Carpal Tunnel Syndrome

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a common condition that causes pain, numbness, and tingling in the hand and arm. It occurs when one of the major nerves to the hand - the median nerve - is squeezed or compressed as it travels through the wrist.

At Blacktown Health, our team of Physiotherapists, Chiropractors, and Exercise Physiologists often see patients with carpal tunnel syndrome, and understand how worrying it can be when your hand starts going numb. So we've put together this guide on carpal tunnel syndrome so you can better understand this condition and the treatments you can use to help it get better.

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What are the symptoms of carpal tunnel syndrome?

The symptoms of carpal tunnel syndrome usually start gradually and can include:

• Numbness, tingling, or burning sensations in your thumb, index, middle, and ring fingers
• Pain or aching in your fingers, hand, or arm
• Weakness in your hand, making it difficult to grip objects
• A feeling that your fingers are swollen, even though they don't look swollen
• Symptoms that are often worse at night or early in the morning

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What causes carpal tunnel syndrome?

Carpal tunnel syndrome is caused by pressure on the median nerve in your wrist. This pressure can come from several sources:

• Repetitive hand movements: Such as typing, using tools, or playing certain sports
• Hand and wrist position: Keeping your hands bent up or down for long periods
• Pregnancy: Hormonal changes can cause swelling in the wrist
• Health conditions: Such as diabetes, rheumatoid arthritis, or thyroid problems
• Wrist injuries: Fractures or sprains can affect the carpal tunnel
• Genetics: The carpal tunnel is naturally smaller in some people

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How is carpal tunnel syndrome diagnosed?

When you visit Blacktown Health with symptoms of carpal tunnel syndrome, our healthcare professionals will use several methods to diagnose your condition:

• Medical history: They'll ask about your symptoms, when they started, and how they affect your daily life.
• Physical examination: Your Physiotherapist or Chiropractor will check your hand, wrist, arm, and neck for signs of carpal tunnel syndrome.
• Specific tests: There are several tests that can help diagnose carpal tunnel syndrome, such as:
  • Tinel's sign: Tapping on the median nerve to see if it causes tingling in the fingers
  • Phalen's maneuver: Holding the wrists in a flexed position to see if it causes symptoms
  • Two-point discrimination test: Checking if you can feel two separate points of pressure close together
• Nerve conduction studies: These tests measure how well your median nerve is working.
• Imaging tests: In some cases, X-rays, ultrasound, or MRI scans may be recommended.

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Do I need any scans for carpal tunnel syndrome?

While carpal tunnel syndrome is often diagnosed through physical examination and nerve conduction studies, imaging tests can sometimes be helpful. These may include:

• X-rays: These can show if there are any bone abnormalities or arthritis affecting the carpal tunnel.
• Ultrasound: This can show if the median nerve is compressed and can help guide treatment.
• MRI (Magnetic Resonance Imaging): This gives a detailed view of the tissues in the wrist and can show if there's swelling of the median nerve.

At Blacktown Health, our Physiotherapists and Chiropractors can refer you for these scans if necessary and explain what the results mean for your condition and treatment.

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How is carpal tunnel syndrome treated?

Treatment for carpal tunnel syndrome depends on the severity of your symptoms and how long you've had them, and includes:

• Wrist splinting: Wearing a splint at night can help keep your wrist in a neutral position.
• Exercises: Our Physios, Chiros, and EPs can teach you exercises to improve the flexibility and strength of your hand and wrist.
• Manual Therapy: Such as massage over the muscles, joint mobilisations, nerve mobilisations along the median nerve path through the arm.
• Activity modifications: We can suggest ways to change how you use your hands to reduce stress on your wrist.
• Ergonomic adjustments: Changes to your work setup can help prevent further strain on your wrist.
• Pain relief: Over-the-counter pain medications or prescription drugs may be recommended to manage pain and inflammation.
• Corticosteroid injections: These can provide temporary relief in some cases.
• Surgery: In severe cases or when other treatments haven't helped, surgery might be necessary.

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When is surgery required for carpal tunnel syndrome?

