What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is a common health condition which causes pins and needless and numbness in the hands and arm. This is usually caused by irritation of the median nerve, as it runs through the 'carpal tunnel' of the wrist (a small round hole formed by the bones and ligaments). As this nerve provides sensation to the skin over your thumb, index and middle fingers, any irritation of this nerve can often lead to the feelings of pins and needles and numbness.
How does Carpal Tunnel Syndrome present?
Most people with carpal tunnel syndrome will present with numbness and/or pins and needles in the hand. One of the classic features is when people wake up in the morning having to shake their hands to help get the feeling back. As the condition progresses though, this can lead to the symptoms spreading from the hand up into the forearm and arm, and these symptoms become more constant throughout the day rather than just at night. If left untreated, the muscles of the thumb can start to shrink and waste away.
What causes Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome is very common, and 1 in 10 people will experience the condition at some point during their lives. Those who are pregnant, have inflammatory conditions, diabetes, and are overweight are at higher risks of developing the condition, as well as people who use their hands repetitively (such as with typing, vibrating tools, and repetitive gripping).
How is Carpal Tunnel Syndrome diagnosed?
To diagnose carpal tunnel syndrome, most practitioners can spot this condition by asking a few questions and performing a few simple tests. The most important thing is to look for any wasting of the thumb muscles, and to determine if the nerve is getting irritated at the elbow, shoulder, or neck, which are also common reasons that people can get numbness and pins and needles in their hands. Sometimes an ultrasound scan and nerve conduction study can be used to confirm the diagnosis, and this can be arranged through your general practitioner.
How is Carpal Tunnel Syndrome treated?
At Dural Health, our Physiotherapists and Chiropractors first start by trying to identify any triggers that may be irritating the nerve as it passes through the wrist. This might be to modify any sleeping positions, making workstation setups more ergonomic, or reducing any repetitive tasks. We usually then recommend a simple wrist splint that should be worn at night for a minimum of 6 weeks, and we let people try some different brands and styles so they can pick which is most comfortable for them.
If there is some tightness in the wrist and forearm muscles, we may work on these tight muscles to help loosen them up to allow the tendons and nerves to glide more freely through the carpal tunnel. This form of manual therapy has been shown to be effective in managing carpal tunnel syndrome, and can help avoid the need for surgery.
An exercise program is then prescribed to help the tendons and nerves, and progressively build up the strength of your fingers, hands, and arm muscles. This can help build up the arm's ability to handle doing physical tasks for prolonged periods such as typing, lifting, gripping, and gardening. In the rare cases that symptoms fail to improve, we might recommend a corticosteroid injection and/or review with a hand surgeon to discuss any surgical options. Surgery is only used as a last resort though and fortunately most people will respond to our comprehensive approach.
If you would like to learn more about Carpal Tunnel Syndrome, our Physiotherapists (Doris Qu, Alex Fielding, and Brian Tran) and Chiropractors (Nico Ebilane, Alex Fielding, and Brian Tran) are all experienced in managing this condition. To make an appointment, call us on 02 8403 4200 or book online today!