Wondering if you might have carpal tunnel syndrome? At first, you notice that your fingers “fall asleep” and become numb at night. When you wake up the next day your hands are numb and there is a tingling sensation. Throughout the day, your pain and numbness may flare while you’re holding something with your wrist bent. Early on, you can shake your hands for symptom relief. As it progresses, you notice you have less grip strength and the muscles in your hand seem to be shrinking.
Carpal tunnel syndrome occurs when the median nerve in the wrist is compressed. The carpal tunnel is located on the palmar side of the wrist. The roof of the carpal tunnel is formed by the flexor retinaculum, which is a fibrous connective tissue band. Within this tunnel are the flexor tendons for the fingers, the flexor tendon for the thumb and the median nerve. Increasing the volume of any of these components causes compression of the median nerve, impairing blood supply and decreasing nerve signal transmission.
This results in pain in the hand that may spread into the forearm and shoulder, as the median nerve travels from the neck down to the hand. The median nerve supplies sensation to the thumb, index and middle finger. Sensory symptoms may include burning, tingling, pins and needles and numbness in those fingers. The median nerve also innervates the muscles that aid in grip strength and small hand movements. Therefore, motor symptoms may include decreased grip strength and difficulties fully bending your first three fingers.
What causes compression of the median nerve? The most common cause is repetitive, overuse stresses. Examples are the repetitive and forceful movement of the wrist and fingers and occupational exposure to excess vibration, increased hand force and repeated flexion and extension. Trauma, such as a fracture or dislocation in the area, can also cause compression.
Carpal tunnel syndrome can also occur secondary to other conditions such as flexor tenosynovitis, infections, osteoarthritis, rheumatoid arthritis, pregnancy, renal failure, diabetes mellitus, thyroid dysfunction, alcoholism, lupus, gout, obesity, and menopause. As well, a lesion, such as ganglions, lipomas or cysts can take up space and compress the median nerve.
Calgary’s Panther Sports Medicine and Rehabilitation Centers have qualified physiotherapists who will be able to guide you through managing the condition. Treatment will initially focus on education regarding avoiding, reducing or modifying exacerbating activities. Next, they will aid in providing strategies on how to reduce median nerve stress while still completing your necessary daily tasks. Pain management will also be achieved through the usage of ultrasound, acupuncture, electrical stimulation, and manual therapy.
Therapeutic exercise will focus on stretching and strengthening the wrist and hand. Visit one of Calgary’s nine Panther clinics today to get started on your personalized road to recovery.