Surgery for carpal tunnel syndrome is generally considered when:

• Conservative treatments haven't improved your symptoms after several months
• You have severe, persistent pain or numbness
• You have muscle weakness or atrophy in your hand
• Nerve tests show severe compression of the median nerve

The most common surgery for carpal tunnel syndrome is called carpal tunnel release. It involves cutting the ligament that forms the roof of the carpal tunnel to reduce pressure on the median nerve. If surgery is being considered, our Physiotherapists, Chiropractors, and Exercise Physiologists in Blacktown can help you understand the procedure and guide you through the post-surgical rehabilitation required afterwards.

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What exercises should I do for carpal tunnel syndrome?

Exercise is an important part of treating and preventing carpal tunnel syndrome. It helps to:

• Improve flexibility in your wrists and hands
• Strengthen the muscles in your hands and forearms
• Reduce pain and stiffness
• Improve circulation to the nerves in your wrists

Our Physiotherapists, Chiropractors, and Exercise Physiologists at Blacktown Health can design you an exercise program tailored to your specific needs. This might include:

• Wrist flexor and extensor stretches
• Median nerve gliding exercises
• Hand and finger exercises to improve grip strength
• Exercises to improve overall arm strength and flexibility

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How does splinting help with carpal tunnel syndrome?

Splinting is often one of the first treatments recommended for carpal tunnel syndrome. Here's how it helps:

• Keeps your wrist in a neutral position: This reduces pressure on the median nerve.
• Prevents extreme wrist movements: Especially helpful during sleep when you might unknowingly bend your wrist.
• Provides rest: Gives your wrist a chance to recover from repetitive movements.
• Can be worn during activities: Some splints are designed to be worn while working or doing other activities.

At Blacktown Health, our Physiotherapists and Chiropractors in Blacktown can fit you with the right splint and show you how to use it effectively.

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How can I prevent carpal tunnel syndrome?

While you can't prevent all cases of carpal tunnel syndrome, there are steps you can take to reduce your risk or prevent it from worsening:

• Take frequent breaks: If you do repetitive hand movements, take regular breaks to rest your hands.
• Improve your posture: Good posture can help reduce strain on your wrists and hands.
• Keep your hands warm: Cold hands are more prone to stiffness and pain.
• Maintain a neutral wrist position: Try to keep your wrists straight, not bent up or down, when working.
• Use ergonomic tools: Choose tools and equipment designed to reduce wrist strain.
• Stay physically active: Regular exercise can help maintain overall health and reduce risk factors.
• Manage health conditions: Conditions like diabetes and arthritis can increase your risk, so it's important to manage them well.

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When should I see a healthcare professional about hand and wrist pain?

You should consider seeing a healthcare professional if:

• You have persistent numbness, tingling, or pain in your hand or wrist
• Your symptoms are interfering with your sleep or daily activities
• You're having difficulty gripping objects or performing fine motor tasks
• Your symptoms have been getting worse over time
• You've tried home remedies without success

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Can carpal tunnel syndrome go away on its own?

In some cases, particularly if caught early, mild carpal tunnel syndrome may improve with rest and lifestyle changes. However, without proper treatment, it often progresses and can lead to permanent nerve damage. That's why it's important to seek professional help if you're experiencing symptoms.

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How long does it take to recover from carpal tunnel syndrome?

Recovery time can vary greatly depending on the severity of your condition and the treatment approach:

• For mild cases treated conservatively: You might see improvement in a few weeks to a couple of months.
• For more severe cases or those requiring surgery: Recovery can take several months, with some people needing up to a year to regain full strength and function.

Remember, everyone's recovery is different. Factors like your age, overall health, and how well you follow your treatment plan can all affect your recovery time.

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Take home message

Carpal tunnel syndrome is a common condition that can significantly impact your daily life and work. However, with proper diagnosis and treatment, most people with carpal tunnel syndrome can find relief and improve their hand function.

At Blacktown Health, our team of experienced Physiotherapists, Chiropractors, and Exercise Physiologists in Blacktown can help you manage your carpal tunnel syndrome effectively. We offer a range of treatments and can provide personalised advice on exercises, ergonomics, and lifestyle modifications to help you achieve long-term hand and wrist health. Remember, early intervention is key in managing carpal tunnel syndrome.

If you're experiencing persistent hand or wrist pain, numbness, or tingling, don't hesitate to contact us at Blacktown Health. We have clinics conveniently located around Sydney in Mt Kuring-Gai, Asquith, Willoughby, Milsons Point, Dural, and Blacktown, so you can get the right advice and treatment for your carpal tunnel syndrome.