Carpal Tunnel Syndrome is an extremely common disorder that can cause a tingling sensation, numbness and in some cases pain in the hands and fingers - most notably the index finger, middle finger and thumb. Learn more about Carpal Tunnel Syndrome with our detailed guide below...
What is Carpal Tunnel Syndrome?
What is the cause of Carpal Tunnel Syndrome?
Symptoms of Carpal Tunnel Syndrome
How is Carpal Tunnel Syndrome diagnosed?
Treatments for Carpal Tunnel Syndrome
Exercise guide after Carpal Tunnel surgery
Wrist splint for Carpal Tunnel Syndrome
Can Carpal Tunnel Syndrome cause shoulder pain?
Carpal tunnel syndrome is something that most people have heard of but a lot of people are not clear on exactly what it is. So what is carpal tunnel syndrome? Carpal tunnel syndrome is when the nerve that runs from your wrist up to your arm, called the median nerve, gets compressed. This results in the movement in your thumb and fingers being restricted as well as pain in your arm and hand.
There is no clear consensus on the precise cause of Carpal Tunnel Syndrome, although there are certain factors that are known to increase your chances of developing it. These include:
Of course, not everyone who fits this profile will get Carpal Tunnel Syndrome but it does mean there is an increased chance of it. For example, up to 50% of pregnant women will develop Carpal Tunnel Syndrome.
It is useful to know what the symptoms of Carpal Tunnel Syndrome are so that you can get a carpal tunnel test if you suspect you have it. Some of the Carpal Tunnel Syndrome symptoms include:
Displaying these symptoms does not always mean that you have Carpal Tunnel Syndrome, so you should certainly visit your GP to discuss things before looking for treatments.
There are two main tests that are used for diagnosing Carpal Tunnel Syndrome. They are called the Tinel and Phalen Manoeuvres. The Tinel test involves tapping on the palm side of the wrist. If positive, the test will produce a tingling sensation in the fingers.
The Phalen Manoeuvre involves manipulating the wrist into a flexed position. Again, the tingling sensation indicates a positive test. In cases that have progressed, an electromyogram test and nerve conduction studies may be undertaken to establish the extent of nerve damage. Electromyograms measure electrical activity in nerves and muscles whilst nerve conduction studies measure the ability of nerves to transmit electrical impulses. However, nerve damage may not show up on these tests until the nerve damage is significant.
It’s also been found that the severity of symptoms doesn’t necessarily relate to the extent of nerve damage revealed on electromyograms and nerve conduction studies. Although many cases of Carpal Tunnel Syndrome go away on their own after a number of weeks or months, many cases require further treatment. If you’re experiencing the symptoms of Carpal Tunnel Syndrome, you should seek medical assistance. If caught early, some cases of Carpal Tunnel Syndrome may be successfully treated with exercises and lifestyle changes and surgery may be avoided.
In approximately 25% of cases, the symptoms of Carpal Tunnel Syndrome will subside on their own within a few months. If you find that your symptoms persist or are more severe then you can have minor surgery to correct the problem. The surgery for Carpal Tunnel Syndrome is very minor and is carried out under local anaesthetic in most cases. The surgery has a very high success rate and will usually clear up all symptoms of Carpal Tunnel Syndrome. If you don't like the sound of surgery then there are a couple of alternative treatments available, firstly a wrist splint.
This can be a very effective form of treatment for some people although it can hinder everyday activities, which is why many people will only wear it at night. Another alternative treatment is steroid injections into the wrist. This treatment has proven to be very effective, especially in the short-term, with three out of four people who get steroid injections reporting that it completely disappeared. However, this number falls to around half of people when it comes to long-term relief
Surgery to relieve Carpal Tunnel Syndrome consists of an incision made to the wrist at the base of the palm. The ligament that forms the top of the carpal tunnel is cut which allows it to expand thus alleviating pressure on the median nerve. If thickening around the tendons is present, this can also be cut away, allowing the median nerve more room within the carpal tunnel. After surgery, a dressing will be applied to the hand and wrist. The dressing will be deliberately large and bulky to try to keep your wrist in a neutral position. If you’re allowed home the same day, your nurse or healthcare professional will advise you when you can reduce the size of the dressing. You will have sutures, which will be taken out around ten to fourteen days after surgery. To speed your recovery, it’s advisable to elevate your hand as much as possible. When you go to bed, try to place your hand on a pillow to keep it raised. This will minimise swelling. After your wound is completely healed and your dressing and sutures have been removed, you can work on minimising the appearance of scarring. Massage the scar and surrounding skin with non-perfumed hand cream. This will decrease sensitivity in the area and soften the scar tissue, accelerating the healing of the skin.
For best results, perform these exercises two or three times a day, repeating each movement ten to fifteen times each. To begin with, these exercises may be a little bit uncomfortable, but if you experience significant pain then you should stop immediately.
Once the pain from the surgery begins to subside, you can begin using your hand again for less challenging daily activities such as eating or getting dressed – provided it doesn’t cause pain. Gradually, you’ll be able to use your hand more and more and by around two weeks after surgery, you’ll be able to engage in most of your normal daily activities.
Don’t resume driving until you’re confident that you can maintain control of the vehicle. Although it’s important to engage in gentle activity to rehabilitate your hand and wrist post-surgery, you must be careful not to overuse your affected hand. If you do so, you risk prolonging your healing time. Watch out for increased pain, redness or swelling and cut back on your exercises and activities until your hand recovers. In more severe cases of Carpal Tunnel Syndrome, it can take up to sixth months for your hand to recover. In some extremely severe cases, you may not entirely regain the same level of strength in your hand and wrist that you used to have.
With Carpal Tunnel Syndrome, it’s important to manage the symptoms to reduce pain. Often, it is recommended that you wear a hand brace to help keep your wrist in a neutral position. Read more about how wrist splints can help Carpal Tunnel here.
Read more about Carpel Tunnel here:
8 Great Carpal Tunnel Exercises