Carpal Tunnel Syndrome is the most common peripheral neuropathy in the upper limb and most often affects those aged between 40 and 60 years, and will occur ten times more in women than men. In carpal tunnel syndrome, the median nerve is affected and this reduces mobility of the nerve within its canal. Hand discomfort is caused by compression and the reduction of sliding of the median nerve. This compression is often linked to repetitive hand movements, poor posture, or underlying health conditions like diabetes or rheumatoid arthritis. Over time, if left untreated, carpal tunnel syndrome can lead to muscle weakness, decreased hand function, and persistent discomfort. With early intervention, including physical therapy, exercises, and ergonomic adjustments, many individuals can find relief and return to normal daily activities.
Frequently Asked Questions
How does carpal tunnel syndrome present?
The initial signs of carpal tunnel syndrome include pain, numbness, and paresthesias within the median nerve distribution – this includes in the palm of the hand and most often fingers 2-4. As carpal tunnel syndrome is a progressive condition in most patients, it can result in permanent loss of sensation, reduced strength (particularly grip strength) and loss of function in the hand if it is not adequately identified and treated.
What causes carpal tunnel syndrome?
Prolonged wrist overload, injuries, age, obesity, diabetes, osteoarthritis. Origins related to dysfunction of the median nerve sensory fibers. Impaired reception of sensory information of deep sensation causes a reduction in the precision of hand movements and pincer grip resulting in generating more pinch force than necessary.
How do you diagnose carpal tunnel?
A patient history will be taken by the treating practitioner and clinical symptoms will be recorded to diagnose carpal tunnel syndrome. The Boston Carpal Tunnel Questionnaire may be used in conjunction with a physical assessment to determine the severity of the condition. It may be necessary to perform electroneurography (ENG), a nerve conduction test, to diagnose carpal tunnel syndrome. An ultrasound or MRI can also be used to diagnose carpal tunnel syndrome, though these are a lower degree of sensitivity when compared to the ENG. A practitioner may also choose to perform a neurodynamic test. These include the Phalen and Tinnel test.
What are the best interventions or treatments for carpal tunnel syndrome?
Physiotherapy will focus on decompression of the median nerve. Passive techniques including nerve gliding exercises, soft tissue mobilisation and joint mobilisations of the wrist and hand. If necessary, a wrist splint or brace may be used to maintain wrist position in neutral and reduce the strain of completing repetitive activities. In conjunction with these interventions, exercise will be used to strengthen the wrist and hand and improve the capacity of the wrist to perform repetitive activities in the future. Exercise may focus on the wrist and finger extensors to reduce muscular compression in the flexor aspect of the forearm and wrist.