Carpal tunnel syndrome is a painful disorder in the hand and wrist as a result of the median nerve being compressed in the carpal tunnel. The median nerve supplies the hand and wrist with the ability to feel and move.
What are the causes of Carpal Tunnel Syndrome?
The pressure inside the tunnel increases due to either a fluid build-up (swelling from fracture, dislocation or wrist sprain) or when the contents such as tendons, blood vessels or the median nerve, running through the tunnel enlarge.
Who is at risk?
- Occupations involving gripping, repetitive wrist movements, and machinery causing vibrations
- Pregnancy
- Gender (females more than males)
- Age
- Genetics (Narrow tunnel)
What are the symptoms?
As carpal tunnel syndrome is a result of a repetitive injury, the symptoms are usually gradual and develop over time. Night-time symptoms are usually reported first, which gradually develop into symptoms all the time.
These symptoms are:
- pins and needles
- burning sensation
- numbness
- swelling
- weakness affecting the thumb, index finger and middle finger (Not often the pinkie finger)
How is Carpal Tunnel Syndrome diagnosed?
Diagnosis is usually based on a thorough clinical history taken by your Doctor or Physiotherapist. There are specific tests that can be performed in order to confirm the diagnosis, such as the Tinel’s or Phalen’s test.
It is, once again, important to rule out any possibility of the pain being referred from a different source such as your neck. The use of radiological diagnosis is not necessary, but sometimes you may be referred for nerve conduction tests.
What are the treatment options?
Non-surgical treatment
- Splinting and bracing: Wearing a brace at night can help keep the wrist in a neutral position with minimal compression on the nerve.
- NSAIDS (Non-steroidal anti-inflammatory drugs) can reduce the amount of inflammation in the tunnel, reducing the pain.
- Modification of activities: Reducing repetitive activities, modifying postures at workstations
- Cortisone injections: A strong anti-inflammatory that can help reduce the pain, but is often only temporary relief
Physiotherapy treatment
- A review and change in your activities.
- Educating you more about the condition and what can be done.
- Neural and joint mobilisation.
- Exercises.
- Pain relief.
- Treatment of the cervical/thoracic areas if there is evidence or referral.
Surgical options
Surgery will only be considered if conservative treatment has not been successful, or if there has been severe neurological damage.
This article was submitted by Rikki Malherbe who practises at Lamberti Physiotherapy in Paulshof You can contact her regarding treatment for this condition by using our appointment form
References:
- Clinical Sports Medicine 5th Edition – Brukner & Khan
- Treatment and Rehabilitation of the Wrist and Hand – SPT 2016
- Common wrist injuries of the hand and wrist – SPT 2016
- Physio-pedia.com – Carpal Tunnel Syndrome
- https://physioworks.com.au 2019 – Carpal Tunnel Syndrome
- Orthoinfo.aaos.org 2019 – Carpal Tunnel Syndrome