Many people believe that there is little that can be done for Carpal Tunnel Syndrome (CTS) except wait for surgery – they’re wrong! Here is a brief overview for you of Carpal Tunnel Syndrome and what can be done to help:
The Carpal Tunnel is a tunnel shaped space that runs from the wrist into the bottom of the hand on the same side as the palm of your hand. The Carpal ligament runs across the base of your hand and forms the roof of the tunnel. Through this tunnel run some tendons and the median nerve. CTS develops when pressure is exerted on the median nerve as it passes through the tunnel, tendons are tough and can cope with the pressure, but the sensitive median nerve gets irritated and produces CTS symptoms. These symptoms can include pain, weakness and numbness in the 1st – 4th fingers, a lot of people find that these symptoms are worse at night. This can be very disabling as it can affect your ability to carry out fine motor tasks such as writing and doing up buttons.
It is not always known what causes CTS but it is more common:
- in pregnancy when extra fluid can accumulate around the tunnel
- trauma such as a wrist fracture due to swelling
- With older age due to possible arthritis in the surrounding joints
- Diabetes
- People who use their wrist repetitively such as hairdressers and gardeners
Treatment can include:
- Splinting to hold the wrist at a slightly extended position and decrease the pressure on the tunnel (this is particularly helpful for night symptoms)
- Neural mobilisation to ensure that the median nerve is moving through the tissues of the upper limb as well as possible – your physiotherapist will instruct you on this
- Joint mobilisation at the cervical spine (neck) to ensure the nerve root is not being compressed by a stiff joint (carried out by your physiotherapist)
- Soft tissue massage and joint mobilisation around the carpal tunnel
- Advice regarding activity modification
- Acupuncture
When this condition becomes more advanced steroid injections and, ultimately, surgery to release the carpal tunnel may be necessary. Carpal tunnel release surgery is relatively minor and can be done under local anaesthetic, it involves surgically cutting the carpal ligament to release the pressure on the tunnel.
Physiotherapy is particularly good at treating the earlier stages of CTS, before any weakness develops. When the nerve has been compressed for a prolonged period surgery is necessary, so it is important to start treatment as early as possible.
Book online here for an assessment of your CTS. We keep wrist braces constantly in stock.
(The information in this blog is not intended as a replacement for proper medical advice. Always see a medical professional for an individual assessment of your condition.)