Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a common nerve entrapment condition which is characterised by pain, numbness, tingling and sometimes weakness in the hand and arm which is typically aggravated by static gripping actions. This occurs when one of the main nerves to the hand is compressed as it travels through a passage of the wrist called the carpal tunnel – formed by the bones of the wrist and a ligamentous structure which acts to protect the local nerves and tendons. The nerve is called the median nerve and supplies your thumbs, and 2nd, 3rd and 4th digits of the hand.

Although the symptoms are experienced in the wrist and hand, this does not always relate to the origin of the symptoms. Disorders of the neck are a common contributor to the common physical complaints of CTS. If the muscles of the neck become over-active and inflamed, they can irritate the nerves in which the median nerve branches off from.

Similarly, brachial plexus injury can also lead to comparable symptoms. The brachial plexus is the network of nerves which stem from the neck and supply the arm, hand and wrist. Following a traumatic injury, a vigorous stretching mechanism or compression, this cluster of nerves can be damaged and inflamed which can lead to referred pain being experienced further along that nerve supply. 

The symptoms can develop spontaneously and tend to progressively become worse, typically more noticeable at night and early in the morning. However, as previously outlined CTS can also occur secondary to other factors which can affect the structures of the carpal tunnel such as trauma, inflammation of local structures and systemic conditions, anatomical variances and conditions that impact fluid distribution.

These include being overweight, having diabetes, and partaking in activities/actions which involve repeated bending/gripping tasks e.g. playing instruments, heavy manual jobs. The symptoms can also appear whilst being pregnant. Carpal tunnel syndrome has shown to have peak prevalence in those aged 45 – 59 in which 75% are female, and 75–84, 64% being female.   

At Pure Physiotherapy, your therapist will carry out a comprehensive assessment and physical examination to identify potential reasons for why the symptoms may have started and offer advice on how to adapt these.

These may include workplace factors or physical factors. Exercises can include stretching drills for the neck and upper limb, and some postural/strength work.

Please find the patient resources section of our website where we have created a series of recommended exercise programmes to effectively manage carpal tunnel syndrome with wrist and neck movements. To access these, please contact us to obtain the password. We advise consulting with your Physiotherapist prior to trying any of these exercises.

At Pure Physiotherapy, our expert clinicians may also give you advice and signpost to suitable splinting/bracing to help with the symptoms, giving you the ability to address the underlying cause and empower you with the knowledge and skills to manage independently.

https://www.nhs.uk/conditions/carpal-tunnel-syndrome/

These are some examples of wrist splints you can purchase which are used by the NHS: https://actesso.co.uk/used-by-the-nhs/