Carpal Tunnel Syndrome

What Is Carpal Tunnel Syndrome?

Carpal tunnel is a condition where the median nerve becomes compressed within the carpal tunnel (the arch-like region within the wrist where the nerve runs between the bone and stabilizing wrist ligaments). This compression of the median nerve causes pain, numbness and tingling, and weakness within the hand.


What Are The Causes Of Carpal Tunnel Syndrome?

CTS is often “idiopathic” and the cause is unknown. The highest incidence is among middle-aged females, but it is also found in individuals who do a lot of repetitive motions (typically someone who works with their hands). The mechanical cause of CTS is compression of the median nerve within the “carpal tunnel” region of the wrist. This is often due to irritation in the region leading to inflammation. Irritation may arise from joint abnormalities, joint hypermobility, joint stiffness, general swelling in the hand/wrist, swelling due to pregnancy, or wrist tendonitis.


What Are The Signs And Symptoms Of Carpal Tunnel Syndrome?

CTS often presents with numbness and tingling in the median nerve distribution of the hand. The median nerve innervates the palmar side of the thumb, index finger, middle finger, and half of the ring finger, as well as in the tips of these fingers surrounding the nail-bed region. Patients may also experience symptoms of burning pain, and muscle atrophy at the base of the thumb. Weakness may occur in hand, grip or pinch strength and patients may feel clumsiness or drop things more frequently. Those with CTS may feel the need to shake their hands out to help alleviate symptoms.


What Are The Risk Factors Of Carpal Tunnel Syndrome?

High BMI, participating in a job where you do repetitive activities with your hands, pregnancy. It is also more prevalent in women and in those over 45.


How Is Carpal Tunnel Syndrome Diagnosed?

It can be diagnosed by a PT when a patient presents with the signs, symptoms, and positive special tests that are consistent with CTS. MRI imaging, electromyogram testing, and x-ray may help with the diagnosis.


What Are The Possible Treatments For Carpal Tunnel Syndrome?

PTs will instruct patients in activity modifications to attempt to decrease irritation and inflammation in the region. PTs will utilize hands-on manual therapy techniques, including soft tissue massage and myofascial mobilization, to improve muscle and other soft tissue flexibility. Manual therapy also aims to reduce swelling and encourage blood flow and healing. Joint mobilization may be applied to improve hypermobile joints that are stuck or restricted. PT applied passive nerve mobilizations and patient applied active nerve mobilizations may be performed. PTs also utilize various therapeutic exercises to improve strength and stability.
PTs will discuss other supplemental treatments, such as wrist braces or splints, oral steroids, steroid injections, and anti-inflammatories. Severe cases may require surgical intervention.


Are There Preventative Steps Or Measures To Avoid Carpal Tunnel Syndrome?

Maintaining good flexibility of the joints and muscles in the hands, wrists, and forearms, participating in a good stretching and strengthening program, avoiding performing prolonged repetitive motions when possible.


What Are The Risks If Carpal Tunnel Syndrome Is Left Untreated?

Severe carpal tunnel syndrome may cause permanent nerve damage, chronic pain, weakness, and muscle atrophy if left untreated.


Are There Other Related Conditions To A Carpal Tunnel Syndrome?

CTS may present with similar symptoms to pronator teres syndrome or cervical radiculopathy.


Key Takeaways About Carpal Tunnel

-If you experience symptoms of numbness/tingling in the wrists and hands, weakness, difficulty gripping and holding onto objects, and pain or burning in the wrist and hands, you should be evaluated for CTS.
-Maintain good flexibility in the hands, wrists, and forearms by stretching out these areas after use.
-If you work at a computer all day consider using a soft gel pad to cushion the wrists and help prevent additional compression through the region.


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