Carpal Tunnel Syndrome

What is it?

Carpal tunnel syndrome refers to a nerve disorder occurring at the wrist which causes pain, sensory changes and a loss of function within the hand.

How does it happen?

Carpal tunnel syndrome results from compression of the median nerve as it passes through the carpal tunnel. The carpal tunnel is made up on three sides by the wrist bones, with the roof of the tunnel consisting of a strong, broad ligament. Passing through this tunnel is the median nerve which sends signals from the brain to the hand, and a number of tendons which move the fingers. As the walls of the tunnel are inflexible, if any of the contained tendons become inflamed or swell, the median nerve can become compressed. This can interfere with the messages or signals transmitted by the nerve.

How does it feel?

Carpal tunnel syndrome can produce a number of sensations, all resulting from the compression of the median nerve. The most common include pain in the wrist and hand, and numbness and tingling in the fingers (not including the little finger). These may be present when the wrist is moved. However, they may also be present when the hand is resting or even at night-time. Carpal tunnel syndrome may also cause a sensation of weakness in the hand. This may result in a clumsy hand, the frequent dropping of objects and the poor performance in any sport which requires a strong grip.

What should you do?

If you have or suspect you have carpal tunnel syndrome, you should consult your sports physiotherapist. In the meantime, you should avoid any activities which cause your pain, or numbness and tingling to worsen.

What shouldn’t you do?

If you have or suspect you have carpal tunnel syndrome, you shouldn’t ignore the problem. This can lead to your problem getting worse. If this occurs, your recovery may be prolonged.

Could there be any long-term effects?

In many cases of carpal tunnel syndrome there are no long-term effects, as long as it is properly diagnosed and appropriately treated. However, in serious cases and in cases that are left untreated, recovery may be prolonged. In these cases, the muscles in the hand may weaken and the hand may feel numb most of the time. To remove the compression on the nerve and enable recovery in these cases, surgery may be required.

Management

The assistance of a sports and exercise physiotherapist is important in the treatment of carpal tunnel syndrome. Initially, they can assist in confirming your diagnosis and determining its severity. This may require the use of special nerve conduction tests which assess the transmission of signals along the median nerve. From their assessment, the sports and exercise physiotherapist will be able to determine an appropriate treatment plan. This may involve activity modification, the taking of anti-inflammatory medications and splinting of the wrist and hand. In severe or long-standing cases, surgery may be required.

Tom is a physio in Balgowlah who is highly trained in the assessment and management of carpal tunnel syndrome. For a complete understanding of your wrist pain, you will need an assessment face-to-face. To see the most highly regarded physio in Balgowlah, book here.

Brukner & Khan (2012) Clinical Sports Medicine.