Do you suffer from pain, tingling or numbness in your hands? Have you noticed that you have become more clumsy or feel weakness in your hands? You may be suffering from Carpal Tunnel Syndrome. Here is some information from our senior physiotherapist Julie Nicholson that you might find useful.
What is Carpel Tunnel Syndrome?
CTS is a condition where the median nerve is compressed at the wrist joint, within the carpel tunnel.
The nerves tuck under the transverse carpal ligament at the wrist
The carpel tunnel is a space between the bones of the wrist and the transverse carpel ligament that lies over the front of your wrist.
What causes CTS?
A number of things can cause CTS including trauma, tenosynovitis (swelling of the tendon sheath) repetitive activities, arthritis and pregnancy. However, the cause is often not known.
What are the symptoms?
Numbness, pins and needles, burning and tingling are commonly described. These altered sensations are usually felt in the thumb, index and middle finger. Weakness and loss of dexterity (clumsiness) can develop. Pain in the hand and fingers can also be experienced up the arm, most commonly as far as the elbow. The symptoms are usually worse at night.
How can CTS be diagnosed?
A detailed history with a physical assessment is usually enough to make a diagnosis. If there is any doubt a nerve conduction test can be performed via your GP. This measures the speed and strength of signals as they pass through your nerves to check for any nerve damage.
Can physiotherapy help Carpal Tunnel Syndrome?
Splinting – the use of a wrist splint holding the wrist in a neutral position maintains the most ‘open’ position of the carpal tunnel. It is initially advised to wear the splint at night only.
Tendon gliding exercises – of the tendons that pass through the carpal tunnel. This involves a sequence of finger and wrist movements.
Carpal joint mobilisation and stretching of the flexor retinaculum – manual techniques to open the carpal tunnel.
Ultrasound – electrotherapy treatment to reduce inflammation.
Posture/ergonomics – repetitive movements and sustained positions can be the cause of CTS. Treatment can involve advice on workstation set up, exercises and postural re-education, as well as manual techniques to improve posture and range of movement.
Soft tissue release and neural mobilisation – to reduce the tightness of the muscles and fascia to limit the irritation of the structures that can cause CTS and ensure free movement of the nerves.
Cervicothoracic mobilisation – if an assessment highlights referral of symptoms from the spine.
Strengthening exercises – of the upper limb, wrist and hand.
If you think that you might be suffering with Carpal Tunnel Syndrome or are puzzled by other hand and arm symptoms don’t hesitate to book an assessment with one of our experienced physiotherapists.
