Carpal Tunnel Syndrome (CTS) is a common condition that occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes compressed or squeezed at the wrist. This compression leads to pain, numbness, tingling, and weakness in the hand and fingers. Treatment is essential to alleviate symptoms, prevent further nerve damage, and improve hand function.
What Is Carpal Tunnel Syndrome, and Why Is Treatment Important?
What Are the Causes and Risk Factors of Carpal Tunnel Syndrome?
Repetitive Hand Movements – Performing repetitive hand or wrist movements, such as typing, using a computer mouse, or assembly line work, can strain the tendons and tissues within the carpal tunnel, leading to inflammation and compression of the median nerve.
Anatomical Factors – Certain anatomical features, such as a smaller carpal tunnel size or variations in the shape of the wrist bones, may increase the risk of developing CTS.
Medical Conditions – Conditions such as diabetes, thyroid disorders, obesity, rheumatoid arthritis, or pregnancy can increase the risk of developing Carpal Tunnel Syndrome due to their effects on nerve function or fluid retention.
Trauma or Injury – Previous wrist fractures, sprains, or trauma to the wrist area can cause swelling or inflammation within the carpal tunnel, leading to compression of the median nerve.
Hormonal Changes – Hormonal changes associated with pregnancy, menopause, or hormone replacement therapy can increase fluid retention and predispose individuals to develop CTS symptoms.
Age and Gender – Carpal Tunnel Syndrome is more common in individuals aged 40 to 60 years and is more prevalent in women than men, possibly due to hormonal factors or differences in hand anatomy.
What Are the Common Symptoms of Carpal Tunnel Syndrome?
Hand Pain – Pain, aching, or discomfort in the hand or wrist, particularly at night or upon waking in the morning.
Numbness or Tingling – Numbness, tingling, or pins-and-needles sensations in the thumb, index finger, middle finger, and half of the ring finger, often radiating from the wrist to the fingertips.
Weakness – Weakness or clumsiness in the hand, making it difficult to grasp or hold objects, or perform fine motor tasks.
Burning Sensation – A burning sensation or electric shock-like feeling in the hand or fingers, particularly with certain movements or activities.
Worsening Symptoms – Symptoms may worsen with repetitive hand or wrist movements, such as typing, gripping, or using tools, and may improve with rest or changes in hand position.
Thumb Muscle Weakness – Weakness or atrophy of the muscles at the base of the thumb (thenar muscles), leading to difficulty with pinching or grasping objects.
How Is Carpal Tunnel Syndrome Diagnosed?
Medical History – Your doctor will ask about your symptoms, including any pain, numbness, tingling, or weakness in your hand or fingers, particularly in the thumb, index, middle, or ring fingers. They may inquire about activities or repetitive movements that could be exacerbating your symptoms, as well as any underlying medical conditions that may contribute to nerve compression, such as diabetes or thyroid disorders.
Physical Examination – During the physical examination, your doctor will:
- Assess the distribution of symptoms, particularly whether they affect the thumb, index, middle, or ring fingers, which are typically associated with the median nerve.
- Perform specific maneuvers to reproduce symptoms, such as Tinel’s sign (tapping over the median nerve at the wrist to elicit tingling or electric shock-like sensations) or Phalen’s maneuver (flexing the wrist for 60 seconds to elicit symptoms).
- Check for muscle weakness, particularly in the thumb muscles, and assess grip strength.
- Palpate the wrist and hand for tenderness, swelling, or other abnormalities.
Nerve Conduction Studies (Electromyography – EMG) – In some cases, your doctor may recommend nerve conduction studies or electromyography (EMG) to assess nerve function and confirm the diagnosis of carpal tunnel syndrome.
These tests measure the speed and strength of electrical impulses as they travel along the median nerve and can help identify nerve compression and the extent of nerve damage.
What Are The Carpal Tunnel Syndrome Treatment Options?
Rest and Activity Modification
Resting the affected hand and avoiding activities that exacerbate symptoms can help reduce inflammation and pressure on the median nerve.
Rest and Activity Modification
Resting the affected hand and avoiding activities that exacerbate symptoms can help reduce inflammation and pressure on the median nerve.
