Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS)

John Miller Physiotherapist

Article by John Miller

Carpal Tunnel Syndrome

Understanding Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) occurs when the median nerve is compressed in the wrist’s carpal tunnel. This condition leads to symptoms like numbness, tingling, and pain, often intensifying at night. CTS can be caused by repetitive hand movements, swelling from injury, pregnancy, or arthritis.

The Anatomy of Your Carpal Tunnel

The carpal tunnel is a narrow passage in your wrist, housing the median nerve and tendons. It’s surrounded by wrist bones and a ligament band. When this space reduces or its contents increase, the nerve’s pressure heightens, causing CTS symptoms.

Causes Beyond the Wrist

CTS symptoms can originate from nerve compression in areas other than the carpal tunnel. A common example is a pinched nerve in the neck, mimicking CTS. This “double crush syndrome” highlights the importance of identifying the correct compression site.

Neurodynamics’ Role

Nerves require free movement along their pathways. Obstructions, like scar tissue or tight muscles, can disrupt this and cause CTS-like symptoms. Physiotherapists can assess these neurodynamic factors.

Hormonal and Occupational Influences

Hormonal changes, particularly in middle-aged or pregnant women, can lead to CTS. Jobs that involve repetitive wrist movements or use of vibrating tools also increase the risk.

Recognising Symptoms

CTS is characterised by pain, numbness, tingling, or burning in the hand and fingers. These symptoms often worsen at night and can progress to muscle weakness and clumsiness in hand movements.

Diagnosing Carpal Tunnel Syndrome

Diagnosis typically combines symptom evaluation and tests like Phalen’s or Tinel’s test. Examining the neck and upper back is essential to exclude other causes. Nerve conduction studies or ultrasounds may be used.

carpal tunnel syndrome
Carpal Tunnel Syndrome

Effective Treatment Approaches

Rest and educating patients about factors aggravating CTS are key. Night wrist splints can help by preventing wrist bending. Physiotherapy is highly beneficial, focusing on carpal bone mobilisation, nerve and tendon gliding exercises, and addressing any cervical spine issues.

Alternative Therapies

Treatments like ultrasound therapy, acupuncture, massage, and yoga have been beneficial in CTS management. Workplace ergonomic assessments can help prevent recurrence.

Surgical Considerations

Surgery is usually considered after conservative treatments, such as physiotherapy, have been tried. It’s crucial to ensure CTS isn’t part of a “double crush syndrome” before surgery.

Prognosis and Prevention

Early treatment offers a favourable prognosis for mild to moderate CTS. In chronic cases or those with muscle atrophy, surgery might be required. Preventative measures include ergonomic adjustments and regular physiotherapy check-ups.

Conclusion: Seek Professional Advice

Carpal Tunnel Syndrome can significantly affect daily activities. Understanding and accurate diagnosis are essential for effective treatment. If you’re experiencing CTS symptoms, consult a physiotherapist for a customised treatment plan. They can offer non-invasive options and guide you through the process, ensuring the best outcome for your condition.

Common Wrist & Hand Pain or Injuries

Welcome to the Common Wrist & Hand Pain page, where we provide valuable information on various conditions affecting the wrist and hand. Traumatic injuries like broken wrists, fingers, and thumb sprains can cause significant discomfort.

Overuse injuries like carpal tunnel syndrome, de Quervain's tenosynovitis, and repetitive strain injury can result from repetitive motions. Additionally, degenerative or systemic conditions such as hand or wrist arthritis and rheumatoid arthritis can lead to chronic pain.

We also offer a range of treatment options, including general management strategies, early injury treatment techniques, ergonomics, and physiotherapy modalities like joint mobilisation, muscle treatment, support and protection methods, pain relief approaches such as acupuncture and dry needling, as well as electrotherapy and local modalities like heat packs and TENS machine.

Please click the links below for more information.

Traumatic Injuries

Overuse Injuries

Referred Symptoms

Degenerative or Systemic Conditions

Common Wrist & Hand Pain Treatments

General Management

Treatment Options

Joint Movement

Muscle Treatment

Support & Protection

Pain Relief

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