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What is Carpal Tunnel Syndrome?

Updated: Jun 14

Lots of people have heard of carpal tunnel syndrome but you may be wondering what it is. Carpal tunnel syndrome is essentially a compressed (pinched) nerve at the wrist. It is called carpal tunnel because the nerve is compressed in a tunnel which is formed by the carpal bones, and a ligament across the roof of the tunnel called the transverse carpal ligament.

Diagram showing the anatomy of the carpal tunnel with the median nerve being compressed inside the tunnel

What are the signs of carpal tunnel?

Early signs of carpal tunnel syndrome are usually tingling and numbness in the tips of the thumb, index, middle and ring fingers. This is often worse at night or first thing in the morning. It is easy to dismiss tingling at night as “I just slept funny” but if left untreated, severe carpal tunnel syndrome can lead to permanent nerve damage. If the nerve becomes more severely compressed, the fingers may become constantly numb and you may find yourself dropping things. In severe cases, carpal tunnel syndrome can also cause pain which radiates up the arm and the muscles around the thumb may become weak.

Why are carpal tunnel symptoms worse at night?

Once we are asleep our wrists and fingers tend to curl up. This increases the pressure within the carpal tunnel which further reduces the blood flow to the median nerve. After we have been asleep for a few hours, our blood pressure lowers slightly which further reduces the blood flowing through the nerve; this why a night splint is recommended to treat carpal tunnel. A wrist splint maintains the wrist is the optimal position to reduce pressure on the nerve overnight.

What causes carpal tunnel syndrome?

Carpal tunnel syndrome is more common in people between the ages of 40–60. There are many factors which can contribute to a person developing carpal tunnel, such as family history, diabetes, wrist arthritis, working with vibrating tools and machinery.

It’s important to remember that not everyone with numb or tingling hands has carpal tunnel. The median nerve can also be compressed at other sites closer to the elbow and the symptoms can mimic carpal tunnel syndrome. To ensure an accurate diagnosis and appropriate treatment, our therapists will take a thorough history and perform a series of clinical tests.

How is carpal tunnel treated?

Hand therapy can be very effective in reducing the severity of symptoms and delaying the need for carpal tunnel surgery. Hand therapy treatment includes wearing a wrist splint at night which reduces compression of the nerve. There are numerous splint options available. Some commercially produced splints may be too short to effectively stabilise your wrist and they may be very hot in our Queensland climate. Our hand therapists can fabricate a custom-made splint which ensures the wrist is held in the ideal position at night. As these splints only cover half of the palm and forearm, they may be cooler than off-the-shelf options.

A custom made thermoplastic splint to control symptoms related to carpal tunnel syndrome

Your therapist will also teach you exercises to improve gliding of the nerve through the carpal tunnel and will recommend ways to modify your activities to reduce pressure on the nerve. If you experience swelling, you may be fitted with a compression glove to reduce swelling in the hand over night. Results of conservative treatment are best if the symptoms are mild or have not been present for an extended period. More chronic and severe cases may require surgery to release the Transverse Carpal Ligament to relieve pressure on the nerve; so if you think that you may have carpal tunnel syndrome, don't delay, contact us today for an assessment with one of our experienced hand therapists.

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