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Carpal tunnel syndrome

Introduction

Carpal tunnel syndrome (CTS) is a common problem affecting the hand and wrist. Symptoms begin when the median nerve gets squeezed inside the carpal tunnel of the wrist, a medical condition known as nerve entrapment. Any condition that decreases the size of the carpal tunnel or enlarges the tissues inside the tunnel can produce the symptoms of CTS.

The carpal tunnel is an opening through the wrist to the hand that is formed by the bones of the wrist on one side and the transverse carpal ligament on the other. (Ligaments connect bones together.) This opening forms the carpal tunnel. The median nerve passes through the carpal tunnel into the hand. It gives sensation to the thumb, index finger, long finger, and half of the ring finger. It also sends a nerve branch to control the muscles of the thumb.

What causes Carpal tunnel syndrome?

Any condition that makes the area inside the carpal tunnel smaller or increases the size of the tissues within the tunnel can lead to symptoms of Carpal tunnel syndrome. The majority of the cause is due to the way people use their wrist in an improper posture and repetitive motion, this can put them at more risk for problems of CTS. Another causes include a traumatic wrist injury may cause swelling and extra pressure within the carpal tunnel. The area inside the tunnel can also be reduced after a wrist fracture or dislocation if the bone pushes into the tunnel.

Other conditions in the body can produce symptoms of Carpal tunnel symptom. Pregnancy can cause fluid to be retained, leading to extra pressure in the carpal tunnel. Diabetics may report symptoms of CTS, which may be from a problem in the nerve (called neuropathy) or from actual pressure on the median nerve. People with low thyroid function (called hypothyroidism) are more prone to problems of CTS.

Symptom of carpal tunnel syndrome

One of the first symptoms of CTS is gradual tingling and numbness in the areas supplied by the median nerve. This is typically followed by dull, vague pain where the nerve gives sensation in the hand. The hand may begin to feel like it’s asleep, especially in the early morning hours after a night’s rest.

Sometimes pain may even spread up the arm to the shoulder. If the condition progresses, the thumb muscles can weaken, causing the hand to be clumsy when picking up a glass or cup. If the pressure keeps building in the carpal tunnel, the thenar muscles may begin to shrink.

How does physiotherapist treat carpal tunnel syndrome?

Our physiotherapist will recommend that you change or stop the activities that are causing your symptoms if at all possible. Avoid repetitive hand motions, heavy grasping, holding onto vibrating tools, and positioning or working with your wrist bent down and out.

Our physiotherapist may have you wear a wrist brace. This sometimes decreases the symptoms in the early stages of CTS. A brace keeps the wrist in a resting position, not bent back or bent down too far. A brace can be especially helpful for easing the numbness and pain felt at night because it can keep your hand from curling under as you sleep. The wrist brace can also be worn during the day to calm symptoms and rest the tissues in the carpal tunnel.

The main focus of our treatment is to reduce or eliminate the cause of pressure in the carpal tunnel. Our physiotherapist may check your workstation and the way you do your work tasks. We may provide suggestions about the use of healthy body alignment and wrist positions, helpful exercises, and tips on how to prevent future problems. Our physiotherapist may also begin treatments and apply electrical current, ultrasound, shock wave to reduce inflammation and to encourage normal gliding of the tendons and median nerve within the carpal tunnel.

Although time required for recovery is different for every patient, as a general rule, you may see improvement in four to six weeks. We may ask you to continue wearing your wrist splint at night to control symptoms and keep your wrist from curling under as you sleep. Try to do your activities using healthy body and wrist alignment. Limit activities that require repeated motions, heavy grasping, and vibration in the hand.

Exercise

Exercise for carpal tunnel syndrome: Exercise 1

1. Place one arm straight out in front of you, elbow straight, with your wrist extended and fingers facing the floor.
2. Spread your fingers slightly and use your other hand to apply gentle pressure to down-facing hand, stretching your wrist and fingers as far as you’re able to.
3. When you reach your maximum point of flexibility, hold this position for about 20 seconds.
4. Switch hands; Do this exercise 3 times per set, 3 sets per day.

Exercise 2: Prayer stretch

1. Start with your palms together in front of your chest just below your chin.
2. Slowly lower your hands toward your waistline, keeping your hands close to your stomach and your palms together, until you feel a mild to moderate stretch under your forearms.
3. Hold for at least 15 to 30 seconds. Repeat 2 to 4 times.
4. Do this exercise 3 times per set, 3 sets per day.