Carpal Tunnel Syndrome
Carpal tunnel syndrome, otherwise known as or median nerve entrapment, is the most common type of trapped nerve that people experience. So common, in fact, that 11% of us are experiencing it at any one time. (1,2).
This uncomfortable, sometimes painful condition can lead to the sufferer needing to take time off work, which can result in lost wages and a great deal of frustration. To top this off, the symptoms of carpal tunnel syndrome are often worse at night, meaning that you can add poor sleep quality at night and tiredness during the day to the list of its potential for causing misery.
What is the carpal tunnel?
The carpal tunnel is a canal leading from the wrist into the hand. It contains nine tendons and a nerve – the median nerve. Inflammation and swelling in the carpal tunnel can lead to compression of this nerve, and this can lead to pain and changes in sensation such as pins and needles, tingling, numbness or burning in the fingers that the nerve supplies, which is pretty much all of them. The thumb, middle finger, index finger and half of the ring finger can all be affected.
I don’t know how much you’ve tried to do using only half of your ring finger and little finger, having only these two digits unaffected isn’t particularly helpful.
What causes carpal tunnel?
No one is 100% sure about what causes carpal tunnel syndrome, but there are some patterns that have been observed. Carpal tunnel syndrome has been linked to:
- Previous trauma to the wrist, e.g arthritis or past fractures
- Repetitive hand movements, vibration and strong gripping (which can cause irritation and scarring, leading to inflammation in the carpal tunnel (4)
- Certain health conditions such as diabetes, under-active thyroid and obesity
- Post menopausal women appear to be the most commonly affected by carpal tunnel syndrome
What are the treatment options for carpal tunnel?
There are a number of different treatment options available for people with carpal tunnel syndrome, including manual therapy (such as osteopathy), corticosteroid injections into the carpal tunnel, ultrasound, using a splint to keep the wrist in a neutral position, and, in the most stubborn cases, surgery.
However, it’s worth bearing in mind that if you’ve been suffering with the conditions for some time, you might want to take a moment before you throw yourself upon the mercy of the scalpel.
A recent study into the effectiveness of physical therapy and surgery found that both methods had the same end results, but that the symptoms eased sooner with manual therapy (5).
In our practice, we find that many of the people who come in talking about pain in their hands and arms have more than one thing going on. There may be some compression of the nerve or nerves higher up in the body – perhaps through the muscles of the arm or in the shoulder or neck, as this can give symptoms very similar to carpal tunnel syndrome. For example, there’s a muscle called pronator teres in the forearm, and if it’s too tight, it can squeeze the median nerve!
From our experience as osteopaths, we’ve seen that people who work with computers and phones have often adapted their posture over time, which has left them vulnerable to neck and arm problems. Repetitive use of a mouse can also encourage strong gripping and irritation in office workers’ hands and wrists.
Thankfully, learning how to adopt a more protective posture and getting in the habit of moving well is pretty straightforward, and can be helped along by something as simple as investing in a keyboard wrist rest, which you can buy for less than £10 from a lot of online retailers.
Structures in the body that are putting pressure on the median nerve can be released using techniques to loosen muscles that are too tight and to increase blood supply, promoting healing to the nerve itself. This is something Swansea Body Kinetics can help you with.
If you have carpal tunnel syndrome, we know just how much of a disruption to your well-being and daily life this can be, and our practice offers several tools that can help. As well as being able to offer manual therapy, we also work in conjunction with a yoga therapist to promote moving in a way that’s conducive to the health of your joints and the nerves. We’ve also found that neural flossing exercises can help with carpal tunnel, as they’re targeted towards promoting neural health
If you’d like any more information about what kind of treatment is available to you, please don’t hesitate to give the clinic a call. We’d love to chat to you.
Don’t just put up with pain…
There is no reason why you should put up with discomfort when help is at hand
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- Thiese MS, Gerr F, Hegmann KT, Harris-Adamson C, Dale AM, Evanoff B, Eisen EA, Kapellusch J, Garg A, Burt S, Bao S, Silverstein B, Merlino L, Rempel D. (2014) Effects of varying case definition on carpal tunnel syndrome prevalence estimates in a pooled cohort. Arch Phys Med Rehabil 95: 2320-2326
- Ibrahim, I., Khan, W.S., Goddard, N., Smitham, P. (2012) Carpal tunnel syndrome: a review of the recent literature. Open. Orthop. J. 6, 69e76.
- Pratelli E, Pintucci M, Cultrera P, Baldini E, Stecco A, Petrocelli A, Pasquetti P. (2014) – Conservative treatment of carpal tunnel syndrome: Comparison between laser therapy and fascial manipulation. Journal of Bodywork and Movement Therapies 19(1) 113-118
- Raja S, Carlos A. (2015) Carpal tunnel syndrome – current controversies. Orthopaedics and trauma 29 (4) 273-277 5. Fan Z, Harris-Adamson C, Gerr F (2015) Associations between workplace factors and carpal tunnel syndrome: a multi-site cross sectional study. Am J Ind Med 58 509-518
- Fernandez-de-las Penas C, Ortega-Santiago R, de la Llave-Rincon A, Martınez-Perez A, Fahandezh-Saddi Dıaz H, Martınez-Martın J, Pareja J, Cuadrado-Perez M. (2015) Manual Physical Therapy Versus Surgery for Carpal Tunnel Syndrome: A Randomized Parallel-Group Trial. The Journal of Pain 16 (11) 1087-1094