Carpal Tunnel Syndrome
Carpal Tunnel Syndrome occurs when the Median Nerve is squashed or compressed at the wrist in a narrow Tunnel which is formed by the Carpal Bones and held together by the Transverse Carpal Ligament. In this Tunnel there are tendons that bend the fingers, blood vessels and the Median Nerve. When there is swelling or increased external pressure it is the nerve being compressed which causes pain, tingling and or numbness.
Common Symptoms:
- Pain in the hand, fingers or wrist which can refer up the arm
- Numbness or tingling often starting in the thumb, index or middle fingers
- Weakness in the hands, including grip and pinch strength
- Reduced dexterity, increased clumsiness
- Disruption to sleep with symptoms being worse overnight
Causes:
- Repetitive work or activities eg carrying babies/children, manual labour
- External pressure on the underside of the wrist such as when resting wrists on a table during computer work
- Sustained postures such as sleeping with the wrists curled forwards or backwards at night
- Injury to the hand/wrist eg a wrist fracture resulting in swelling and pressure on the median nerve
- As a complication or progression of various medical conditions eg Diabetes, Arthritis and Thyroid conditions
- Pregnancy – this is usually due to hormonal changes and increased swelling associated with fluid retention
Assessment:
Subjective assessment: We will ask you about your hand and wrist symptoms, when they started and how and when they are limiting you. We want to know your individual daily activities and preferred sports, your general health and other potential factors that may contribute to your concerns or to your recovery. We will also ask you what activities you enjoy and what your goal is.
Objective assessment: We will look at your hand, wrist, forearm and likely shoulders and neck as well as palpating around the area. We will quantify your hand and wrist movement and your grip strength. We may perform special tests such as Tinels or Phalens amongst others to assist us in an accurate diagnosis.
Treatment:
- Education regarding your symptoms and how to manage/reduce them
- Neural mobilisation
Muscle and/or other soft tissue release - Activity modification
- Custom made thermoplastic splint to hold your wrist in a neutral position (the pharmacy bought ones, tend to hold the wrist in some extension which is not ideal in the case)
- Dry needling
- Home exercise program including stretching, movement and strengthening exercises
- Ultrasound therapy
Plan:
From the moment we meet you, we are planning an individualised and holistic approach to help you reach your goal and be your best!
Rehabilitate, Educate, Innovate.
Providing excellence in physiotherapy from assessment to diagnosis, treatment and rehabilitation