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Carpal Tunnel Syndrome

Carpal tunnel syndrome is a condition that affects the hand and wrist. More specifically, it is an entrapment of the median nerve as it travels through a tunnel in the wrist (named the carpal tunnel).

Causes

Carpal tunnel syndrome can occur for a number of reasons. It usually occurs due to activities that cause pressure or compression to the median nerve. This includes activities such as repeated use of vibrating hand tools such as a drill, or activities involving repetitive wrist flexion such as sleeping with wrists curled. Other contributing factors include pregnancy, menopause, cyst or tumour, trauma to the wrist such as a sprain or fracture that causes swelling, rheumatoid arthritis. Often there are multiple factors that contribute.

Women are more likely to suffer from carpal tunnel syndrome than men. Those with metabolic disorders or diabetes are also more at risk.

Symptoms

Symptoms such as weakness in the hand, along with tingling or numbness are present. These symptoms often start gradually with numbness or tingling in the fingers, particularly the thumb, index and middle fingers. This can occur in one or both hands, and is usually worse at night. As the condition worsens, tingling during the day may be present with activities such as typing on a computer or driving. It may be difficult to grip objects due to weakness.

Treatment

For those with mild or moderate symptoms, a period of conservative management/physiotherapy is recommended. This includes strategies such as night splints, exercises, manual therapy and activity modifications. Avoiding activities that aggravate symptoms is required, as well as altering posture. Cold packs on the wrist can help reduce symptoms, as well as NSAIDs if needed. Sometimes steroid injections are recommended to further assist in settling symptoms.

Altering desk setups and workspaces to ensure the wrist is maintained in a neutral position during work or activity is important. Taking breaks from repetitive tasks, completing stretches and correcting posture and wrist position can make a big difference. This is mainly to avoid prolonged wrist flexion.

For those who have severe symptoms, symptoms for a long period of time, or where conservative treatment has failed, surgery is often recommended. This involves releasing ligament around the wrist to reduce compression on the median nerve.

Our Physiotherapists at Seville Health can assess your wrist pain and perform certain tests to determine if you have carpal tunnel syndrome. Treatment can then be provided as well as advice on managing symptoms. The sooner you get on to it, the better!