Carpal Tunnel Syndrome and treatment options

The carpal tunnel is an anatomical structure within the wrist. It acts as a passageway for 10 different structures (9 tendons and the median nerve) and is surrounded by a tough band of tissue called the flexor retinaculum. For a variety of reasons, the carpal tunnel can become compressed, or swollen, which places additional stress and irritation on the contents of the tunnel.

Most commonly, the median nerve gets compressed which results in numbness, tingling, pain and muscle weakness in the hand. This dysfunction of the median nerve and resulting symptoms is what is known as Carpal Tunnel Syndrome (CTS).

Symptoms of Carpal Tunnel Syndrome

CTS symptoms usually worsen gradually over time. Initial symptoms commonly include numbness of the thumb, index or middle fingers (palm side) and pain at night. Without proper intervention, CTS symptoms will usually get worse and can include:

  • Numbness, tingling, and pain in your thumb and the first three fingers of your hand (palmar side)
  • Pain and burning that travels up your arm
  • Wrist pain at night that interferes with sleep
  • Weakness in the muscles of the hand

What Causes Carpal Tunnel Syndrome?

CTS is known to affect more women than men, and is more commonly seen in older adults. CTS can also be caused by a series of other health conditions, including but not limited to:

  • Thyroid dysfunction
  • Menopause or fluid retention during pregnancy
  • Diabetes
  • Obesity
  • Autoimmune disorders like rheumatoid arthritis
  • High blood pressure
  • Injuries, fractures, and trauma of the wrist
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Various occupations can also increase an individual’s likelihood of developing carpal tunnel syndrome. Excessive motion of the wrist and hand can cause swelling and irritation of the median nerve, resulting in carpal tunnel symptoms. This could be because of the:

  • The positioning of your wrists when typing or using a mouse
  • Excessive exposure to vibration in certain tools or power gears
  • Repetitive motion that overextends the wrist, like playing the piano, working on an assembly line, working in hairstyling/beauty services

Prevention

Prevention of CTS includes managing any associated comorbid conditions (listed above), and minimizing repeated and frequent movements/vibrations to the hands while at work. For those who are at increased risk, performing a regular wrist stretching and strengthening routine, nerve mobility exercises and various wrist braces and ergonomic devices can help reduce your risk of developing CTS.

How Can Physiotherapy Help?

Treatment for CTS depends on the severity of pain, weakness, and symptoms. Most often, CTS symptoms can be resolved with rest, hot/cold compressions, management of the inflammation, manual therapy, and moderate physical exercise of the wrist.

Non-surgical options include:

  • Avoiding overextension of the wrist
  • Wrist splints to hold the hand in a neutral position
  • Painkillers and anti-inflammatory medications
  • Treatment of other causative conditions like diabetes or arthritis
  • Steroid injections in the wrist to minimize swelling

Surgery is suggested if there is severe nerve damage, which is diagnosed by a nerve conduction test. CTS surgery involves cutting the “roof” of the carpal tunnel (the flexor retinaculum) to reduce the pressure on the median nerve. Certain factors affect the success of surgical treatment including age, symptom duration, presence of other conditions, and severity of pre-surgery symptoms.

Why Pillars of Wellness?

At Pillars of Wellness, in Burlington, Ontario, we are proud to provide a truly integrated care approach that employs a variety of treatments to achieve a faster recovery. Our clinic offers various services such as physiotherapy, chiropractic, naturopathy, counselling, occupational therapy, yoga therapy, acupuncture, and holistic nutrition.

With multiple services and specialties in one place, you’ll get the best care possible — without having to look elsewhere. Pillars of Wellness is your one-stop-health solution, located right here in Burlington.

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