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Carpal Tunnel Syndrome (CTS)
Carpal tunnel syndrome (CTS) is when the median nerve is compressed within the carpal tunnel space of the wrist. It typically causes numbness, tingling, and/or weakness into your hand.
The Anatomy
The carpal tunnel is a narrow passageway (about an inch wide). The floor and sides of the tunnel are formed by the small wrist bones, known as the carpal bones. The roof of the tunnel is a band of strong connective tissue, called the transverse carpal ligament. These boundaries of the carpal tunnel are all extremely rigid, giving very little ability to expand or ‘stretch’.
The median nerve originates as a group of nerves in the neck, which joint together in the arm to form one nerve. It runs the length of the arm, into the forearm, travels through the carpal tunnel in the wrist, and ends in the hand. This nerve controls sensation in the thumb, index, middle, and ring fingers, and also controls the muscles around the base of the thumb.
As well as the median nerve, there are nine tendons that control the movements of the fingers and thumb.
Common causes:
- Repetitive movements, including typing and using a screwdriver.
- Conditions such as hypothyroidism, obesity, rheumatoid arthritis, and diabetes.
- Pregnancy
- Trauma/ wrist fracture
Symptoms of carpal tunnel syndrome may include:
- Numbness, tingling, burning, and pain—primarily in the thumb and index, middle, and ring fingers
- Occasional shock-like sensations that radiate to the thumb and index, middle, and ring fingers
- Pain or tingling that may travel up the forearm toward the shoulder
- Weakness and clumsiness in the hand—this may make it difficult to perform fine movements such as buttoning your clothes
- Dropping things—due to weakness, numbness, or a loss of proprioception (awareness of where your hand is in space)
- Night-time pain- symptoms may awaken you from sleep
Manual Therapy Treatment for CTS:
Manual therapy can be an effective form of treatment for CTS. As well as exercises/ stretches to perform in between treatments; treatment aims will comprise of soft tissue techniques to soften the surrounding muscles in the hand and forearm, articulatory techniques to mobilise the surrounding carpal bones, and possibly manipulative techniques to loosen any restrictions within the carpal joints.
Our physiotherapists can also administer Extracorporeal Shock Wave Therapy (ESWT) in order to promote healing and rejuvenate damaged tissue.