Wrist Splinting
Wearing a wrist splint, particularly at night or during activities that aggravate symptoms, can help keep the wrist in a neutral position and alleviate pressure on the median nerve.
Ergonomic Modifications
Physical Therapy
Medications
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) – Over-the-counter or prescription NSAIDs such as ibuprofen or naproxen may help reduce pain and inflammation associated with carpal tunnel syndrome.
Corticosteroid Injections – Injections of corticosteroids into the carpal tunnel may help reduce inflammation and alleviate symptoms, particularly in cases of moderate to severe carpal tunnel syndrome.
Nerve Gliding Exercises
Bracing and Splinting
Carpal Tunnel Release Surgery
Complementary and Alternative Therapies
Recovery And Prevention Strategies For Carpal Tunnel Syndrome
For Recovery:
- Resting the affected hand and avoiding activities that exacerbate symptoms can help reduce inflammation and relieve pressure on the median nerve. Immobilising the wrist with a splint or brace, particularly at night, can help keep the wrist in a neutral position and alleviate symptoms.
- Applying ice packs to the affected wrist can help reduce pain and inflammation associated with carpal tunnel syndrome. Wrap the ice pack in a cloth to protect the skin, and apply it for 15-20 minutes several times a day.
- Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help reduce pain and inflammation associated with carpal tunnel syndrome. Follow the recommended dosage and consult a healthcare professional if you have any concerns or underlying medical conditions.
- Perform gentle stretching and strengthening exercises for the wrists and hands to improve flexibility, reduce stiffness, and promote circulation. Avoid movements that exacerbate symptoms and consult a healthcare professional or physical therapist for guidance on appropriate exercises.
- A physical therapist can design a customised rehabilitation program to address muscle imbalances, improve wrist and hand function, and alleviate symptoms of carpal tunnel syndrome. Treatment may include manual therapy, therapeutic exercises, and ultrasound or electrical stimulation modalities.
- Injections of corticosteroid medications into the carpal tunnel can help reduce inflammation and alleviate symptoms, particularly in moderate to severe carpal tunnel syndrome cases. Repeat injections may be necessary for long-term symptom relief.
- In severe or persistent symptoms that do not respond to conservative treatments, surgical intervention may be necessary to relieve pressure on the median nerve. Carpal tunnel release surgery involves cutting the ligament that forms the roof of the carpal tunnel to relieve compression on the median nerve.
For Prevention:
- Maintain proper ergonomics at your workstation to reduce strain on the wrists and hands. Use an ergonomic keyboard and mouse, adjust the height of your chair and desk, and position your computer monitor at eye level to promote neutral wrist and hand positions.
- Take regular breaks from repetitive tasks that involve prolonged wrist or hand movements, such as typing or using a computer mouse. Alternate tasks or incorporate stretching exercises into your routine to reduce the risk of overuse injuries.
- Use wrist splints or braces during activities that may exacerbate symptoms of carpal tunnel syndrome, such as typing, using power tools, or engaging in sports activities. Wrist support can help maintain proper alignment and reduce strain on the median nerve.
- Maintain neutral wrist and hand positions during activities to reduce stress on the median nerve. Avoid excessive bending or flexion of the wrists and use proper hand placement and grip techniques to minimise strain.
- Incorporate wrist and hand exercises into your daily routine to strengthen the muscles surrounding the carpal tunnel and improve flexibility. Focus on exercises that target the wrist extensors, flexors, and rotators to promote joint stability and prevent muscle imbalances.
- Maintain a healthy weight, eat a balanced diet, stay hydrated, and exercise regularly to promote overall joint health and reduce the risk of conditions that may exacerbate carpal tunnel syndrome, such as obesity or diabetes.
- Schedule regular check-ups with a healthcare professional to monitor symptoms of carpal tunnel syndrome and address any underlying medical conditions that may contribute to or exacerbate symptoms. Early detection and intervention can help prevent progression and improve treatment outcomes.
Implementing these recovery and prevention strategies can effectively manage symptoms of carpal tunnel syndrome, reduce the risk of complications, and improve wrist and hand function.
Work closely with healthcare professionals, such as orthopaedic specialists, physical therapists, or occupational therapists, to develop a personalised treatment and prevention plan based on individual needs and circumstances.
