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  • Writer's pictureDane Monaghan

Carpal Tunnel Syndrome: What is it and how can your Physio can help?

Updated: May 23, 2023


Carpal Tunnel syndrome introduction holding painful wrist

Carpal Tunnel Syndrome is a common, often painful condition that affects the hand, wrist and forearms. It generally presents as tingling, numbness and/or pain in the forearm or hand.


It's a common condition in athletes and people who use their forearms repetitively such as manual workers and people who spend a lot of time in front of a computer.


But what causes Carpal Tunnel Syndrome and how can your Physiotherapist help? Let's dive into the detail, symptoms and some ways to get relief.


What is the Carpal Tunnel and what does it do?

The Carpal Tunnel is a narrow passageway in the wrist which contains the median nerve and flexor tendons. Its role is to protect the wrist flexor tendons and median nerve. The tendons in the fingers responsible for bending the fingers also run through the carpal tunnel.


What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is a nerve entrapment injury (Neuropathy) caused by compression of the median nerve as it travels to the wrist through the carpal tunnel.

This is the most common Neuropathy accounting for 90% of carpel tunnel presentations. Carpal tunnel syndrome results from increased pressure in the carpal tunnel and subsequent compression of the median nerve.

Carpal tunnel and surrounding structures in the wrist


How Common is carpal tunnel syndrome?

Around 10-15 % of adults can expect to get carpal tunnel syndrome sometime in their lifetime.


It's most common in females between the ages of 36-60.


Risk factors include:

  • Pregnancy

  • Genetics

  • Rheumatoid arthritis

  • Obesity

Key causes of carpal tunnel syndrome

The main cause of carpal tunnel syndrome is repetitive wrist movements which can include chopping, push-ups, gardening, typing, gripping, and plenty more.




person chopping and pregnant woman - causes and risk factors of carpal tunnel syndrome


Signs and Symptoms?
  • Pain

  • Numbness

  • Paraesthesia

Mainly in the Thumb, pointer, and middle finger

Generally, this is a gradual onset Patients may notice aggravation of symptoms with static gripping of objects such as a phone or steering wheel but also at night or early in the morning. Many patients will report an improvement in symptoms following shaking or flicking of their hands.

As the disorder progresses, the feeling of tingling or numbness may become constant and patients may complain of burning pain.


The final symptoms are weakness and atrophy of muscles of the thenar eminence. These combined effects of sensory deprivation and weakness may result in a complaint of clumsiness and loss of grip and pinch strength or dropping things

Hand out stretched with nerve distribution from carpal tunnel signs and symptoms



Treatment

Firstly, with your Physio, identify and modify activities that may be contributing to this pain occurring in the first place


Physiotherapy treatment techniques will look to impact the soft tissue structures (9 flexor tendons) that feed through the Carpal tunnel. Helping release these structures can reduce the pressure in the carpal tunnel Our physios will also help reduce the pressure in the Carpal Tunnel by mobilisation the carpal bones to help free up joint movement at the wrist and hand. Our Median Nerve also runs through the Carpal Tunnel so it is important for a physio to identify if the nerve is being impacted anywhere else apart from the Carpal Tunnel. Median Nerve originates from C5 to T1 nerve roots from the spine at our neck. This means that anywhere along the nerve path could also be affected. For example, someone who has Carpal Tunnel Syndrome may benefit from purely treating the neck if that is impacting the nerve. Strength is another key component to managing Carpal Tunnel Syndrome pain. The key principle behind this is to keep the tendons and nerves that run through the carpal tunnel moving to ensure that we attempt to prevent and reduce adhesions as well as reduce swelling and increase load tolerance. It is important that this is carefully prescribed by your physio once they determine the level of activity that is tolerable for each patient


Physio advice for carpal tunnel syndrome

So if you or someone you love is suffering from what sounds like Carpal Tunnel Syndrome then please do not hesitate to contact us here at High Line Active Physiotherapy - Richmond.


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