Carpal Tunnel Syndrome: Expert Care at Palms Physiotherapy & Allied Health

What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome occurs when the median nerve, which controls sensation in the thumb, index, and middle fingers, becomes compressed as it passes through the carpal tunnel in the wrist. The carpal tunnel is a narrow passageway formed by bones and ligaments, and when it becomes constricted, pressure on the median nerve can lead to symptoms.

CTS is a common condition that is often associated with repetitive hand movements or pressure on the wrist, but it can also be caused by various other factors, including inflammation, pregnancy, or injury.

Symptoms of Carpal Tunnel Syndrome

The symptoms of Carpal Tunnel Syndrome can vary in severity and may develop gradually over time. Common symptoms include:

1. Numbness and Tingling

• A sensation of tingling, pins and needles, or numbness in the thumb, index, and middle fingers, often occurring at night.

• This sensation can extend into the palm or even the entire hand.

2. Pain

• Pain in the wrist, palm, or fingers, which may worsen during activities that require repetitive hand movements such as typing, knitting, or using a mouse.

• The pain may also radiate up the forearm or into the shoulder.

3. Weakness in the Hand

• Weakness in the hand, making it difficult to grip objects or perform daily tasks like holding a pen or opening a jar.

• The condition can affect fine motor control, such as typing or texting.

4. Nighttime Symptoms

• Symptoms are often worse at night, leading to disturbed sleep due to numbness, tingling, or pain in the hand or wrist.

Causes of Carpal Tunnel Syndrome

Carpal Tunnel Syndrome can result from a combination of genetic, environmental, and lifestyle factors. Some common causes include:

1. Repetitive Strain or Overuse

• Repetitive hand movements such as typing, using a computer mouse, or performing assembly line tasks can lead to inflammation and swelling of the tendons in the wrist, compressing the median nerve.

2. Wrist Injury

• Fractures or sprains in the wrist can lead to swelling or deformities that narrow the carpal tunnel and compress the median nerve.

3. Pregnancy

• Pregnancy-related hormonal changes can lead to fluid retention, which can increase pressure within the carpal tunnel, resulting in CTS symptoms.

4. Diabetes and Other Medical Conditions

• Conditions such as diabetes, rheumatoid arthritis, and thyroid dysfunction can increase the risk of developing Carpal Tunnel Syndrome due to inflammation and fluid retention around the nerve.

5. Anatomical Variations

• Some people may be born with a naturally narrower carpal tunnel, making them more susceptible to CTS.

Diagnosing Carpal Tunnel Syndrome

At Palms Physiotherapy & Allied Health, accurate diagnosis is crucial for effective treatment. We use a combination of thorough clinical assessment and diagnostic tests to identify the presence of Carpal Tunnel Syndrome:

1. Physical Examination

• Tinel's Sign: This test involves tapping the median nerve at the wrist to see if it elicits tingling or discomfort in the fingers.

• Phalen’s Maneuver: A test where the wrists are flexed for 60 seconds to see if symptoms worsen (numbness, tingling, or pain).

• Manual Tests: Your physiotherapist may test your wrist strength, flexibility, and nerve function.

2. Imaging

• Ultrasound: Can be used to assess the size of the carpal tunnel and detect any structural changes such as swelling or changes in the median nerve.

• X-rays: While X-rays do not show soft tissue, they can be used to rule out fractures or arthritis that may be contributing to CTS.

3. Nerve Conduction Studies (NCS)

• Nerve conduction studies or electromyography (EMG) may be conducted to measure how well the median nerve is functioning and to rule out other conditions that may mimic CTS.

Treatment for Carpal Tunnel Syndrome at Palms Physiotherapy & Allied Health

Our goal is to alleviate the symptoms of Carpal Tunnel Syndrome and restore function without the need for surgery. The team at Palms Physiotherapy & Allied Health will create a personalized treatment plan that may include a variety of approaches:

1. Physiotherapy

• Manual Therapy: Hands-on treatments such as soft tissue mobilization, joint mobilization, and nerve gliding exercises are used to reduce nerve compression and improve wrist mobility.

• Stretching and Strengthening: Specific exercises are tailored to stretch tight muscles and tendons in the forearm and strengthen the muscles of the wrist and hand, improving overall function.

• Ergonomic Advice: We provide practical advice on improving posture and modifying activities to reduce strain on the wrist during daily tasks.

2. Wrist Splinting

• A wrist splint or brace may be recommended to keep the wrist in a neutral position, particularly during sleep when symptoms often worsen. Wearing the splint can help reduce pressure on the median nerve and ease nighttime discomfort.

3. Anti-inflammatory Treatments

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may be used to reduce inflammation and alleviate pain.

• Corticosteroid Injections: In more severe cases, a corticosteroid injection may be administered to reduce inflammation around the carpal tunnel and provide temporary relief.

4. Lifestyle and Activity Modifications

• We work with you to adjust your daily habits and ergonomic practices to avoid aggravating your symptoms. This may include taking frequent breaks from repetitive tasks, using ergonomic devices, or changing your workstation setup.

5. Surgery (In Severe Cases)

• In cases where conservative treatments fail, and symptoms are persistent or worsening, surgery may be considered. Carpal Tunnel Release Surgery involves cutting the ligament that forms the roof of the carpal tunnel, thereby reducing pressure on the median nerve.

Preventing Carpal Tunnel Syndrome

While Carpal Tunnel Syndrome may not always be preventable, several strategies can help reduce the risk of developing this condition:

1. Proper Ergonomics

• Setting up your workstation with ergonomic equipment, such as a split keyboard or an adjustable chair, can reduce strain on the wrists and hands.

2. Take Regular Breaks

• If your work or hobbies involve repetitive hand movements, make sure to take regular breaks to rest your wrists and stretch your hands and forearms.

3. Maintain Wrist Strength and Flexibility

• Regularly performing stretching and strengthening exercises for the wrist and forearm muscles can help prevent overuse injuries.

4. Manage Medical Conditions

• Proper management of conditions like diabetes or rheumatoid arthritis can reduce inflammation and minimize the risk of developing CTS.

Why Choose Palms Physiotherapy & Allied Health for Carpal Tunnel Syndrome?

• Expert Care: Our experienced physiotherapists and occupational therapists specialize in treating Carpal Tunnel Syndrome and provide a thorough, individualized approach to your recovery.

• Holistic Treatment: We offer a combination of hands-on therapy, exercises, and ergonomic advice to address the root cause of your symptoms and restore full function.

• State-of-the-Art Facilities: Our clinic is equipped with advanced rehabilitation tools and a sensory room, offering a comfortable and supportive environment for your recovery.

Book Your Appointment Today

If you're experiencing symptoms of Carpal Tunnel Syndrome, don't wait to get help. Book an appointment with our team of experts at Palms Physiotherapy & Allied Health to start your recovery today.