Carpal Tunnel Syndrome


What is Carpal Tunnel Syndrome?

The carpal tunnel is a space in your wrist where the tendons and nerves to your hand run through. It contains the tendons for the muscles that bend your fingers, and also your median nerve. In carpal tunnel syndrome, the space in the carpal tunnel decreases, which leads to compression and irritation of your median nerve.

Causes of decreased space in the carpal tunnel include:

• Arthritis – this can increase swelling in the wrist
• Pregnancy – due to increased fluid retention
• Trauma to the wrist (e.g. wrist fractures) – this can increase swelling in the wrist
• Overuse injuries to the tendons that pass through the carpal tunnel – this can increase the size of these tendons, decreasing the size of the space


Symptoms of Carpal Tunnel Syndrome:

The symptoms of carpal tunnel vary from person to person, but can include:

• Pain on the palmar side of your wrist
• Numbness and/or pins and needles in your thumb, index finger, middle finger and/or thumb side of your ring finger
• Pain at night time
• Pain in your forearm, elbow and shoulder


Assessment of Carpal Tunnel Syndrome:

You All Care Physiotherapist will ask you a series of questions about the onset and behaviour of your pain, any activities you do and will get a short history of your pain to date. They will then complete a comprehensive assessment that may include:

• Neck, shoulder, elbow, wrist and/or hand range of motion
• Degree of movement of the individual joints in your thoracic spine, neck and/or wrist
• Grip strength
• Sensation assessment
• Neurodynamic tests (how well your nerves move within your arm)
• Special tests for carpal tunnel syndrome (e.g. Phalen’s or Tinel’s test)


Treatment of Carpal Tunnel Syndrome:

It is recommended that conservative treatment (i.e. Physiotherapy) be attempted prior to any surgical review, particularly in mild to moderate cases. In these instances, physiotherapy is effective in treating carpal tunnel syndrome. Treatment will vary depending on your presentation, and the suspected cause of your symptoms. Treatment can include:

• Ultrasound
• Soft tissue releases
• Wrist joint mobilisations
• Hand and wrist muscle strengthening exercises
• Neck joint mobilisations
• Nerve gliding exercises
• A splint for you to wear at night


What Can You Do to Help?

Three things that you can do to help are:

1. Stopping aggravating activities:

• This gives your tendon time to rest and heal.
• It is important to make sure that when you re-commence the activity that it is pain-free.

2. Wrist splint

• Your All Care physiotherapist can provide you with a splint that will restrict particular wrist movements that cause aggravation of the carpal tunnel, especially at night

3. Gentle wrist movement/stretch

• Have your arms out stretched, point the fingers of the affected side up to the ceiling, with the other hand gently pull the fingers and hand towards your head. Hold for 20 secs and repeat 3 times


To get control your wrist and hand pain, call All Care Physiotherapy today on 1300 291 133 and get back to the activities you enjoy!