10 Things You Need to Know About Carpal Tunnel Syndrome

1) Carpal tunnel syndrome affects the hands in a distinctive pattern. Often the thumb and index finger are most affected but the other fingers can become affected if more time passes.

2) The symptoms feel like a pins and needles type pain or numbness. It feels like your arm has ‘gone to sleep’

3) Carpal tunnel syndrome commonly affects pregnant women, older women going through menopause, people who use very repetitive movements in their work or people who are over weight.

4) The symptoms can be due to the compression of the median nerve at the wrist where it passes through a small tunnel.  If this space is reduced by certain repetitive movements and poor positions which we adopt, or by fluid during pregnancy, then the nerve becomes irritated and gives symptoms into the hand.

5) Carpal tunnel syndrome must be properly differentiated from other common conditions that affect the same area such as neck injuries causing referred hand pain, De Quervain syndrome, tendinopathy or osteoarthritis of the thumb or wrist so that it can be properly treated.

6) Accurate assessment includes careful questioning by your physio, clinical tests to confirm including neural dynamic assessment, Tinel’s tests, Phalen’s test and nerve palpating tests. They may also look to eliminate an osteoarthritis diagnosis by reviewing X-Rays of the wrist and thumb.

7) Effective treatment could include night resting splints for which there is some evidence, joint mobilisations by a trained physiotherapists if stiffness is found, neural mobilisation exercises to improve the health of the nerve, and massage techniques to release the nerve if trapped or not moving well through the tissues.

8) Acupuncture has been shown to work for some people to relieve the symptoms of carpal tunnel alongside other treatments mentioned above.

9) Postural advice is needed in order for you to learn the most effective working positions, as well as advice on how to hold your baby, as this will otherwise make symptoms persist.

10) If the physiotherapy treatment doesn’t give the desired result then the next step after this might be to consider a surgical opinion for a release of the tunnel to allow better nerve movement. Most consultants will encourage you to have tried physiotherapy conservative management options first though as they can be very successful.

Post by Leanne Plenge, Physiotherapist and Bristol Manager.

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