Carpal Tunnel Syndrome (CTS) is a common condition that affects millions, causing discomfort, numbness, and weakness in the hand and arm. It arises when the median nerve, which runs from the forearm into the hand, becomes compressed or squeezed at the wrist within a narrow passageway called the carpal tunnel. Understanding what CTS is, who is typically affected, and how various treatments can bring relief is crucial for those experiencing its often debilitating symptoms.
What is Carpal Tunnel Syndrome?
The carpal tunnel is a narrow, rigid passageway located on the palm side of your wrist. It’s formed by the carpal bones at the bottom and the strong transverse carpal ligament at the top. Through this tunnel pass the median nerve and nine tendons that control finger movement.
Carpal Tunnel Syndrome occurs when anything causes the median nerve to become compressed within this confined space. This compression can be due to:
- Swelling: From inflammation of the tendons (tenosynovitis), fluid retention (e.g., during pregnancy), or conditions like rheumatoid arthritis.
- Thickening of the Ligament: The transverse carpal ligament can thicken over time.
- Pressure from Outside: Less commonly, a cyst or tumour.
The most common symptoms of CTS include:
- Numbness or Tingling: Often in the thumb, index, middle, and half of the ring finger. This can wake people at night.
- Pain: Radiating from the wrist up the arm towards the shoulder, or down into the fingers.
- Weakness: Difficulty gripping objects, dropping things, or performing fine motor tasks.
- Burning Sensation: In the hand and fingers.
- Reduced Sensation: Difficulty telling hot from cold, or feeling textures.
Symptoms often worsen at night or with repetitive hand movements, driving, or holding a phone.
Who is Carpal Tunnel Treatment For?
Carpal Tunnel treatment is for anyone experiencing the symptoms of CTS, particularly when these symptoms begin to interfere with daily activities, work, or sleep. While anyone can develop CTS, certain demographics and occupations are at higher risk:
- Individuals with Repetitive Hand/Wrist Movements: This includes those working in manufacturing (assembly lines), typing/data entry, using vibrating tools (e.g., jackhammers), musicians, hairdressers, and carpenters.
- Women: CTS is more common in women, possibly due to smaller carpal tunnels and hormonal factors.
- Pregnant Women: Hormonal changes and fluid retention during pregnancy can often lead to temporary CTS, which usually resolves after childbirth.
- People with Underlying Medical Conditions:
- Diabetes: Nerve damage is a common complication.
- Thyroid Disorders (Hypothyroidism): Can cause fluid retention.
- Rheumatoid Arthritis and other inflammatory conditions: Can cause swelling and inflammation around the tendons.
- Obesity: Increased pressure and inflammation.
- Kidney Failure: Can lead to fluid retention.
- Older Adults: The condition tends to be more prevalent with age due to natural tissue changes.
If you suspect you have CTS, seeking a diagnosis from your GP or a specialist (such as an orthopaedic surgeon, neurologist, or physiotherapist) is the first step.
How Carpal Tunnel Treatment Helps
The goal of Carpal Tunnel treatment is to relieve the pressure on the median nerve, alleviate symptoms, and restore hand and wrist function. Treatment approaches range from conservative methods to surgical intervention, often progressing from less invasive to more invasive options depending on the severity and duration of symptoms.
- Conservative Treatments (Often First Line for Mild to Moderate CTS):
- Wrist Splinting/Bracing: Wearing a splint, especially at night, keeps the wrist in a neutral position, reducing pressure on the nerve.
- How it helps: Reduces flexion and extension of the wrist during sleep or repetitive tasks, allowing the nerve to rest and decreasing inflammation.
- Activity Modification & Ergonomics: Identifying and changing activities that aggravate symptoms. This might involve adjusting keyboard height, mouse position, or how tools are held.
- How it helps: Reduces repetitive strain and external pressure on the carpal tunnel, giving the nerve space to recover.
- Medication:
- Over-the-counter pain relievers: NSAIDs (e.g., ibuprofen) can help reduce pain and inflammation.
- Corticosteroid Injections: A steroid injected directly into the carpal tunnel can reduce swelling and inflammation around the nerve.
- How it helps: Provides localised relief from inflammation and pain, offering a temporary window for symptoms to subside.
- Physiotherapy/Occupational Therapy: Specific exercises and stretches guided by a therapist.
- How it helps: Improves nerve gliding, strengthens hand and wrist muscles, and educates on posture and ergonomic techniques to prevent recurrence.
- Surgical Treatment (For Severe CTS or When Conservative Methods Fail):
- Carpal Tunnel Release Surgery: This is the most effective treatment for severe or persistent CTS. The surgeon cuts the transverse carpal ligament, which forms the roof of the carpal tunnel, to relieve pressure on the median nerve.
- How it helps: By cutting the ligament, the carpal tunnel is enlarged, immediately alleviating the compression on the median nerve. This provides significant, often permanent, relief from numbness, tingling, and pain.
- Methods: Can be performed as:
- Open surgery: A small incision (typically 2-3 cm) is made in the palm.
- Endoscopic (keyhole) surgery: One or two smaller incisions are made, and a tiny camera guides the surgeon.
- Recovery: Patients usually experience immediate relief from numbness, though strength and sensation may take weeks to months to fully recover. Hand therapy is often recommended post-surgery.
How Treatment Helps Overall
- Pain Relief: Significantly reduces or eliminates the nagging pain, tingling, and numbness.
- Restored Function: Improves grip strength, dexterity, and sensation, allowing individuals to return to daily activities, hobbies, and work without hindrance.
- Improved Sleep Quality: Alleviates nocturnal symptoms, leading to more restful sleep.
- Prevention of Permanent Nerve Damage: Untreated, severe CTS can lead to irreversible nerve damage, muscle wasting in the hand, and permanent loss of sensation and strength. Treatment prevents this progression.
If you are experiencing symptoms of Carpal Tunnel Syndrome, particularly at night or affecting your daily tasks, consulting with a healthcare professional such as True Physio is the crucial first step towards an accurate diagnosis and effective treatment plan, helping you find lasting relief and regain full use of your hands.
