of the thumb.

What Are The Risk Factors Associated With Carpal Tunnel Syndrome?

Carpal tunnel syndrome is more likely to develop in women compared to men. It usually only occurs in adults. Those with diabetes or other metabolic disorders that affect the nerves and make them more susceptible to compression are also at higher risk. Manual work of a repetitive nature can also place one at risk. It can affect both hands.

What Are The Causes Of Carpal Tunnel Syndrome?

• Arthritis, particularly rheumatoid arthritis, can cause inflammation and swelling
• Pregnancy – the hormones associated with pregnancy can cause general fluid retention, which can compress the median nerve
• Wrist fractures – bony fragments can reduce the amount of space in the carpal tunnel and can also irritate the surrounding nerves, causing inflammation
• Congenital factors – some people are born with a naturally smaller carpal tunnel
• Overuse injury – the tendons that run through the carpal tunnel can become irritated and inflamed by awkward postures or repetitive movements, and then will compress the nerve

What Are The Symptoms Of Carpal Tunnel Syndrome?

• ,,Pain in the wrist
• Numbness
• Pins and needles in the thumb, index and middle fingers
• Pain is significant at night if the wrist is in a bent position for too long
• As it progresses, your symptoms will become more prominent during the day with certain activities such as driving, holding your phone, or gardening
• Weakness in grip strength
• Loss of hand function, difficulty grasping small objects
• Wasting of muscles at the base of the thumb

Treatment Of Carpal Tunnel Syndrome

1. Wearing a splint during the night

Initial treatment of carpal tunnel syndrome involves wearing a splint during the night.  The splint prevents your wrist from bending, reducing excess pressure on the nerve, thereby helping to reduce your pain at night.

2. Checking daily activity isn’t causing further pain

Modify daily activities that are aggravating symptoms.  This may include taking more frequent breaks with repetitive tasks, or altering your technique so the wrist is in a better position.

3. Ice packs during the day, heat packs before bed

Ice packs can help if the wrist is red, warm and swollen.  You can also use heat packs before bed to help relax the muscles and alleviate your pain

Anti-inflammatories can be taken to help provide some pain relief in the short term.

4. If pain persists, see a physiotherapist

If pain persists, you should seek out a physiotherapist to assist in alleviating pain, and ensuring the next right steps are taken for treatment.

How Can Physiotherapy Help With Carpal Tunnel Syndrome?

,,Physiotherapy treatment is beneficial in relieving carpal tunnel pain through joint mobilisations, nerve and tendon gliding exercises, as well as soft tissue work to the surrounding tight muscles in the wrist.

We will prescribe you with a comprehensive exercise program consisting of stretching and strength work for your wrist and hand.  We can also provide you with a splint for night time which will limit wrist bending. And therefore reduce your night pain.  We will offer you advice on how you can modify your aggravating activities, and optimise your work station set up to help reduce your symptoms.

In more severe cases, surgical intervention may be necessary.  A carpal tunnel release would be performed to reduce the pressure on the nerve.  Physiotherapy is required after surgery to help restore your range of motion and strength.

Preventing Carpal Tunnel Syndrome

• Perform regular stretching exercises through the working day
• Take frequent rest breaks when performing repetitive tasks
• Modify your workstation or daily tasks to ensure your wrist is in the correct position.  Avoid having your wrist bent all the way up or down.  It should remain in a neutral position. Your keyboard should be slightly lower than your elbow, when your elbow is bent to 90 degrees.
• Relax your grip and reduce your force with hand and finger movements.  For example, with typing, hit the keys more softly.  With prolonged writing, use a larger pen with a soft grip and free-flowing ink.
• Keep your hands warm to prevent pain and stiffness from developing.  Wearing fingerless gloves at work can help do this.

If you are suffering from carpal tunnel syndrome or have any further questions, please don’t hesitate to contact us!  Give us a call on 9875 3760 or email us on info@wphphysio.com.au.  We would be more than happy to help!