Carpal tunnel syndrome is a condition that causes the hand and arm to experience pain, numbness, and tingling. This occurs when the median nerve in the hand is squeezed or compressed in the area where it passes through the wrist. This is caused by the carpal tunnel becoming narrowed or when tissues around the tendons swell up and put pressure on the median nerve. Pressure on the nerve is what causes the numbness, tingling, pain and weakness in the hand.
What is the carpal tunnel?
The carpal tunnel is a small passageway in the wrist that is formed by wrist bones called carpal bones. This tunnel serves the function of protecting important structures such as the median nerve, blood vessels and tendons.
What is the median nerve?
The median nerve is one of the main nerves in the hand and it begins in the neck as a group of nerve roots. The nerve roots form a single nerve goes from the arm down to the hand, passing through the carpal tunnel at the wrist. This nerve allows us to feel things in our fingers and helps us control the muscles around the base of our thumb.
What causes carpal tunnel syndrome?
There are many factors that may contribute to carpal tunnel syndrome. Some of these include:
Heredity: Some people may have naturally smaller carpal tunnels due to genetics, which means there is less space for the median nerve. This can make it easier for the nerve to be compressed by changes in the surrounding area.
Injury to the hand and wrist: If someone frequently has to repeat the same hand and wrist motions for a prolonged period of time, this may cause the tendons in the wrist to swell up. This swelling is what puts pressure on the nerve as it crowds up the space in the carpal tunnel. Doing activities that require the hand and wrist to be over-flexed or extended for a long time can also increase pressure on the nerve.
Pregnancy: Hormonal changes in the body during pregnancy can cause swelling in hands and feet. This can cause the wrist area to swell and result in carpal tunnel syndrome. Health conditions such as diabetes, arthritis and thyroid gland imbalance are also associated with carpal tunnel syndrome.
It is important to note that the median nerve can also be compressed somewhere else besides the wrist such as the neck or along the arm and still cause carpal tunnel syndromes.
Common symptoms include feeling pain or aching in the hand, mainly the fingers. Tingling, numbness, weakness, cramping and swelling are also symptoms. There may occasionally be shock-like sensations in the hand. Handgrip will be weak and clumsiness is common as it will be difficult to use your hand normally.
At the start of the condition, symptoms begin gradually and may come and go. If the condition worsens and is untreated, these symptoms may be more frequent, more intense and persist for longer periods of time. This can disrupt daily life as there are many activities such as driving, using a phone and carrying things that will be difficult to do. These symptoms usually get worse at night and can also disrupt sleep.
Carpal tunnel syndromes can worsen without treatment, so it is important to be diagnosed early and start treatment early in order to slow down or stop the symptoms from worsening.
If symptoms are mild, surgery isn't required and treatment can involve the use of braces or splints to prevent bending of the wrist especially while sleeping. Braces and splints can also help to keep the wrist in a position that reduces pressure on the nerve. Medication can help by relieving pain and inflammation.
One of the most important things to do when treating the condition is rest. Stop doing activities that require the hand and wrist to be in the same position for too long or require repetitive hand movements. Continuing to carry out these activities will only aggravate the condition and make the symptoms worse.
Physiotherapy is beneficial for people suffering from carpal tunnel syndrome as it can help restore movement and function in the hand. This is done through exercises recommended by the physiotherapist such as nerve gliding exercises, strengthening and endurance exercises for the arm, wrist and hand. Dry needling and massage can also assist in reducing pain and help grip strength.
Extracorporeal Shock Wave