Understanding carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is a condition that affects the hand and wrist, causing pain, numbness, and tingling sensations. It occurs when the median nerve, which runs from the forearm to the hand, is compressed or squeezed in the wrist within a narrow passageway known as the carpal tunnel. This compression can lead to a variety of uncomfortable symptoms. 

Causes of carpal tunnel syndrome 

CTS can result from various factors, including: 

Repetitive hand movements: Engaging in repetitive hand and wrist movements, such as typing or process line work, can contribute to the development of CTS over time. 

Medical conditions: Certain medical conditions, including diabetes, rheumatoid arthritis, and thyroid disorders, can increase the risk of CTS. 

Pregnancy: Hormonal changes during pregnancy can lead to fluid retention and swelling, which may contribute to CTS symptoms. 

Hand and wrist anatomy: Some individuals have a naturally smaller carpal tunnel, making them more prone to CTS. 

Trauma or injury: An injury to the wrist or a fracture can lead to swelling and pressure on the median nerve, causing CTS symptoms. 

Symptoms of carpal tunnel syndrome 

Recognising the symptoms of CTS is essential for early diagnosis and appropriate treatment.

Common signs include: 

Numbness and tingling: Numbness and tingling sensations, often starting in the thumb and index, middle, or ring fingers. 

Pain: Aching or pain in the hand, wrist, or forearm, which can radiate up the arm. 

Weakness: A loss of strength makes it challenging to grasp objects or perform fine motor tasks, which often leads to dropping items.

Night-time Symptoms: Symptoms are often more pronounced at night, leading to disrupted sleep. 

Thumb weakness: Difficulty pinching objects or performing tasks involving the thumb, such as buttoning a shirt. 

Treatment and recovery

If you suspect you have CTS, it's essential to seek advice.

Consult with an expert: An Accredited Hand Therapist is a physiotherapist or occupational therapist with expertise in the finger, hand, wrist, elbow, and shoulder. They can assess your symptoms and recommend further diagnostic tests, such as nerve conduction studies or electromyography (EMG), to confirm the diagnosis. 

The treatment of CTS depends on the severity of the condition.

Common approaches include: 

Wrist splinting: Wearing a wrist orthosis or brace, particularly at night, can help keep the wrist in a neutral position, reducing pressure on the median nerve. 

Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections may be prescribed to reduce inflammation and alleviate pain. 

Rehabilitation exercises: An Accredited Hand Therapist will prescribe exercises to improve wrist and hand strength and flexibility. 

Lifestyle modifications: Changing your daily routine, such as taking frequent breaks from repetitive hand activities, can help alleviate symptoms. 

Surgery: In severe cases where conservative treatments fail to provide relief, surgical intervention may be recommended. Carpal tunnel release surgery involves cutting the ligament that forms the roof of the carpal tunnel to relieve pressure on the median nerve. 

Find a local Accredited Hand Therapist

Patients can find a local Accredited Hand Therapist on our website using the link below.

Find an Accredited Hand Therapist