Carpal Tunnel Syndrome occurs as a result of compression of the median nerve. This nerve provides sensation to the palm side of your thumb and fingers, with exception of your little finger. It also provides the motor movement to your thumb.
Things such as fracture can narrow the carpal tunnel space, which will lead to irritation and compression of the nerve. However, in many cases no single cause can be identified. It could be a combination of risk factors that contributes to the development of the condition.
Females are more likely to suffer from this condition as their tunnel is generally narrower than men and there may be less room for error.
Some chronic illness such as diabetes can increase your risk of nerve damage. Inflammatory conditions such as Rheumatoid Arthritis can affect the tendons, exerting pressure over the median nerve.
Pregnant women are more prone to developing this condition as a result of increased fluid retention, which increases the pressure through the tunnel. This generally resolves after pregnancy has ended.
There are other causes such as obesity, thyroid disorders and menopause.
It is possible that workplace factors can contribute such as working with vibrating tools or on an assemble line that requires prolonged and repetitive flexing of the wrist which can over time result in harmful pressure on the median nerve.
Carpal Tunnel Syndrome
DIAGNOSIS
To be able to diagnosis this condition you will need to provide a full medical history to see the pattern of your signs and symptoms.
You will be required to have a physical examination with a number of tests to rule the condition in or out.
An x-ray may be needed but not always.
In some cases an Electromyogram is require which measures the tiny electrical discharges produced by the muscles. This can determine if muscle damage has occurred and can rule out any other conditions.
Nerve conduction study will test the median nerve, this will create a small shock through the nerve to see if electrical impulses are slowed in the carpal tunnel.
MANAGEMENT TIPS
- Take quick breaks from repetitive activities involving the use of your hands.
- Rotate your wrists and stretch your palms and fingers.
- Take pain relief.
- Wear a wrist splint overnight, these can be bought through the clinic or at your local pharmacy.
- Avoid sleeping on your hands to help ease the pain or numbness in your wrist or hands.
TREATMENT OPTIONS
It is suggested that carpal tunnel syndrome is treated as early as possible after you begin to experience symptoms by seeing your Osteopath or Chiropractor so that they can do the examination and history to identify the diagnosis.
Taking more frequent breaks to rest the hands and avoiding activities that worsen symptoms along with applying cold packs to reduce any localised swelling.
Wrist splinting is advisable in severe cases, particularly at night so that you can sleep. This is particularly good when you are pregnant.
Non-steroidal anti-inflammatory drugs may help relieve the pain short term but are not advisable long term. There is no evidence that these improve carpal tunnel syndrome.
Corticosteroids may be injected into the tunnel to relive the pain by your GP.
Surgery is the final option if the symptoms persist after trying nonsurgical intervention. The goal is to relieve the pressure on your nerve by cutting the ligament pressing on the nerve.
Article written by Dr Kristy Buist (Osteopath)
References
- Journal of Orthopaedic Surgery and Research 2011
- Book: Mayo Clinic Family Health Book, 4th Edition
