Carpal Tunnel Syndrome

The carpal tunnel is a narrow tunnel at the wrist, formed by the small wrist bones and a thick ligament. The median nerve (the electrical cord that supplies the muscles in your hand) runs through this tunnel along with the tendons (muscles) to the fingers and thumb. Carpal Tunnel Syndrome (CTS) is a condition caused by the median nerve being compressed as it passes though the carpal tunnel. 

Causes

The median nerve is very sensitive to pressure.  Factors that could increase your risk of developing carpal tunnel syndrome are:

  • Any form of fractures or arthritis (cartilage breakdown or low grade inflammation) in the wrist
  • Hormonal changes
  • Fluid retention (i.e. during pregnancy)
  • Diabetes
  • Obesity
  • Work that places heavy demand on your wrist
  • Using vibrating tools
  • Genetic factors
  • Age
Carpal Tunnel Syndrome
Carpal-tunnel-syndrome-symptoms

Carpal tunnel syndrome symptoms

  • Carpal tunnel syndrome can cause a variety of symptoms including
    • Hand pain or a burning sensation in the palm of your hand
    • Hand tingling
    • Numb fingers (especially when sleeping at night)
    • Hand Swelling 
    • Hand weakness or clumsiness – constantly dropping things.
  • Symptoms are typically seen in the thumb, index and middle fingers.
  • Symptoms are often worse at night, but may also occur during the day.
  • Long term compression of the nerve can result in increased symptoms and even permanent damage to the nerve.

Treatment options

Conservative management may be indicated when there is only mild pain or numbness. Phone your therapist for an appointment.  Once the symptoms cause functional limitations, surgery may be indicated.

Conservative treatment

Splinting

Splinting the wrist (helps reduce pressure on the nerve)

Hand exercises

Nerve gliding exercises to encourage glide of the nerve and aim to release the nerve at the area of entrapment.

contact us for an appointment

Conservative-treatment

Surgical management

DURING SURGERY

During surgery, the ligament that forms the roof of your carpal tunnel is cut. This is done to release pressure on the median nerve and relieve the symptoms of carpal tunnel syndrome.

Post-operative management

Although your post-operative splint and bandage is removed you are not allowed to lift any heavy weights of start using your hand and wrist in strenuous functional tasks. Care should be taken to perform light functional tasks for the first 4-6 weeks after surgery.

You will be immobilized in a splint and bandage for 8 – 14 days after surgery. Your stitches may be either dissolvable or the doctor will remove them after 10 – 14 days.

The pain and numbness may go away right after surgery or may take two to three months to subside, depending on the severity of you nerve compression before the surgery.

Aims-of-hand-therapy

Aims of hand therapy

The main aims of hand therapy are to prevent the nerve from getting stuck in the scar tissue where the surgical incision was made to release the nerve. Therefore, it is very important to attend therapy soon after surgery to start with nerve gliding exercises and scar management.

Aims of hand therapy include:
  • Management of swelling & wound care
  • Management of pain
  • Mobilisation
  • Scar management
  • Improvement of grip strength.

After carpal tunnel surgery, patients may be followed up for hand and upper limb rehabilitation for three to four times. Follow up appointments may vary from person to person depending on soft tissue healing and progress made in therapy.

Please don’t hesitate to contact us for more information or to book an appointment.

*The above text is for information purposes only and should not be seen as health advice. Please consult with your medical practitioner should you require health advice or medical treatment.