Carpal Tunnel Syndrome

About the width of your thumb, the carpal tunnel is a narrow channel on the palm side of your wrist. The tunnel protects the nerves and the tendons that bend your fingers. Pressure on the nerve can cause pain and weakness in your wrist and hand and numbness or tingling in some of your fingers which can lead to CTS.
Extreme wrist positions, as well as a lot of finger use, especially with a lot of force or vibration (such as holding the steering wheel when driving heavy machinery) can all contribute to CTS.
CTS is common in professions such as assembly line work, particularly meat packing, and jobs requiring the use of hand tools, especially tools that vibrate. Although excessive keyboard and computer use is often associated with CTS, those performing assembly line work can develop CTS as well as those who perform computer work. Some leisure activities can also create CTS, such as sewing, sports such as tennis and golf and playing string instruments such as the violin or guitar.

The following health conditions can also lead to CTS in some individuals:

  • Inflammation and swelling of the tendons of the wrist
  • Injuries to the wrist (strain, sprain, dislocation, fracture)
  • Hormone or metabolic changes (pregnancy, menopause, thyroid imbalance)
  • Fluid retention (e.g. during pregnancy)
  • Diabetes
  • Certain medicine use (e.g. steroids)
  • Degenerative and rheumatoid arthritis

Signs and Symptoms

CTS usually starts gradually, with symptoms such as burning, tingling, “pins and needles”, or numbness in the palm of the hand and fingers. Often the symptoms are more noticeable during the night and individuals often report being wakened with symptoms. Many people feel the need to “shake out” their hands to try to relieve the symptoms.
As the condition progresses, the symptoms are noticed during the daytime and are often worse when holding items such as a heavy book or a hairbrush. Weakness of the hand and more constant numbness may occur if the pressure on the nerve continues. You may find that you drop objects unexpectedly or have a weakness in your grip. Accurate diagnosis will have to be completed by your local chartered physiotherapist or G.P.

Treatment

Treatment for CTS can range from physiotherapeutic to surgical intervention.

Physiotherapy Intervention can alleviate the symptoms and help restore normal functioning of the wrist and hands. However in more severe cases, surgical intervention is indicated to relieve carpal tunnel pressure.

Accurate diagnosis will need to be identified by your local Chartered Physiotherapist or G.P.

P.S.J. Keane
Chartered Physiotherapist