Carpal Tunnel Syndrome (Numbness of the hand and fingers)
What is Carpal Tunnel Syndrome?
Carpal Tunnel is a condition of the wrist that presents as pain, numbness, tingling or weakness of the hand - primarily in the thumb and first three fingers. You may find trouble gripping certain objects, feeling ‘clumsy’ with that hand or it may wake you at night.
How Does Carpal Tunnel Syndrome occur?
The symptoms of carpal tunnel occur when the median nerve (see above), which travels through the wrist and supplies sensation to the hand, gets entrapped or inflamed. The entrapment usually occurs due to swelling of the tendons that pass through the carpal tunnel, as well as inflammation of the transverse carpal ligament (see above) which holds all the structures that run through the tunnel in place.
Why does Carpal Tunnel Syndrome occur?
There are a few reasons why Carpal Tunnel occurs:
Repetitive strain: If you perform a repetitive task such as hammering for hours on end, this increases your risk of inflammation of the tendons that travel through the area.
Family History: If someone in your immediate family has experienced Carpal Tunnel, you are at an increased risk of developing it in the future.
Ergonomics (Desk set-up): If your home or work office isn’t set up correctly, this can lead to awkward hand and wrist positions.
Pregnancy: Water retention is a common symptom during pregnancy and when retention is in the hands/wrist, it can compress the median nerve running through the carpal tunnel, causing symptoms.
Comorbidities: Having other health conditions such as autoimmune disorders, gout, hypertension, obesity and many more.
Lifestyle factors: Certain habits such as smoking, a sedentary lifestyle, working on an assembly line work, and a high salt-intake can all increase your risk.
What are the treatment options for Carpal Tunnel Syndrome?
Home management - Carpal tunnel is often successfully treated with conservative methods which include:
Rest: Avoiding the aggravating factors, to the best of your ability, will allow time for the inflammation to clear.
Splinting and bracing: There are many different types of splints/braces for carpal tunnel. Many can be worn overnight to avoid waking at night with numbness of the hand and fingers, and compromising your hand position while you sleep. Others are worn during work days to encourage a neutral wrist position to avoid reaggravation.
Medication: Non-steroidal anti-inflammatories (NSAIDs) such as aspirin, ibuprofen and naproxen can reduce the inflammation in the area, decompressing the trapped nerve. (Always discuss medications with your general practitioner)
Steroid Injection: A steroid injection such as cortisone may be suggested by your doctor. This is usually performed if the condition is not responding to more conservative methods and before surgery is suggested.
Can I have surgery for Carpal Tunnel?
Surgery is most often recommended when more conservative methods and corticosteroid injections have failed to relieve the symptoms of pain, hand numbness, weakness and tingling. Prior to surgery your osteopath and general practitioner may refer you off for imaging to assess the severity and progression of the condition. The surgery is referred to as a ‘carpal tunnel release’, with the goal of increasing space within the tunnel, allowing room for the nerve to glide freely.
Physical Therapy and Osteopathy for the treatment of Carpal Tunnel Syndrome
The Academy of Orthopaedic Surgeons released guidelines in 2008 for the treatment and management of carpal tunnel where they stated that conservative methods, such as manual therapy, should be implemented before resorting to surgery.
Your osteopath will be able to help you identify the actions in your day-to-day life, which may be contributing to your condition.
Specific soft tissue, joint manipulation and adjunct treatment techniques are just some of the therapies that can be implemented during your 45min appointment to promote tissue healing and fluid movement.
Exercises and stretches are always important to strengthen the supporting muscles and loosen the overactive structures. Here are a few we recommend:
Wrist stretch: With your uninjured hand, help bend your wrist to the end-range of flexion and extension, holding for 15-30 seconds and repeating 2-3 times.
Tendon Glide: Bend your fingers slowly until the tips of your fingers are touching your palm. Hold this position for 2-3 seconds then release. Repeat this 20 times.
Weighted wrist extension: Holding a light weight or can of soup/beans in a neutral/ straight position, extend your wrist backwards holding for 2 seconds then returning to neutral. Repeat this 15 times and complete 2 sets.
Carpal tunnel can be inconvenient and painful. Let Doctors of Osteo help with our quality osteopathic treatments. Click the button below to book an appointment.
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