Carpal tunnel Syndrome (CTS) is a common condition that causes numbness, tingling, and pain in the hand and forearm. It is caused by compression of a key nerve, the median nerve and can cause you to feel to need to “shake out” your hand or wrist. CTS can affect the use of the entire arm. In most patients, carpal tunnel syndrome gets worse over time. If untreated for too long, it can lead to permanent dysfunction of the hand. For this reason, it is important to diagnose and treat carpal tunnel syndrome as soon as possible.

For many people with CTS working with a physio can relieve pain and numbness. It can often help restore normal hand, wrist, and arm use without the need for surgery.

Carpal Tunnel Syndrome Symptoms

Symptoms can first appear in one or both hands during the night. The dominant hand is usually affected first and bears the brunt of the most severe symptoms.

Symptoms usually include

• Frequent numbness or tingling in the fingers, especially the thumb and the index and middle fingers.
• A feeling the fingers are useless or swollen
• A tingling sensation or pain in the fingers.
• Tingling during the day, especially whilst doing activities using the hands and wrists like tying on a keyboard, holding a phone or driving.
• Mild to severe pain, sometimes worse at night
• Some loss of movement in the hand
• Hand weakness which can make it difficult to grasp small objects or perform other manual tasks.
• If left untreated, grip strength can decrease and muscle wastage in the area can occur.

Carpal Tunnel Syndrome Causes

Most cases of carpal tunnel syndrome are caused by a combination of factors. Along with this, it is more likely to appear in women and the older population. However, there are some other factors at play.

Other causes include

• Heredity. There may be anatomic differences that change the amount of space for the nerve and these traits can run in families.
  Repetitive hand use.
• Repeating the same hand and wrist motions or activities over a prolonged period of time may aggravate the tendons in the wrist, causing swelling that puts pressure on the nerve.
• Hand and wrist position. Doing activities that involve extreme flexion or extension of the hand and wrist for a prolonged period of time can increase pressure on the nerve.
• Pregnancy. Hormonal changes during pregnancy can cause swelling that results in pressure on the nerve.
• Health conditions. Diabetes, Parkinson’s, rheumatoid arthritis and thyroid gland imbalance are conditions that are associated with carpal tunnel syndrome.

Carpal Tunnel Syndrome Treatment: What can a Physio do?

Help diagnose- When you attend our Chartered Physiotherapy clinic we will complete different tests and assessments or refer you for further tests like a nerve conduction test or MRI.

Physical Therapy–In the early stages physical therapy treatment can be effective to reduce your symptoms and help you get back to your everyday activities. This can include soft tissue techniques and joint mobilisations.

Patient Education–Patient education teaches you ways to improve your condition and keep it from getting worse. Education on changing wrist positions, repeated stress and movements associated with it, posture assessment.

Stretching exercises & Strengthening exercises-Gentle stretching exercises can improve your wrist, hand, and finger flexibility. Along with this Exercise to strengthen muscles to help maintain better posture. Once your symptoms have decreased, strengthening exercises for the hand, wrist, and forearm may be prescribed.

Splinting–Using a splint at night can help reduce discomfort.

Other options include nonsteroidal anti-inflammatories drugs prescribed by your GP on recommendation from us and corticosteroid injections provided by an Orthopaedic specialist.

Reduce the risk of Carpal Tunnel Syndrome

After an assessment with a physiotherapist, we can help guide you on the journey to reducing your risk of prolonged CTS. Preventing or reducing carpal tunnel syndrome is achievable and can result in reduced pain and issues. Getting an early diagnosis is important to avoid surgery and as you can see there are plenty of techniques we can use to do that.

Carpel Tunnel Syndrome Treatment-Physiotherapy After Surgery

If your CTS has advanced or if your symptoms persist, and surgery is the only option, we may refer you to consult with a surgeon. We can work with you after your surgery to prevent scar tissue formation, restore strength and mobility to the wrist, education around your movement patterns or habits that may have had a factor in developing CTS and a work site mock-up to show you proper workstation setup to avoid future issues.