There is a good chance you know someone who has Carpal Tunnel Syndrome or may even have it yourself. It is the most common nerve injury affecting the arm and can be quite debilitating. It usually begins gradually with a burning pain in the hand at night that makes it difficult to sleep. Shaking the hands or keeping them warm usually helps ease the pain. As the condition progresses the symptoms become more severe, including weakness in the hand, and more frequent during the day.
So what is it?
Symptoms are caused by compression of the median nerve in the wrist. Nerves, like the rest of our body, need a good blood supply to function normally. When the blood supply is restricted the normal messages through the nerve can be interrupted causing tingling/numbness, pain and weakness. This can be especially worse at night when our blood pressure naturally drops.
The median nerve enters the hand through the Carpal Tunnel in the wrist. As the name suggests it is a tunnel formed by bones, fat and ligaments. If anything takes up more space in the tunnel, there is no chance for the tunnel to expand, instead the contents (eg. Median Nerve) become compressed. The space may be taken up by inflammation of tendons, bony changes or even scar tissue.
We know that being female between 40-60 years old and having a higher BMI increases your risk of developing it. People often think that heavy work with the hands or vibrating equipment increases the risk, but we don’t really know.
How is it treated?
Wearing a wrist splint at night and avoiding activities that aggravate your symptoms is usually the first port of call for treatment. If typing on a keyboard or using the mouse flares your symptoms, you may find it helpful to prop your wrists up slightly on a folded hand towel. If the condition continues to progress surgery is eventually indicated. Evidence advises to first try conservative treatments like the following provided by a physiotherapist:
- Night splints
- Education and advise regarding modification of activities
- Massage and joint mobilisation
- Nerve mobilisation tehniques and exercises
- Correction of any other neck or arm issues that may be contributing
Everyone responds differently to conservative treatments but in some cases they can be enough to avoid surgery.