Carpal tunnel syndrome (CTS) is a medical condition due to compression of the median nerve as it travels through the wrist at the carpal tunnel. The main symptoms are pain, numbness and tingling in the thumb, index finger, middle finger and the thumb side of the ring fingers.
If the carpal tunnel narrows, it can be due to swelling and inflammation of the flexor tendons, thus putting pressure on the median nerve. These tissues are called synovium – synovium has a job of lubricating the tendons, allowing movement of the fingers.
How is it caused?
Some studies have stated that it is more likely to develop in women and older people. However in most cases carpal tunnel syndrome is caused by a combination of factors including;
- Heredity. This is likely an important factor. The carpal tunnel may be smaller in some people or there may be anatomic differences that change the amount of space for the nerve—and these traits can run in families.
- Repetitive hand use. Repeating the same hand and wrist motions or activities over a prolonged period of time may aggravate the tendons in the wrist, causing swelling that puts pressure on the nerve.
- Hand and wrist position. Doing activities that involve extreme flexion or extension of the hand and wrist for a prolonged period of time can increase pressure on the nerve.
- Pregnancy. Hormonal changes during pregnancy can cause swelling.
- Health conditions. Diabetes, rheumatoid arthritis, and thyroid gland imbalance are conditions that are associated with carpal tunnel syndrome.
Symptoms can include the following;
- Altered sensation, tingling, number in hand and/or fingers, pain, weakness
- Numbness, tingling, burning, and pain – primarily in the thumb and index, middle, and ring fingers.
- Occasional shock-like sensations that radiate into fingers.
- Pain or tinging that may travel up the forearm towards the shoulder
- Weakness – difficulty gripping and perform fine motor skills such as buttoning your clothes
- Reduced proprioceptive awareness – dropping things.
Diagnostic tests can include a Tinel test (a tapping procedure to detect irritated nerves), MRI or ultrasound. Once diagnosed there’s many short term solutions your GP may recommend. Including Manual Therapy (A therapist can use mobilisations techniques to aid and reduce pain at the wrist), non steroidal anti-inflammatory drugs (ibuprofen/naproxen), Exercise therapy (Physiotherapy) or acupuncture (The use of needles, this can “remap” the brain so it modifies the pain signal from the wrist).
As beneficial as the above can be, they are not cures. If pressure on the median nerve continues, it can lead to nerve damage and worsening symptoms. To prevent permanent damage, surgery to take pressure off the median nerve may be recommended for some patients.
If you need help or advice, our Physiotherapists and Sports Therapist’s at J&P are here to help get you back to health. Contact us to book an appointment, or find out more.
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