Carpal Tunnel Syndrome
What are the symptoms?
Carpal Tunnel Syndrome (CTS) symptoms can range from numbness and occasional mild pain from the hand to the arm, as well as a tingling sensation in the hands and fingers; through to pins and needles, dry skin, swelling and/or changes to the colour of the skin on the hand. Other symptoms include impaired dexterity, loss of sensation and wasting away/weakness of the muscles at the base of the thumb.
The condition mainly affects the thumb, index finger, middle finger and half of the ring finger. Initially symptoms can be worse at night and first thing in the morning and you can find that the condition spreads from one arm/hand to both.
What causes Carpal Tunnel Syndrome symptoms?
Carpal Tunnel Syndrome is caused by the compression of the median nerve; which is one of the nerves that controls sensation and movement in the hands. This nerve compression can occur in the wrist, further up the arm, or around the first rib.
Where it occurs in the wrist it is usually in the carpal tunnel itself causing the problem; which is a narrow ‘tunnel’ comprising of small bones and a tough band of tissue that acts as a pulley for the tendons that bend the fingers. The nerve compression can be caused either by fluid build-up in the wrist, a thickening of the tissues in the carpal tunnel (leading to increased friction), or by the carpal bones becoming unstable and narrowing the tunnel. There are other also other things that can increase your risk of suffering, these are;
- Pregnancy: up to 50% of pregnant women develop it
- Family history of the condition: one in four have a close relative with the condition
- Injury to the wrist
- Diabetes, under active thyroid and rheumatoid arthritis
- Strenuous/repetitive work using the hands e.g. playing a musical instrument or playing on games consoles for long periods of time.
- Obesity in young people
- Some drugs which are used to treat breast cancer e.g. exemestane
What can I do to get rid of Carpal Tunnel Syndrome?
In the first instance speak to your GP to ensure there is no underlying medical condition causing the problem. Assuming there isn’t, most cases can respond to non-surgical intervention such as Massage and Acupuncture. You can also try using a wrist splint. However, immobilising a joint for long periods can weaken the muscle structure around it, so it’s important not to wear a splint all the time. If Carpal Tunnel Syndrome occurs during pregnancy the symptoms normally disappear within 12 weeks of giving birth.
Suitable Therapies and Advice
If you have a job that involves that exacerbates the problem, e.g. using vibrating machinery, it is unrealistic to stop work, however, you should take regular breaks. Our therapists can also give you stretches to perform during these breaks which may relieve pressure on the median nerve, as well as demonstrating different ways to massage the affected areas at home. Posture can also affect Carpal Tunnel Syndrome and learning how to sit correctly at a desk and stretch/move more will help enormously. Yoga and Pilates are particularly good for postural issues.
Sports Massage is extremely beneficial and our therapists will focus on the shoulder and neck as well as the forearm. The median nerve emerges from under the pec major (chest) and deltoid (shoulder/top of arm) and could be compressed at the thoracic outlet rather than the wrist. Often the scalenes (front of neck) are the primary source of symptoms if an incorrect diagnosis of carpal tunnel syndrome is made. With severe symptoms, trigger points in as many as thirty-eight muscles of the neck, chest, upper back, shoulder, upper arm, forearm, and hand may be involved in causing referred symptoms in the wrist, hand and fingers. Trigger point therapy is proven to be very effective in the treatment of carpal tunnel syndrome and can be incorporated into your massage along with stretching.
Acupuncture can assist with reducing pain and increasing mobility in the affected areas.