What is Carpal Tunnel Syndrome (CTS)?

Carpal tunnel syndrome is a wrist injury that can be linked with impact trauma, repetitive strain and genetics. The pain and sometimes weakness in the joint is caused by the compression of the median nerve that travels through the wrist. This nerve passes through a narrow channel called the carpal tunnel, accompanied by the flexor digitorum superficialis and flexor pollicis longus tendons.

Possible Causes

The injury occurs when a narrowing of the space; through which the median nerve passes, happens. This narrowing can take place due to swelling, inflammation, fluid retention and structural problems (e.g. fracture). However it has been found that cases of carpel tunnel syndrome may be without specific cause and could be related to certain individuals being genetically predisposed to this condition.

 Here are some of the factors that can cause CTS:

•    Repetitive use of vibrating machinery

•    Arthritis

•    Congenital: A naturally smaller, narrower carpel tunnel

•    Repetitive strain of the wrist (RSI).

•    Traumatic wrist injury like sprains and fractures.

Some professions are more at risk from this injury due to their repetitive nature or the machinery they are using. It also effects woman three times more than men, probably due to their smaller bone structure, which leads to a smaller tunnel.

CTS Symptoms

Carpel Tunnel Syndrome can occur in both wrists, but usually it is found in your dominant hand. The symptoms are:

•    Tingling sensation in the arm

•    Dull ache in the forearms and wrist

•    Numbness

•    Pain in the wrist and fingers (mainly at night due to sleeping positions)

•    Pain can extend to the shoulder and neck.

•    Weakness in fingers and hands

Anatomy

The carpal tunnel is located at the base of the wrist. This tunnel is surrounded by the carpal bones that form the arch. The nerve and tendons that pass through the tunnel allow movement and, function and feeling for the fingers. There are 9 flexor tendons and the median nerve. Your carpel tunnel is approximately as wide as your thumb and finishes just where the skin crease of your wrist is, travelling 3cm towards your elbow.

Points of origin for tendons: Medial epicondyle of the elbow

Points of insertions foe tendons: Metaphalangeal (MP), Proximal Interphalangeal (PIP), and Distal Interphalangeal bones of the fingers and thumb (BSI

How to treat Carpal Tunnel

Any treatment should initially start with a period of rest. Your next steps should be led by your Dr or a fully qualified Physiotherapist. The Health professional may immobilise your hand and wrist in a splint to help recovery and reduce risk of further damage. If there is swelling and inflammation present then Dr may also prescribe you with anti-inflammatory medication. Furthermore cold treatment can be applied to further repair.  This is where you ice the area for 15 – 20 minutes at a time. It is used with the world renowned R.I.C.E (Rest, Ice, Compression, and Elevation) technique. For best results try plunging the joint in ice water.

 Once inflammation and swelling has reduced stretching techniques should be practiced on the wrist, hand and fingers. You should only stretch and start to strengthen (use resistance bands) the joint if pain free! There are also other methods for injury relief, these are stated below.

•    Night Splints (prevent movement)

•    Sports massage

•    Acupuncture

•    Yoga

•    Corticosteroid injection

•    Surgery, if symptoms persist over a 6 month period