Carpal Tunnel Syndrome

Weak grip? Pain, tingling and numbness in your thumb, index, middle finger and wrist? You may be suffering from Carpal Tunnel Syndrome.

What is Carpal Tunnel Syndrome or CTS? What causes CTS? What are the symptoms? What can you do for CTS? What can your physio/osteo do for carpal tunnel syndrome? How long until carpal tunnel syndrome gets better? This article answers everything you need to know about carpal tunnel syndrome.

If you’re feeling time poor, why not check out this short video with Dr Abbey Davidson (Osteopath)?:

What is Carpal Tunnel Syndrome?

carap tunnel is caused by compression of the median nerve
Source: staff (2014)

The carpal tunnel is made up of your wrist bones and the transverse carpal ligament. This forms a small passageway or “tunnel” where the median nerve and several tendons travel to supply the hand. In Carpal Tunnel syndrome or CTS there is pressure placed on the median nerve as is passes through this space presenting with pain, tingling and numbness in the hand.

CTS is 3x more likely in women 3 times more likely and more common in smokers.




Causes of Carpal Tunnel Syndrome:

Carpal tunnel syndrome is caused by a reduction of the carpal tunnel space. This can be due to swelling/inflammation or overuse.

Swelling or inflammation in the carpal tunnel reduces the space available for the median nerve to pass through. Diabetes, high blood pressure, arthritis, thyroid disorders or direct trauma can result in swelling impacting the carpal tunnel and median nerve.

Repetitive hyper-extensions of the wrist (e.g. using a keyboard incorrectly, vibrating power tools, etc.) can result in an overuse type injury. This can cause repetitive compression the median nerve or result in scar tissue being laid down reducing the space inside the carpal tunnel .

Signs and Symptoms of Carpal Tunnel Syndrome:

Someone suffering with carpal tunnel syndrome will often have the following signs or symptoms:

  • Decreased grip/hand strength
  • Pain in thumb, index, middle, half ring finger and/or distal forearm
  • Numbness/tingling same distribution
  • Night pain/disrupting sleep

If you think you may be suffering from carpal tunnel syndrome we recommend getting assessed by a health professional like a physiotherapist or osteopath.

What you can do right now for Carpal Tunnel Syndrome?

CTS can be managed with the use of splinting, avoiding aggravating activities, stretching, nerve glide exercises and decreasing inflammation.

Splinting the wrist with an orthopedic brace (available at pharmacies and physio clinics) can be really useful in the treatment of carpal tunnel syndrome. Being diligent with bracing especially at night time can reduce mechanical stress placed on the wrist and increase the space where median nerve travels.

Avoid aggravating activities. You want to ensure you are not reaggravating your CTS with repetitive hyperextensions throughout the day. This is often occupation (keyboard use, power tool use, painting, etc.) so this may require you taking some time away from work or altering the duties you perform until your symptoms improve.

Stretches targeting your the muscles and tendons of the forearm and hand may provide some relief if performed 2-3 times per day. There is a demonstration of these in the video at the top of page. Decreasing muscular tightness throughout the arm/wrist/hand improves wrist mechanics and increases size of the carpal tunnel.

Nerve gliding exercises especially targeting the median nerve can be helpful in the treatment of CTS. This insures the nerve travel freely all the way from the neck, down through the armand into the fingers. Decreasing pressure on the nerve can assists its passage through the carpal tunnel and therefore decrease the symptoms you’re experiencing. It is important that with nerve gliding exercises you start and the most simple and mild variation and slowly increase the difficulty to avoid flaring up your symptoms

Swelling decreases the space available in the carpal tunnel which we want to minimize. Decreasing inflammation or swelling at the wrist can help provide symptomatic relief. Using an icepack (avoid direct skin contact) 10 minutes on, 20 minutes off or applying topical anti-inflammatory gels.

Physio and osteo treatment for Carpal Tunnel Syndrome:

The signs and symptoms of carpal tunnel syndrome can often be confused with other conditions. Your physio or osteo’s primary role will be to give you a clear diagnosis by collating your clinical history, medical history and information gained in physical assessment. In some circumstances they may send you for further testing or imaging to confirm their suspicions.


How long until Carpal Tunnel Syndrome gets better?

Your recovery from carpal tunnel is dependent on your compliance to your health professional’s advice. Avoiding repetitive actions (like keyboard use) is key, using braces/splints as prescribed and performing tailored exercises regularly are all important to seeing your symptoms improve.

In some severe cases of carpal tunnel syndrome or in cases of CTS which do not responds to conservative treatments for a period greater than 12 months surgery may be required.



By Sydney CBD Osteopath Dr Abbey Davidson

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