Carpal Tunnel Syndrome Signs and Treatment

Do you have a tingling sensation in your fingers when you pick up your morning coffee, swing your golf club, or open the car doors for a school run?

A feeling of tingling and perhaps numbness spreading from your palm to your fingers, towards the thumb side of your hand?

Is your grip suddenly weak?

Chances are you have carpal tunnel syndrome (CTS).
 

What are Carpal Tunnel Symptoms

Put simply, CTS is caused by compression of the median nerve at the level of the wrist. The areas most affected are the thumb, index finger, and middle fingers. Symptoms include swelling, pain, numbness, tingling and loss of strength in the wrist and hand.
 

How Carpal Tunnel (CTS) Happens

“Athletes who play a sport requiring them to grasp something while repeatedly twisting and turning their wrists are at increased risk of developing CTS” (Mueller Sports Med).

Compression on the median nerve is caused by a number of factors including:

  • Sports that put repetitive strain on the wrist ie. golf, tennis, bodybuilding, rock climbing and swimming
  • Repetitive manual labour, such as gripping heavy power tools for long periods of time
  • Activities involving repetitive use of the wrists and fingers ie. guitar, smartphones, tablets, keyboards/mouse
  • A sprain or fractured wrist.

Essentially, any activity where the wrist is flexed (bent) and the fingers are active, for most days over long periods of time, runs the risk of straining the wrist.

CTS due to increased use of technology has become a common underlying cause over the last decade ie. using a keyboard or mouse in an awkward position over a few years. “Text claw” and “cell phone elbow” have become regularly used terms among physical therapists! (The Orthopedic Institute).

Also, interestingly, women are three times more likely to develop CTS than men, particularly during pregnancy and menopause (Women’s Health).

Other underlying causes include:

  • Diabetes
  • Cysts that encroach on carpal tunnel passageway
  • Thyroid disease
  • Arthritis affecting the wrist
  • Bone spurs in the wrist
  • Hereditary factors
  • Being overweight
  • Drinking alcohol

(Harvard Health)

 

Carpal Tunnel Treatment

It’s important to first visit a doctor to diagnose the Carpal Tunnel Syndrome and the underlying cause (particularly if there is tingling or numbness in the fingers). For mild cases of CTS, resting your hand, stopping or reducing repetitive actions, wearing a wrist splint at night, and a course of physical therapy (typically deep tissue massage) are often all that is needed.

Physical therapy can reduce pressure on the median nerve by softening and lengthening the surrounding tissue. A thorough assessment by your physical therapist will also identify and treat possible median nerve impingements in your neck (Urban Company; Head to Toe Muscle Clinic).

Deep tissue massage will involve gradually relaxing the muscles and relieving the tension in muscles and tissue surrounding the wrist, forearm, elbow, shoulder, and possibly the chest and neck. For best results this should always be coupled with stretching and mobilisation of the hand/arm/shoulder.

Stable therapist Konrad adds “typically, your physical therapist will also suggest strengthening the wrist and arm through targeted corrective exercises. Initially this might be as simple as slowly clenching the fingers to form a fist, or squeezing a soft rubber ball. Progressing into holding a very light dumbbell in the affected hand and taking the wrist through various motions, with the arm resting on a bench or table in order to isolate the wrist.”

If the CTS is a result of long-term physical activity such as a sport or using a power tool (rather than a sudden injury) and the patient intends to return to such activity, the manner in which the activity is resumed needs to be addressed in order to prevent further strain occurring.

To minimise CTS risk from technology use, the Orthopedic Institute recommends:

  • Using a hands-free device or an earphone
  • Reducing usage time
  • Constant positional changes
  • Using headsets when speaking on a smartphone
  • Heat/cold packs
  • Wrist stretches

If you are experiencing CTS symptoms, first visit your GP to assess the underlying causes, then on the advice of your GP visit your deep tissue massage therapist for targeted relief, and an ongoing treatment plan (including home exercises between appointments). A fitted wrist brace with a splint may be necessary if physical activity is to continue during treatment. A single appointment will most likely provide immediate relief but there is no magic bullet for chronic aches and pains. Long term improvements will happen only with ongoing therapy and an active treatment plan.

Book an appointment with a therapist today on 03 8598 9804 or online.