Carpal Tunnel Syndrome:
Carpal tunnel syndrome (CTS) is the irritation or compression of the median nerve as it passes the wrist. This can lead to pain, numbness, tingling and/or muscle weakness/wasting in the hand, wrist and sometimes arm (Page, 2012). These symptoms are typically seen in the thumb, index, middle finger and part of the ring finger on the palm side (Wipperman, 2016). This condition may cause you to wake up in the night and have to flick/shake the hand for relief (Wipperman, 2016). In very severe cases, there can be wasting of the thumb muscles (Page, 2012).
CTS has been reported as the most common nerve entrapment condition of the upper extremity (Wipperman, 2016). Age and gender can be associated with CTS. People between the ages of 45-64 can account for 45.5% of cases. Women are seen more often than men for CTS (Page, 2012).
Diagnosis can usually be made in a clinic. In some cases, diagnostic imaging and nerve conduction studies may be used. Often these are not necessary for diagnosis. However, they can assist in determining the severity of the CTS (Wipperman, 2016).
There is a variety of recommended treatments for CTS. It is always recommended you speak with a regulated health care professional to guide you towards the best course of treatment. Also, they can rule out other conditions and/or complications. The following are some typical treatment strategies:
Night splinting of the wrist in a neutral position with a brace is recommended (Page, 2012; Wipperman, 2016; Erickson, 2019). This is first line treatment for mild to moderate CTS (Wipperman, 2016). This is a simple, low cost, and easy to apply treatment strategy. Speak to a health care provider such as a physiotherapist regarding a wrist splint for carpal tunnel syndrome. They can ensure good fit and correct use of the splint.
Physiotherapy can help treat CTS for some people. Treatments such as mobilization, nerve gliding exercises, and yoga are effective (Page, 2012; Wipperman, 2016). Therapeutic ultrasound may be used in treating CTS (Page, 2012). Mild to moderate CTS can be treated with stretching exercises and night splinting (Erickson, 2019). However, it is important that a trained health care provider such as a physiotherapist prescribe and apply the appropriate treatments for safety and effectiveness.
If non-surgical treatments do not improve symptoms, then some individuals with severe CTS may be offered surgery (Wipperman, 2016; Erickson, 2019).
Erickson M, Lawrence M, Jansen CWS, et al. Hand pain and sensory deficits: Carpal tunnel syndrome. J Orthop Sports Phys Ther. 2019;49(5);CPG1-CPG85.
Page MJ, O’Connor D, Pitt V, Massy-Westropp N. Exercise and mobilization interventions for carpal tunnel syndrome. Cochrane Database Syst Rev. 2012;(6):CD009899.
Page MJ, Massy-Westropp N, O’Connor D, Pitt V. Splinting for carpal tunnel syndrome. Cochrane Database Syst Rev. 2012;(7):CD10003.
Wipperman J, Goerl, K. Carpal tunnel syndrome: Diagnosis and management. Am Fam Physician. 2016;94(12):993-999.