Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS)

John Miller Physiotherapist

Article by John Miller

Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome (CTS) is a common condition where the median nerve gets compressed at the wrist, leading to symptoms like numbness, tingling, and pain, often worsening at night. Repetitive hand movements, swelling from injuries, pregnancy, or arthritis can cause CTS. Physiotherapy offers non-invasive, effective treatments for CTS, focusing on alleviating symptoms and addressing the underlying causes.

The Anatomy of Your Carpal Tunnel

The carpal tunnel, a narrow passage in your wrist, houses the median nerve and tendons. It’s bordered by wrist bones and a ligament band. CTS symptoms emerge when this space narrows or its contents swell, increasing pressure on the nerve.

Physiotherapist treating middle-aged patient for Carpal Tunnel Syndrome in wrist
Effective Physiotherapy For Carpal Tunnel Syndrome

Causes Beyond the Wrist

CTS symptoms can also stem from nerve compression in other areas, such as a pinched nerve in the neck. This condition, known as “double crush syndrome,” underscores the importance of pinpointing the exact site of compression.

Neurodynamics’ Role

Nerves need to move freely along their paths. Obstructions, such as scar tissue or tight muscles, can disrupt this movement, causing CTS-like symptoms. Physiotherapists assess these neurodynamic factors to provide targeted treatment.

Hormonal and Occupational Influences

Hormonal changes, especially in middle-aged or pregnant women, can lead to CTS. Jobs involving repetitive wrist movements or vibrating tools also heighten the risk.

Recognising Symptoms

CTS manifests as pain, numbness, tingling, or burning in the hand and fingers. Symptoms often intensify at night, leading to muscle weakness and clumsiness in hand movements.

Diagnosing Carpal Tunnel Syndrome

Diagnosing CTS involves evaluating symptoms and conducting tests like Phalen’s or Tinel’s test. It’s crucial to examine the neck and upper back to rule out other causes. Nerve conduction studies or ultrasounds may be employed.

The Effectiveness of Physiotherapy in Carpal Tunnel Syndrome

Physiotherapy plays a pivotal role in the treatment of Carpal Tunnel Syndrome (CTS), as evidenced by a systematic review and meta-analysis conducted by Jiménez-Del-Barrio et al 2020. This study underscores the significance of manual therapy techniques, which include soft tissue and neurodynamic mobilisations.

These therapies have shown notable effectiveness in alleviating pain, improving physical function, and positively influencing nerve conduction studies in CTS patients. The focus on carpal bone mobilisation, nerve and tendon gliding exercises, and addressing cervical spine issues demonstrates a holistic approach to treatment, offering a comprehensive strategy for managing CTS symptoms.

The Role of Night Splints

Night splints play a crucial role in managing Carpal Tunnel Syndrome (CTS). These splints keep the wrist in a neutral position, reducing the pressure on the median nerve during sleep. This alleviation of pressure can significantly lessen the nocturnal symptoms of CTS, such as numbness, tingling, and pain.

Research on Night Splints & Hand Therapy

Recent studies have shown the effectiveness of night splints in CTS treatment. A study published in the Journal of Hand Therapy found that patients using night splints reported a substantial reduction in night-time symptoms. (Šošić et al 2020).

Practical Considerations

When using night splints, it’s essential to ensure they fit properly and maintain the wrist in a neutral position. They should be comfortable enough to wear all night without causing skin irritation or discomfort. It’s also important to note that while night splints are beneficial, they are most effective when used as part of a comprehensive treatment plan, including physiotherapy and ergonomic adjustments.

Night splints are a valuable tool in the management of Carpal Tunnel Syndrome, particularly in reducing night-time symptoms. They work best when combined with other treatments under the guidance of a physiotherapist. If you’re considering night splints for CTS, it’s advisable to consult a physiotherapist for a personalised treatment plan.

Kinesiology Tape in Carpal Tunnel Syndrome Treatment

Kinesiology tape is increasingly being used as an adjunct therapy for Carpal Tunnel Syndrome (CTS). This therapeutic tape is applied over and around the wrist to support and relieve pressure on the median nerve. The elastic properties of kinesiology tape gently lift the skin, enhancing circulation and reducing inflammation in the affected area. (Aktürk et al 2018)

It is typically used alongside other treatments such as physiotherapy exercises and ergonomic adjustments. As always, it’s advisable to consult a physiotherapist or healthcare professional for personalised advice and application techniques.

Surgical Considerations

Surgery is typically considered after conservative treatments like physiotherapy. It’s essential to confirm that CTS isn’t part of a “double crush syndrome” before opting for surgery.

Alternative Therapies

Ultrasound therapy, acupuncture, massage, and yoga may help in managing CTS. Ergonomic assessments in the workplace can help prevent recurrence.

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.

Related Articles

  • Common Causes of Wrist & Hand Pain: This article offers insights into various conditions that affect the wrist and hand, including CTS. It also discusses treatment options like physiotherapy modalities and ergonomics​​.
  • Hand & Wrist Treatments: Here, you’ll find information on different treatment options for hand and wrist conditions. These include joint mobilisation techniques, muscle treatment like soft tissue massage, support and protection methods, and pain relief approaches such as acupuncture​​.
  • Wrist Fracture Guide: Physiotherapy Tips: While focusing on wrist fractures, this guide also provides useful information on wrist supports and pain management techniques that could be applicable for CTS patients​​.
  • Pinched Nerve: This article explains the condition of a pinched nerve, a common cause of symptoms similar to CTS, and offers valuable information on diagnosis and treatment​​.
  • Neck Arm Pain: Since CTS can sometimes be related to issues in the neck and arm, this article provides useful information on how physiotherapy can help with arm symptoms, including those similar to CTS​​.
  • Hand and Wrist Arthritis: This article discusses arthritis in the hand and wrist, which can be a factor in CTS. It covers mobility exercises, pain relief methods, and the role of physiotherapy in managing these conditions​​.
  • Wrist Tendinopathy: Here, readers can learn about wrist tendinopathy, a condition that shares some symptoms with CTS. The article covers carpal bone mobilisation and nerve and tendon gliding exercises, which are also relevant for CTS​​.
  • RSI – Repetitive Strain Injury: Since repetitive strain can lead to CTS, this article offers insights into understanding and managing RSI, which could be helpful for those looking to prevent CTS​​.

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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