Carpal Tunnel Syndrome

The symptoms of carpal tunnel syndrome are caused by compression of the median nerve which passes through the wrist and into the thumb and next three fingers as shown. Before it enters the hand, it passes through the 'carpal tunnel' which is a channel formed by the carpal bones and the flexor retinaculum (the thick ligament type structure shown opposite).

Symptoms

• Pain which comes on gradually and slowly gets worse.
• A dull ache initially in the wrist and hand.
• Pain which radiates into the thumb and four fingers.
• Tingling, burning or numbness.
• Pain is often worse at night.

Causes

The cause of carpal tunnel syndrome is compression of the medial nerve, where it passes through the carpal tunnel. The reason for this compression is either structural (following a fracture or other injury), inflammatory (due to overuse or arthritic conditions) or fluid retention (as during pregnancy). For some people the cause can be congenital, as they have a naturally narrow carpal tunnel.

Carpal tunnel occurs more commonly in women, especially during pregnancy, and also in diabetics. Some occupations are more at risk of developing carpal tunnel syndrome, such as assembly line workers and others who repetitively perform the same hand and wrist movements.

Treatment

If you think you may have carpal tunnel syndrome you should visit your Doctor for a diagnosis. There are several things your Doctor will be looking for, including reproduction of your symptoms on a carpal tunnel test such as tinels sign.

Treatment usually includes the following:

• Immobilisation of the wrist for a period of around 2 weeks.
• A splint or cast will usually be used.
• If there is swelling or inflammation present anti-inflammatories may be prescribed.
• Cold therapy may also be advised to reduce swelling and inflammation.
• After the immobilisation period, if pain-free, exercises can begin.
• Exercises should aim to strengthen the wrist to prevent a reoccurrence.

If this conservative treatment fails, other options to consider include a Corticosteroid injection. If this also fails and symptoms have been persistent for 6 months or more, surgery may be considered. A simple procedure called a carpal tunnel release can be performed, which involves cutting the carpal ligament to make more space for the median nerve.

Further Information

• Carpal tunnel syndrome - for further information on treatment including rehabilitation, taping, sports massage, stretching and more visit sportsinjuryclinic.net