Carpal tunnel syndrome or CTS is a common condition that affects the hands and wrists. It caused when the median nerve that serves part of the hand is pinched as it runs through a structure of bones and ligaments called the carpal tunnel. This structure runs through the palm side of the wrist. The thumb and the first three fingers are usually affected, though it may only affect the ring finger and the pinkie. Carpal tunnel syndrome affects both men and women, but is especially more common in women.
What Causes Carpal Tunnel Syndrome?
Carpal tunnel syndrome is caused by factors that increase the pressure on the nerve and the tendons in the wrist. People who play sports that involve repetitive movements of the wrist, such as racquet sports are at risk for CTS. It can also arise after a blow to the wrist that either fractures or dislocates a bone or causes the wrist to become inflamed. Sometimes, the cause of carpal tunnel syndrome is unknown.
Physicians also believe that women are more susceptible to the condition because they have smaller wrists than men and thus a smaller carpal tunnel. Some women first experience carpal tunnel syndrome when they are pregnant or going through menopause. Other risks for carpal tunnel syndrome are alcoholism, obesity, arthritis, diabetes, and an underactive thyroid.
The symptoms of carpal tunnel syndrome often come on gradually and first present as tingling and numbness in the hand. Eventually, the person experiences shooting pains from the wrist and up into their arm. This tends to be worse at night. The patient also feels burning in their fingers and their affected hand cramps and stiffens, especially in the morning. The thumb becomes weak and eventually, it will become difficult for the hand to make a fist. Because of this, simple everyday tasks may become difficult.
Though there’s no sure fire way to prevent carpal tunnel syndrome. A person who does repetitive wrist movements as part of their job can lessen the risk by taking frequent breaks and learn ways to do their work while easing the stress on their wrists and hands. They can perform wrist and hand exercises even before the symptoms of CTS arise.
Diagnosing Carpal Tunnel Syndrome
Carpal tunnel syndrome is diagnosed by a physician who has taken into account a patient’s descriptions of their symptoms. One way a person can check if they might have the condition is to put the backs of their hands together with their fingers outing down and their elbows pointing out. If they feel pain, tingling or numbness, it may be a sign of CTS.
The physician will also examine the patient’s hand or wrist and orders tests to check the condition of the median nerve.
It is possible that carpal tunnel syndrome can improve without treatment and over time while lessening the strain on the wrists. If it doesn’t, there are several ways to ease the symptoms. Some doctors place a splint on the wrist that the patient wears for about a month to a month and a half. The splint holds the wrist in a neutral position when it’s at rest. Some people only need to wear a splint at night, while others wear them during the day. In some cases, the splint must be worn all day and night. Doctors can also give their patients corticosteroid injections to reduce the inflammation at the wrist.
Alternatively, in more severe cases, surgery may be recommended. The surgery can be an outpatient procedure, which means that the patient can go home to recuperate right after the operation which is called carpal tunnel syndrome release. Some patients only need local anesthesia for this surgery.
During the surgery:
The doctor applies a tourniquet above the patient’s wrist to control the bleeding.
They make an incision in the bottom of the patient’s hand into their wrist. They then use retractors to open the surgical wound and expose the transverse carpal ligament.
The surgeon cuts the carpal ligament which then releases the median nerve. This is usually enough to treat the symptoms of CTS.
The doctor closes the surgical wound with sutures which are removed after about ten days if they are non-absorbable. They then place a bandage over the wound and a splint to stabilize the wrist.
Sometimes the doctor uses an arthroscope. This involves small incisions in the wrist and miniaturized surgical instruments. Ultimately, it will reduce the risk of infection and speeds the patient’s recovery time.
Doctors sometimes recommend physical therapy to patients who have been treated for carpal tunnel syndrome. Physiotherapy can include dumbbell bench presses that strengthen the upper body or scalar circles that help with the patient’s balance and control.
If you think you’re experiencing symptoms of carpal tunnel and would like to look into the benefits of physical therapy to treat your discomfort, contact Focus Physiotherapy. Focus Physiotherapy has 6 convenient physiotherapy clinic locations in the Greater Toronto Area: Etobicoke, Mississauga, Brampton, Bolton, North York and York. Please click one of the locations below for contact information, directions and hours of operation. We look forward to speaking with you.