Carpal Tunnel Syndrome: Causes, Symptoms, Treatment and Exercises
Have you experienced tingling or numbness in your first three fingers or a sudden sharp pain that shoots from your wrist into your fingers? Are these symptoms more severe when you are using your hands for tasks such as gripping, fine dexterity or even while you are typing or using the mouse on your computer? You might be suffering from carpal tunnel syndrome, which is a painful condition caused by compression of your nerve at your wrist. Carpal tunnel syndrome is a condition that occurs when the median nerve, which travels from your neck, down your arm into your wrist becomes entrapped or compressed by the carpal tunnel (a tunnel formed by connective tissue at the wrist). It is very common to be misdiagnosed with carpal tunnel syndrome if the median nerve is compressed in another region that it travels through such as in the muscles of the neck, upper arm or forearm. The symptoms of median nerve compression in another region will be very similar to carpal tunnel syndrome but will usually be associated with symptoms in other areas such as the neck, upper arm or forearm as well. Your physiotherapist or chiropractor will conduct a thorough assessment of your upper extremity to determine where the nerve is entrapped and if it is indeed coming from compression via the carpal tunnel. The carpal tunnel is a narrow passageway at the base of the palmar side of the hand where the median nerve travels through along with tendons of the forearm. If the connective tissue that forms the carpal tunnel becomes thickened or the contents travelling through the carpal tunnel become swollen or irritated then there is risk of compression to the median nerve. When the median nerve is compressed, it can disrupt the conductivity of the nerve and result in pain, loss of strength, tingling in the regions that the nerve controls.
What symptoms will you experience with Carpal Tunnel Syndrome?
Typically symptoms will develop gradually and worsen with further repetitive use of the wrist, forearms and fingers. You will notice that symptoms worsen when your wrist is in positions of extreme flexion, extension or with tasks that require gripping. You might experience burning, tingling, numbness, and or an aching sensation in the palm of your hand, your thumb, index and middle fingers. Also, you may note that your fingers feel swollen. Sufferers may also notice a decrease in grip strength, decreased coordination or issues with other fine motor tasks required by your hands and fingers.
Treatment for Carpal Tunnel Syndrome
If your physiotherapist or chiropractor determines that your symptoms are due to carpal tunnel syndrome then there are many treatment options that you will benefit from. Your therapist will use a combination of soft tissue release techniques, joint mobilizations, nerve flossing strategies (to improve nerve mobility in the soft tissues), as well as acupuncture, ultrasound and laser therapy to facilitate healing. Your therapist will also determine which muscle imbalances exist in your upper extremity and provide you with an individualized exercise program that will prevent this issue from recurring. You will learn a variety of self-management strategies in addition to learning about ideal posture and ergonomics so that you may achieve the best long-term outcomes. If you have many tight muscles that are contributing to your condition, then your physiotherapist may recommend registered massage therapy to speed up healing and help relieve your symptoms quickly. There are many braces and splints that may benefit you as well in the short term while your nerve is healing. If you are not responding to conservative management then your physiotherapist or chiropractor will refer you to a sports medicine physician who may recommend more invasive treatment options that may include surgery or injections. For more information or to speak with one of our sports medicine physicians, physiotherapists or chiropractors, contact us today!
Laurie Bickerton, FCAMPT Physiotherapist
Laurie Bickerton is a FCAMPT physiotherapist practicing at Rebalance Sports Medicine in downtown Toronto.