Carpal Tunnel Syndrome (CTS) is a condition that involves entrapment of a nerve, often at the wrist resulting in pins and needles, and pain into the hand. It affects about 7-16% of the UK population at any one time, impacts women more than men (~2:1) and is the most common type of nerve entrapment we see in practice. You may have heard this diagnosis being discussed amongst your family and friends and wanted to know more about it and how it can be helped.
What causes CTS?
The median nerve is a nerve that runs down the arm on the palm side of the forearm and hand. It’s responsible for the sensations we feel in our thumb, index, and middle fingers in addition to controlling the movement of the thumb. It’s a very important nerve!
Whilst in the wrist, the nerve passes through a canal made up a bones and ligaments - we call this the ‘carpal tunnel.’ If this canal is compromised in anyway and the median nerve gets irritated, we can develop CTS. There are numerous ways in which this canal can become compressed. One of the most common mechanisms is repetitive strain injury, either related to excessive keyboard use, manual work or hand sports. Fluid retention associated with pregnancy, can result in CTS and usually presents in both hands. Diabetics, obese people, and those who suffer with gout or rheumatoid arthritis are also at greater risk of developing the condition
What are the symptoms of CTS and how is it diagnosed?
Symptoms can vary from mild to severe, depending on the amount of compression. They can include:
Occasional tingling into the thumb and first two fingers and intermittent waking at night.
Continuous numbness and tingling into the aforesaid fingers, regular night waking and weakness in the thumb.
Numbness in the fingertips, lack of finger dexterity and wasting of the muscles of the hand around the thumb.
There are certain tests that can be done help diagnose CTS and it is of course always best to speak to a professional before making assumptions. Your practitioner would take your medical history, examine your hands for swelling, muscle wastage and numbness. They would ask you to perform some movements including bending your wrists, with your palms facing your forearm (Phalen’s test) or they may tap over the palm of your wrist to see if that brings on the symptoms (Tinel’s sign).
If it is not clear after the examination, your practitioner may refer you for other tests to help, which could be nerve conduction studies or a diagnostic ultrasound.
How can I help myself?
If you experience symptoms, it is best to act as early as possible to avoid long term damage or reduce the need for surgery further down the line. There are various things that you can do at home to help yourself:
Reduce or stop the activities that aggravate the symptoms. If an activity at work is the cause, speak to your manager for support.
Gentle wrist stretching exercises (if the pain increases after doing these, then stop and seek help for something more specific).
Wearing a wrist splint at night, which can focus awareness on the wrist and also reduce movements which compress the nerve whilst asleep.
Pain relief medication (discuss with your pharmacist or GP for further info).
Vitamin B6 has been shown to be helpful in reducing symptoms of CTS.
Failing the above, you can see a manual therapist such as a massage therapist, Chiropractor or Physiotherapist who may be able to help or advise further. Treatment could include massage, manipulation, acupuncture and nerve gliding exercises. The aims of these treatments are to help open up the carpal tunnel and thus reduce irritation to the median nerve.
If you would like further information or would like to arrange a chat with one of practitioners, please speak to one of our reception team, who will be happy to arrange a free phone call.
Hannah Bellamy is a very talented Level 6 Clinical Massage Therapist at Guildford Chiropractic Centre