Carpal Tunnel Syndrome is a very common cause of wrist and hand pain, which is caused by wrist swelling in an anatomical area known as the Carpal Tunnel. The Carpal Tunnel is a space in the carpal (wrist) bones through which muscles, blood vessels and nerves pass on their way to the hand from the forearm. Compression of the Median nerve causes altered sensation to the wrist and the fingers nearest the thumb, as well as the thumb itself.
Recent studies have shown that the pressure within the Carpal Tunnel is increased if the wrist is held in a position of extension (such as typing at a keyboard) or flexion (when gripping tightly). These positions can often make the symptoms of Carpal Tunnel Syndrome worse, so a proper review of ergonomic factors is often recommended to reduce the impact of these environmental factors. Your Physiotherapist at David Roberts Physiotherapy can advise on this to help best management of your symptoms.
What are the signs & symptoms?
- Hand and wrist pain.
- Pins and needles to the hand.
- Burning, tingling or numbness in the hand.
- Symptoms are often worst at night.
- In severe cases the muscle at the base of the thumb can begin to waste, due to ‘squashing’ of the nerve.
- Reduced ‘pinch grip’ strength.
What are the causes?
Simply put, because there isn’t a great deal of room in the carpal tunnel, any swelling around it can press on your median nerve, causing the symptoms of carpal tunnel syndrome. The exact single cause of carpal tunnel syndrome is not yet known.
Women are statistically more likely to get it than men, and it tends to develop over the age of 45. In addition, if you are overweight or have a very ‘hands on’ job, you are more likely to develop the condition.
Other typical causes of carpal tunnel syndrome:
- start doing a manual job you aren’t used to, such as house painting
- have rheumatoid arthritis in your wrist joint have osteoarthritis in your wrist as a result of an old fracture
- are pregnant
- have thyroid problems
- have acromegaly, a condition caused by too much growth hormone (a chemical produced naturally by your body)
- have diabetes
- have cysts in your carpal tunnel
- take certain medicines, such as the oral contraceptive
For many people, it isn’t known why carpal tunnel syndrome develops. Other nerve and tendon disorders may produce similar symptoms.
Accurate assessment and diagnosis is, therefore, vital to best management of this problem.
Carpal Tunnel Syndrome Treatment
Physiotherapy can help to reduce the swelling within the carpal tunnel andmobilise the carpal bones which form part of the carpal tunnel. This often gives good reduction of symptoms. Physiotherapy treatment is very important in regaining thumb muscle strength, resolving stiffness and regaining wrist range of motion.
Advice and guidance on the best way to set up your workspace, driving position and other ergonomic situations can have huge benefits for new or long-standing sufferers. Our experienced Physiotherapy team are able to advise in a way tailored to your lifestyle.
If conservative (or non-surgical) approaches are not successful, then corticosteroid injection may be more effective. The aim is to reduce inflammation and swelling in the carpal tunnel in more severe cases. Surgery is sometimes required in severe cases, this is often performed under local anaesthetic using keyhole (arthroscopic) technique to enable quicker recovery. Where surgery is required, the transverse carpal ligament is usually divided to relieve the nerve compression.
We can also help with your post-op recovery and enable your return to normal activity in the safest possible time.
If you live in the Manchester area and require expert treatment advice for carpal tunnel symptoms, call david Roberts Physio today.