Carpal Tunnel Syndrome

The carpal tunnel is a narrow passageway located on the underside of your wrist that is surrounded by bones and ligaments. Within this small tunnel is the median nerve and 9 different muscle tendons that are responsible for the flexion (bending) of your hand and fingers. 

Carpal Tunnel Syndrome occurs when the passageway becomes narrowed, usually due to inflammation and swelling, putting pressure on the median nerve and causing uncomfortable sensations such as numbness, tingling, pain and weakness in the hand.

In most patients, Carpal Tunnel Syndrome is an issue that worsens over time, and if left untreated for too long, it can lead to permanent dysfunction in the hand, including loss of sensation in the fingers and weakness. Because of this, it is important to get diagnosed and treated promptly. At Forefront Physiotherapy Geelong, our physios are well trained in the diagnosis and management of carpal tunnel syndrome. They will identify the issue, but more importantly reduce/eliminate the negative impact it is having on your quality of life. 

Symptoms:

• Numbness, tingling, burning sensation or pain - primarily in the thumb, index, middle and ring fingers
• Pain that wakes you up at night
• Occasional shock-like sensations that radiate into the thumb, index, middle and ring fingers
• Pain or tingling that travels up the forearm and towards the shoulder
• Weakness and clumsiness in the hand - this might make it difficult to perform fine movements such as doing up the buttons on your clothes
• Dropping things due to weakness, numbness or loss of awareness of where your hand is in space (proprioception)
• Pain worsens during the day after holding something for a long period of time with the wrist bent forward or backwards - e.g. using a phone, driving, reading a book
• Temporary relief after moving or shaking the hands

Often symptoms begin gradually, without the onset of a specific injury. Patients can experience symptoms that come and go at first, but as the condition worsens over time, these symptoms occur more frequently and persist for longer periods of time. 

Causes:

• Genetics - a family history of carpal tunnel might increase your likelihood for developing the condition. This may be due to anatomical differences such as a smaller carpal tunnel, and hence space for the nerve, which may be passed down genetically.
• Repetitive Hand Use - repeating the same hand and wrist motions or activities over a prolonged period of time may aggravate the tendons that run through the carpal tunnel. This then causes swelling of the tendon which decreases the space within the carpal tunnel and puts pressure on the median nerve. Hand movements that might elicit such a response when prolonged may include the use of hand tools or frequent typing. 
• Pregnancy: hormonal changes during pregnancy can causes increased swelling and fluid retention throughout the body, decreasing the space in the carpal tunnel and putting pressure on the nerve
• Health conditions such as rheumatoid arthritis have been associated with carpal tunnel syndrome.

At Forefront Physiotherapy Geelong we recommend these 4 Tips for managing the symptoms of Carpal Tunnel Syndrome:

1. Wearing a wrist splint whilst sleeping

When sleeping, it is common for your wrist to bend, causing the space within the carpal tunnel to narrow and placing further pressure on the median nerve. Wearing a splint or brace at night will help keep the wrist in a neutral position, stop the wrist from bending and reduce the compression of the median nerve,. Quality sleep is important for everyone in maintaining optimal health and recovering from injury. Our physios at Forefront Physiotherapy Geelong can set you up with a splint or brace fitted to your hand, so that you can sleep without any pain interruptions. 

2. Exercises to keep the nerve mobile

There are some exercises that can be done to help the median nerve move more freely within the small space of the carpal tunnel. A physiotherapist at Forefront Physiotherapy Geelong can prescribe you with these exercises and show you how to do them to minimise your pain.

3. Taking Non-steroidal anti-inflammatory drugs (NSAIDs)

Taking anti-inflammatory medications such as Nurofen or Voltaren can help to relieve pain and inflammation. However, it is important to note that medication is only a bandaid approach and will not help manage your pain and symptoms long term. Hence, it is important to consult with a physiotherapist from Forefront Physiotherapy Geelong to determine an appropriate course of action to get you back to living a life free of pain.

3. Avoid certain activities that aggravate your symptoms

Taking breaks from repetitive tasks and avoiding certain activities or positions that increase the pain can help to provide temporary relief, whilst simultaneously preventing the pain becoming any worse.

4. Steroid Injection into the carpal tunnel

Steroid injections often help relieve painful symptoms. Our physiotherapists at Forefront Physiotherapy Geelong can determine whether they believe a steroid injection would be right for you, whilst providing advice and eduction on the process. Steroid injections are only a short term solution however and do not provide long-term benefits. Hence, it is still important to consult a physiotherapist to determine effective long term management strategies for your symptoms. 

No matter the progression of your condition, our physiotherapists at Forefront Physiotherapy Geelong can undertake a detailed assessment of your wrist and help guide you towards the most effective approach to reduce your pain. There is no point continuing to live feeling restricted by pain, book an appointment at Forefront Physio Geelong today to kickstart your recovery and journey towards a better life!