Carpal Tunnel Syndrome – Understanding and Treatment
You’re going about doing your everyday work when you notice yourself shaking your hand to get rid of the tingling in it. It’s starting to really bother you because you’ve had the tingling at night too. You’re probably wondering if it’ll go away on its own. Does this sound like you? You might have Carpal Tunnel Syndrome.
What is Carpal Tunnel Syndrome (CTS)?
Carpal Tunnel Syndrome is a condition arising from a nerve compression in the wrist. The carpal tunnel is formed by wrist bones and a ligament called the transverse carpal ligament that runs across the palm side of the wrist. Because this tunnel is quite narrow, even a small amount of swelling or thickening of any of the structures in or around the carpal tunnel can put pressure on the median nerve.
The median nerve controls sensations and movements to the palm side of the thumb and most of the fingers.
When there is an increase in pressure on the median nerve, you might get pins and needles, numbness, pain and weakness in the arm, hand or fingers.
How do I know if I have CTS?
Carpal Tunnel Syndrome usually develops gradually over a period of time. Initially, you may feel a tingling, burning or itching sensation in the hand (mainly the thumb, index, middle and ring finger). This commonly occurs at night when you’re sleeping because your wrist is in a bent position where the median nerve is more compressed. In the morning, you might find yourself “shaking it out”. After a few weeks, you may also feel the symptoms during the day, and you may start to lose the strength in your hand and find it hard to grip things like door handles or a cup of coffee. You might even feel like your hand is swollen, even though it’s not. If the condition is left untreated for a long time, not only can the symptoms extend into the arm and become extremely uncomfortable, the weakness may become permanent and you’ll also notice the muscles at the base of the thumb diminishing in size.
If this sounds like you, you should have it assessed by a specialist to confirm and treat the condition. Early diagnosis and treatment of CTS will reduce the chance of any permanent damage to the median nerve.
How do you get CTS?
There are many contributing factors which can reduce the carpal tunnel space and put pressure on the median nerve. For most people, the cause is unknown. Here are some possible causes.
- Repetitive use – repetitive flexing and extending of the hand and wrist for prolonged periods without rest can cause an overuse injury in the tendons in the carpal tunnel. This makes the tendons swell and reduce the carpal tunnel space, therefore increasing pressure on the median nerve. This is common in jobs in assembly line work such as manufacturing, sewing, finishing, cleaning, and meat, poultry, or fish packing.
- Trauma – any injury to your wrist can cause swelling that exerts pressure on the median nerve.
- Other health conditions – these include overactivity of the pituitary gland; hypothyroidism; rheumatoid arthritis; fluid retention during pregnancy or menopause; or the development of a cyst or tumor in the canal.
- Physical characteristics – some people are simply born with smaller carpal tunnels therefore putting them at risk of developing Carpal Tunnel Syndrome. This is thought to be the reason why women are more likely to develop the condition than men.
Can it be fixed?
Carpal Tunnel Syndrome can be treated without surgery, if you seek treatment early. The wrist should be rested as much as possible and movements that involve flexing and extending the wrist should be avoided. You may be provided with a splint in order to help rest the wrist, and this is particularly important to wear at night. Ice to the area will prevent further swelling and inflammation.
You may be prescribed a stretch for the median nerve similar to the video shown below. Once the symptoms have settled, exercises should be done to strengthen specific muscle. You may need to change the way you use your wrist at work and at home in order to prevent the condition from returning.
Anti-inflammatory medications are helpful to reduce any swelling and inflammation. Sometimes a steroid injection into the area can offer some temporary relief.
For more severe cases, treatment may require a Carpal Tunnel Release. This is a surgical procedure to relieve the pressure on the median nerve.
Can I prevent myself from getting Carpal Tunnel Syndrome?
There are no proven strategies to prevent Carpal Tunnel Syndrome, however there are simple measures you can take to help take the strain off your wrist during work.
- Taking regular breaks – this will help reduce the chance of any repetitive strain injuries
- Relaxing your grip – don’t make your muscles work harder than they need to
- Try to maintain a neutral wrist position – avoid holding your wrist in positions which are bent too far forward or backward
- Perform stretching exercises – for your hand, wrist and shoulders to prevent your muscles cramping up
Consultation and Assessment
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