Carpal Tunnel Syndrome is when the median nerve gets trapped or squeezed in the wrist as it works its way down the front of the forearm from the elbow to the fingers. The wrist is a gutter of 8 bones that is formed into a tunnel by a layer of connective tissue over the top. Inside this tunnel various structures pass through from the forearm to the hand including the tendons that flex the fingers, some blood vessels and the median nerve.
The median nerve is one of many nerves in the arm. It supplies power to some of the muscles in the hand and also sensation to the thumb, index finger, middle finger and half the length of the ring finger on each hand.. When the space inside this tunnel is compromised the median nerve is squeezed and this results in pain and pins and needles in the thumb and 2 and a half fingers of the hand.
The nerve can be squeezed if there is an increase of swelling in the area such as fluid retention in pregnancy or if there is a tendonitis and inflammation. The nerve can also be squeezed if the carpal tunnel itself starts to narrow if there is some arthritis or wear and tear in the bones or if the wrists are extended / bent back for long periods of the day when typing or using a mouse. The connective tissue covering the bones can also shorten as we get older and this may be the cause.
Most people with carpal tunnel syndrome complain of pins and needles in the hand and fingers especially in the morning and this may even wake them at night. The hand or hands often feel heavy and numb and they will have to shake them out to “get them going in the morning”. The symptoms may also be aggravated throughout the day if there is a build up of pressure in the wrists for any of the reasons mentioned above.
In order to treat carpal tunnel syndrome the main cause needs to be established. In an office environment incorrect keyboard or mouse use can be a very significant factor. Adjusting the hand, wrist and forearm position so that the hand is in a relaxed and neutral position allows all the structures to pass through the carpal tunnel with the greatest of easy. If you are unsure of how to achieve this contact a Chartered physiotherapist who can arrange a work station assessment for you.
If sleeping is the biggest problem wrist splints can be useful which help keep the wrist in a neutral position overnight so that the median nerve does not get squeezed during the night if you bend your wrist while you sleep. However, if localised swelling is the source of the problem, such swelling is often worse at night and splints may be of limited use. If swelling is a factor then the source of that swelling needs to be address either with appropriate medication as prescribed by your GP or a steroid injection by a specialist.
Physiotherapy can help to identify the correct diagnosis and cause of the problem and may also be able to treat the source of the problem. If all else fails there is a simple surgical procedure which can release the pressure in the tunnel and “fix” the problem.
Remember that carpal tunnel syndrome is not the only cause of pins and needles in the fingers and a thorough assessment is necessary to establish the correct diagnosis
The median nerve is one of many nerves in the arm. It supplies power to some of the muscles in the hand and also sensation to the thumb, index finger, middle finger and half the length of the ring finger on each hand.. When the space inside this tunnel is compromised the median nerve is squeezed and this results in pain and pins and needles in the thumb and 2 and a half fingers of the hand.
The nerve can be squeezed if there is an increase of swelling in the area such as fluid retention in pregnancy or if there is a tendonitis and inflammation. The nerve can also be squeezed if the carpal tunnel itself starts to narrow if there is some arthritis or wear and tear in the bones or if the wrists are extended / bent back for long periods of the day when typing or using a mouse. The connective tissue covering the bones can also shorten as we get older and this may be the cause.
Most people with carpal tunnel syndrome complain of pins and needles in the hand and fingers especially in the morning and this may even wake them at night. The hand or hands often feel heavy and numb and they will have to shake them out to “get them going in the morning”. The symptoms may also be aggravated throughout the day if there is a build up of pressure in the wrists for any of the reasons mentioned above.
In order to treat carpal tunnel syndrome the main cause needs to be established. In an office environment incorrect keyboard or mouse use can be a very significant factor. Adjusting the hand, wrist and forearm position so that the hand is in a relaxed and neutral position allows all the structures to pass through the carpal tunnel with the greatest of easy. If you are unsure of how to achieve this contact a Chartered physiotherapist who can arrange a work station assessment for you.
If sleeping is the biggest problem wrist splints can be useful which help keep the wrist in a neutral position overnight so that the median nerve does not get squeezed during the night if you bend your wrist while you sleep. However, if localised swelling is the source of the problem, such swelling is often worse at night and splints may be of limited use. If swelling is a factor then the source of that swelling needs to be address either with appropriate medication as prescribed by your GP or a steroid injection by a specialist.
Physiotherapy can help to identify the correct diagnosis and cause of the problem and may also be able to treat the source of the problem. If all else fails there is a simple surgical procedure which can release the pressure in the tunnel and “fix” the problem.
Remember that carpal tunnel syndrome is not the only cause of pins and needles in the fingers and a thorough assessment is necessary to establish the correct diagnosis
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