Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS)

Carpal Tunnel Syndrome

What exactly is CTS?

It refers to a condition where the median nerve is being compressed at the level of the wrist as it runs through the carpal tunnel into the hand. The carpal tunnel is the passage way that connects the wrist and hand. It is formed by the carpal bones at the back and sides and closed on the palmar side of the hand with the transverse carpal ligament. The tunnel is filled with the flexor tendons, which bend your fingers, as well as the median nerve. Compression of the median nerve is caused by the structures surrounding the nerve being inflamed/swollen or due to space occupying lesions, for example gout. Due to this pressure and lack of blood flow the median nerve it is not able to function properly.

The median nerve has 2 functions in the hand:

  • It gives sensation to your thumb, index finger, middle finger and half of the ring finger.
  • Innervates some of the muscles in your hand to assist with grip strength and fine motor skills.

Who is at risk?

There are a few risk factors that predispose a person to developing CTS. These include Diabetes Mellitus, Pregnancy, rheumatoid arthritis, female, obesity, hypothyroidism, age, smoking, alcoholism, chronic renal failure and repetitive motion activities. The following is a list of a few occupations which are associated with CTS (due to the repetitive movements involved): office workers, chefs, hairstylists, musicians, factory workers, mechanics and seamstresses. Certain athletic activities like tennis, cycling and throwing can also contribute to developing CTS.

What are the signs and symptoms?

  • Numbness in the thumb, index, middle and half of the ring finger.
  • Clumsiness/weakness in the hand. Dropping objects for no reason.
  • Pain, burning sensation or pins and needles that can awaken patient at night.
  • In severe cases there is muscle wasting on the area of the thumb.
  • Shaking the hand to relieve symptoms especially after sleeping or inactivity.

 CTS diagramCTS muscle

Can it be treated?

Non-operative treatment for CTS include anti-inflammatories, wrist brace/splint, modifying activities and steroid injections. In the case where conservative management fail a carpal tunnel release will be performed by a surgeon.

What can you expect from Physiotherapy?

  • Education about the condition and possible contributing factors.
  • Advice on a wrist brace and how to modify activities to avoid aggravating the condition.
  • Exercises to improve neural mobility and maintain range of motion (ROM) of the fingers and wrist.
  • Pain management.
  • After surgery we will assist with scar management, decreasing pain and swelling, restoring mobility of the wrist and fingers and improving neural mobility.

If you have any of these symptoms please contact us to arrange an appointment for a full assessment. Based on the physiotherapist’s findings they will be able to diagnose you and then recommend what treatment you should receive.