Carpal tunnel

Carpal tunnel is a common condition whereby the medial nerve becomes entrapped as it travels through the wrist into the hand. This can cause pain, numbness, tingling sensations and weakness in the wrist and hand.

The carpal tunnel is a passageway in the palmar side of the wrist that allows the median nerve and nine wrist flexor tendons to run through toward the hand. The median nerve provides sensation and motor function to parts of the thumb and first three fingers. Subsequently, when the median nerve is compressed through the carpal tunnel deficits of these functions are seen.

Compression of the median nerve results from increased pressure in the carpal tunnel. This increase in pressure can be triggered by genetic predisposition with recent studies showing that genetic variations have a higher risk rate of carpal tunnel syndrome. Other causes include obesity, osteoarthritis, trauma to the area, rheumatoid arthritis, and repetitive wrist actions such as typing, machine work, and needlework.

Carpal tunnel syndrome is typically a gradual onset. Symptoms usually involve tingling, numbness and a burning pain across the median nerve distribution. Weakness can also be present, particularly noticed with grip strength, and if left untreated muscle wasting can begin along the thumb side of the palm.

Carpal tunnel syndrome can be diagnosed through various avenues. Ultrasound and MRI can be used to identify nerve compression. Nerve conduction studies can be utilized to determine how well the median nerve is operating. Outside of this there are a number of tests that physiotherapists and other health professionals to do to diagnose Carpal tunnel syndrome. These tests typically involve compressing through the area to see if symptoms are provoked.

Management can look different depending on the severity of symptoms. A major tool used to help resolve symptoms is to decrease or stop all the activities that provoke symptoms. Carpal tunnel symptoms can often be worsened with workplace setups. Proper workplace ergonomics can help to reduce this. Making changes such as having your desk and keyboard at a proper height can help prevent the wrist from being in sustained positions that aggravate symptoms. Similarly, wrist splints can be utilized to limit wrist movements and thus compression through the carpal tunnel.

Physiotherapy management is also a major tool to help reduce symptoms and resolve carpal tunnel. Hands-on treatment can be used to reduce symptoms and a home exercise program including nerve gliding exercises can help promote better movement along the median nerve pathway.

In more severe cases corticosteroid injections may be used to reduce inflammation within the carpal tunnel space or oral non-steroidal anti-inflammatory drugs may be prescribed by a doctor. Surgical intervention may be necessary in some cases. Carpal tunnel surgery involves opening the carpal tunnel to create more space so there is less median nerve compression. This surgery is minimally invasive and has good success rates.

Although a prevalent condition, Carpal Tunnel has many different treatment options to reduce symptoms and resolve the condition. If you are experiencing any of the symptoms discussed it is a great idea to see a healthcare professional to formulate a treatment plan based on your presentation.

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