What Is Carpal Tunnel Syndrome?
Carpal tunnel is a tunnel in the wrist, through which multiple structures of the hand pass by, including the median nerve. Carpal tunnel syndrome is the irritation of the median nerve due to increased in pressure in this tunnel.
Symptoms of carpal tunnel syndrome include: numbness/tingling/pain at the palm and first 4 fingers, weakness, clumsiness/dropping things, . People with carpal tunnel syndrome often find themselves shaking their hand to decrease the discomfort. Prolonged and repetitive use of the hands usually increases these symptoms.
The most common cause of carpal tunnel syndrome is repetitive use of the hands (computer work, seamstress, gardener, etc.).
Certain conditions can mimic carpal tunnel syndrome. Make sure that this is the right diagnosis before you go through surgery. It is not uncommon for me to see clients in clinic, who have gone through directly to carpal tunnel release surgery, and finding out that it did not change their symptoms at all. We find, during our physiotherapy assessment, that we were able to relieve the symptoms these clients had, by moving and mobilizing the neck.
The nerve that is compressed in the carpal tunnel (median nerve) comes out of the neck and goes to the fingers (see picture). If more than part of the nerve is compressed (i.e: at the neck and at the carpal tunnel), the pain and other symptoms can be intensified. This is called Double Crush Syndrome.
Surgery is an effective treatment method for carpal tunnel syndrome, but it is a more invasive procedure. Before you go through with it, be sure that you have tried the more conservative treatment first in physiotherapy, or at least have a physiotherapist assess you to make sure that there is nothing else contributing to your symptoms.
Treatment in physiotherapy for carpal tunnel syndrome may include:
- Muscle Release
- Carpal Joint Mobilization
- Dry-Needling or Intramuscular stimulation
- Exercises: Stretches and Nerve Glides
- Neck Mobilization
- McKenzie Method
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About the Author:
Lily Zhang is a registered physiotherapist with training specializing in the McKenzie Method. She graduated from McGill University and is currently working in Barrhaven (Ottawa, ON). She has over 10 years of professional training/clinical experience in orthopedic physiotherapy. You can Follow Her Blog @PhysioVive Facebook Page.