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Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is a common condition that affects the hand and arm, causing pain, numbness, and tingling. It occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes compressed at the wrist. This nerve controls sensations to the palm side of the thumb and fingers (although not the little finger), as well as impulses to some small muscles in the hand that allow the fingers and thumb to move.

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Symptoms

The symptoms of Carpal Tunnel Syndrome usually start gradually and include:

  • Numbness or Tingling: Often in the thumb, index, middle, and ring fingers, but not the little finger. This sensation may occur while holding a steering wheel, phone, or newspaper, and might wake you from sleep.
  • Pain: Pain may radiate or extend from the wrist up the arm to the shoulder or down into the palm or fingers.
  • Weakness: A tendency to drop objects or difficulty with fine motor tasks due to weakness in the hand or fingers.
  • Shock-like Sensations: These sensations may radiate to the thumb and fingers.

Causes

Several factors can contribute to Carpal Tunnel Syndrome, including:

  • Repetitive Hand Movements: Such as typing, sewing, painting, and other activities that involve the hand and wrist.
  • Wrist Anatomy: A smaller carpal tunnel may predispose individuals to CTS.
  • Health Conditions: Conditions like diabetes, rheumatoid arthritis, thyroid dysfunction, and pregnancy can increase the risk.
  • Injury: Wrist injuries or trauma can cause swelling that compresses the median nerve.

When to See a Physiotherapist

You should consider seeing a physiotherapist if you:

  • Experience persistent symptoms of numbness, tingling, or weakness in your hand and fingers.
  • Have difficulty performing daily tasks due to hand pain or weakness.
  • Do not see improvement in symptoms despite rest and home treatments.
  • Want to prevent the progression of symptoms through therapeutic exercises and ergonomic advice.

Risks

Untreated Carpal Tunnel Syndrome can lead to:

  • Permanent Nerve Damage: Prolonged compression of the median nerve can cause permanent damage.
  • Muscle Atrophy: The muscles at the base of the thumb can waste away.
  • Decreased Hand Function: Severe CTS can lead to a significant reduction in hand function and strength.

How to Prevent

Prevention strategies for Carpal Tunnel Syndrome include:

  • Ergonomic Adjustments: Adjusting the height of your chair, keyboard, and monitor to keep your wrists in a neutral position.
  • Frequent Breaks: Taking breaks to stretch and rest your hands and wrists if you perform repetitive tasks.
  • Wrist Exercises: Performing exercises that stretch and strengthen the wrists and hands.
  • Proper Technique: Ensuring that you use proper form when performing activities that involve repetitive hand and wrist movements.

Treatments

Treatment options for Carpal Tunnel Syndrome range from conservative to surgical and include:

  • Wrist Splinting: Wearing a wrist splint at night can keep the wrist in a neutral position and reduce pressure on the median nerve.
  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These can help relieve pain and inflammation.
  • Corticosteroid Injections: Injections into the carpal tunnel can reduce inflammation and relieve symptoms temporarily.
  • Physical Therapy: A physiotherapist can provide exercises to strengthen and stretch the hand and wrist, as well as ergonomic advice.
  • Surgery: In severe cases, carpal tunnel release surgery may be necessary to cut the ligament pressing on the median nerve.

Conclusion

Carpal Tunnel Syndrome is a condition that can significantly impact hand function and quality of life. Understanding its symptoms, causes, and treatment options can help in managing and preventing this condition effectively. Early intervention and proper management are crucial to preventing long-term damage and maintaining hand function. If symptoms persist, seeking professional help from a physiotherapist or healthcare provider is recommended.

Frequently Asked Questions

Common symptoms include numbness, tingling, and pain in the hand and fingers, particularly the thumb, index, and middle fingers. Some individuals may also experience weakness in the hand or a sensation of “pins and needles.”
Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the hand, becomes compressed or irritated as it passes through the carpal tunnel—a narrow passageway in the wrist. Various factors can contribute to this compression, including repetitive hand movements, wrist injuries, underlying medical conditions such as arthritis or diabetes, and anatomical factors like wrist anatomy or pregnancy.
Diagnosis typically involves a physical examination by a healthcare professional, including evaluation of symptoms, assessment of hand strength and sensation, and specific tests such as the Tinel’s sign and Phalen’s test. In some cases, nerve conduction studies or electromyography (EMG) may be conducted to confirm the diagnosis and assess the severity of nerve damage.

Treatment options for CTS vary depending on the severity of symptoms and underlying causes but may include:

  • Resting the affected hand and avoiding activities that worsen symptoms.
  • Wearing a splint or brace to immobilize the wrist and reduce pressure on the median nerve.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to alleviate pain and inflammation.
  • Physical therapy to improve strength, flexibility, and posture.
  • Corticosteroid injections to reduce inflammation and relieve symptoms.
  • In severe cases, surgical procedures such as carpal tunnel release may be recommended to relieve pressure on the median nerve.

While it may not be entirely preventable, certain measures can help reduce the risk of developing CTS or alleviate symptoms:

  • Taking frequent breaks during repetitive tasks to rest the hands and wrists.
  • Maintaining proper posture and ergonomics when using computers or performing manual tasks.
  • Using wrist splints or supports during activities that require repetitive hand movements.
  • Performing stretching exercises to improve flexibility and reduce muscle tension in the hands and wrists.
  • Avoiding activities that involve prolonged wrist bending or repetitive gripping.

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