Carpal Tunnel Syndrome

What is Carpal tunnel syndrome?

Carpal tunnel syndrome (CTS) is a condition in which the median nerve is squeezed where it passes through a tunnel in the wrist.

This often happens because the tendons in the wrist have become swollen and they press on the nerve. The median nerve controls some of the muscles that move the thumb and it carries information back to the brain about sensations in your thumb and fingers.

When the nerve is squeezed it can cause pain, aching, tingling or numbness in the affected hand. You may not notice the problem at all during the day, though certain activities – such
as writing, typing, DIY or housework can bring on symptoms.

CTS may be associated with pain in the wrist and forearm. In some cases, nerve conduction tests are needed to confirm the diagnosis.

transverse carpal ligament compressed median nerve

transverse carpal ligament compressed median nerve

What are the symptoms?

  •  Altered sensation usually tingling in the hand affecting thumb, index and ring fingers.
  • Tingling usually is worse at night disturbing your sleep or first thing in the morning.
  • Hanging your hand out of bed or shaking it around will often relieve the pain and tingling.
  • Provoked by activities involving gripping an object.
  • May experience pain into the wrist and forearm.

Working too much - suffering from a Carpal tunnel syndrome

 

How is CPS treated?

The main advise would be to minimise activities that exacerbate symptoms. Simple treatment s may also help:

Splints

Wearing a resting splint can help prevent the symptoms occurring at night, or a working splint can be useful if your symptoms are brought on by particular activities.

Wrist support with hand

Wrist support with hand

 

 

 

 

 

 

 

Steroid injections

To reduce inflammation, you may have the option of steroid injection into your carpal tunnel. The injection may be uncomfortable, but the effects can last for weeks or months. A steroid injection into the wrist joint itself may help if you have arthritis in your wrist.

Surgery

Surgery is frequently required. The operation involves opening the roof of the tunnel, which is defined by a ligament to reduce the pressure on the nerve. The outcome is usually a satisfactory resolution of the symptoms. In severe cases, improvement of constant numbness and muscle weakness may be slow or incomplete, but the pain should be greatly reduced. It generally takes about three months to regain full straight, but the hand can be used for light manual handling activities from the day of the surgery.

Exercise

Try simple exercises to alleviate your symptoms and prevent future recurrence.

 

Wrist bend (forward and back)

Rest your elbow on a table, arm pointing up, wrist straight. Gently bend your wrist forward at a right angle and hold for 5 seconds. Straighten your wrist. Gently bend it backwards and hold for 5 seconds. Do 3 sets of 10 repetitions.

Wrist lift

Place your palm on the table and lift the fingers up. Place your other hand across the knuckles at 90° and push down as the bottom hand tries to pull up. You should feel the muscles of your forearms contracting. Swap hands
and repeat.

Wrist flex

Keeping your arm straight
in front with your palm facing down, gently bend your wrist down. Use the opposite
hand to press the stretching hand back towards your
body and hold for 15–30 seconds. Straighten your wrist. Gently bend the stretching hand backwards and use
the opposite hand to pull the fingers back. Hold for 15–30 seconds. Do 3 sets with
each wrist.

Finger bend

Start with your fingers held out straight. Gently bend the middle joints of your fingers down toward your upper palm and hold for 5 seconds. Do 3 sets of 10 repetitions.

Wrist stretch with weight

Holding a light weight (e.g a tin of beans), stretch your arm out in front with your palm down. Slowly bend your wrist upward, and then return to the starting position. Do 3 sets of 10 repetitions. Gradually increase the weight you hold.

Hand squeeze

Squeeze a rubber ball and hold for 5 seconds. Do 3 sets of 10 repetitions

 

Summary