Carpal tunnel syndrome is an irritation of the median nerve as it passes through the carpal tunnel. It is a common compression neuropathy that affects hand function in the general population for various reasons.
Located in the palm, the carpal tunnel composed of the arch of bones on one side and the transverse carpal ligament on the more superficial side. Flexor tendons to the digits and wrist are also present in the tunnel.
The median nerve provides control of the small thumb muscles or thenar muscles in the hand and provides sensation to the thumb, index, middle and partial ring finger. When the median nerve is irritated or compressed, there can be a change in sensation of the fingers, stiffness, weakness, loss of use, and/or pain in the hand and wrist.
Research has found that there is often a change in circulation and the maintenance systems to the nerve. In addition, there can be multiple areas of compression, such as in the neck and shoulder, that can also worsen carpal tunnel symptoms. Part of a thorough assessment includes screening of the entire upper limb, shoulder and neck.
Conservative treatment of carpal tunnel syndrome can be very useful to reduce symptoms. The following methods are often used:
- Use of night resting wrist splint; may be used occasionally during the day, depending on the presentation
- Median nerve mobilization exercises
- Home use of contrast bathing, application of heat/cold temperatures to reduce symptoms
- In the clinic, therapeutic modalities such as TENS, ultrasound, interferential current
- Postural correction: core strengthening, head/ neck/thoracic spine mobilization, and stretching
- Ergonomic considerations such as advice on workstation set up, job task rotation, postural awareness, activity modification, the pacing of activities
- Education about the condition and enhancing self-awareness and symptom monitoring
Not all wrist pain or numbness in the hand is carpal tunnel syndrome, so it is important to see your local hand therapist for a comprehensive assessment before jumping to conclusions!
If you have hand/elbow pain or dysfunction, come see Linda