By Sumaiya Farheen and Andrew Siyabalawatte, May 2023.
On the NHS, carpal tunnel syndrome is treated with surgery. Initially, an injection numbs your wrist so you do not feel pain and then a small cut is made in your hand. The carpal tunnel inside your wrist is cut so it no longer puts pressure on the nerve.
Carpal Tunnel Syndrome (CTS)
Carpal tunnel syndrome (CTS) is a condition that occurs when the main nerve that runs through the wrist becomes compressed or squeezed, causing pain, numbness, tingling, and weakness in the hand and wrist.
What Jobs Cause Carpal Tunnel Syndrome?
Jobs that require repetitive hand movements, such as typing, using a computer mouse, or assembly line work, can cause carpal tunnel syndrome.
Other jobs that involve using vibrating hand tools or prolonged use of hand-held devices such as smartphones can also increase the risk of developing carpal tunnel syndrome.
Some professions that are at higher risk of developing carpal tunnel syndrome include computer programmers, cashiers, hairstylists, musicians, carpenters, and mechanics.
Can Carpal Tunnel Syndrome Start at the Neck and Armpit?
It is indeed possible CTS can become the byproduct of nerves exiting at certain levels of the neck and the armpit being compressed. When the compression is at more than one location i.e. neck and wrist, it is known as a double crush syndrome.
How Can This Happen?
The median nerve, which is the primary nerve affected in carpal tunnel syndrome, originates from a bunch of nerves called the brachial plexus.
The brachial plexus originates from the neck and axilla (armpit) and travels from the forearm through the wrist and into the hand. When this nerve is compressed or irritated in the carpal tunnel, it can cause pain, numbness, and tingling in the hand and fingers.
Is CTS an Occupational Disease?
Yes, (CTS) can be considered an occupational disease, as it is commonly caused by repetitive hand and wrist movements that are often associated with certain occupations.
Workers in industries such as manufacturing, healthcare, and retail are particularly susceptible. However, it’s important to note that there are other factors also such as medical conditions and genetics that contributes to its development.
What will happen if CTS is left untreated?
If left untreated, (CTS) can lead to a number of complications and long-term effects on the affected hand and wrist. Some of the potential consequences are-
Pain and discomfort
Carpal tunnel syndrome can cause persistent pain, numbness, and tingling sensations in the hand and wrist.
Weakness
If carpal tunnel syndrome is not treated, it can lead to weakness and a loss of grip strength in the affected hand.
Reduced range of motion
CTS can cause stiffness and reduced range of motion in the wrist and hand. This can make it difficult to perform everyday activities such as typing, writing, and even simple tasks like holding a cup.
Permanent nerve damage
In severe cases of CTS, prolonged compression of the median nerve can cause permanent nerve damage. This can result in chronic pain and disability.
Reduced quality of life
The symptoms of carpal tunnel syndrome can significantly impact a person’s quality of life, leading to difficulty sleeping, anxiety, and depression.
What Conditions Are Often Misdiagnosed as Carpal Tunnel Syndrome?
Tendonitis and Rheumatoid Arthritis
Tendonitis of the wrist occurs when the muscles of the forearm that attach into the wrist become inflamed. Inflammation of the tendons in the wrist can result in pain, warmth and redness in and around the hand.
With Rheumatoid arthritis, in addition to the symptoms above swelling in the wrist and fingers may also be present.
Carpal Tunnel Syndrome Test
A common test for Carpal Tunnel Syndrome, known as the phalens and reverse phalens, where the hands are flexed for a minimum time of 1 min. This movement entraps the median nerve, the primary nerve affected in carpal tunnel syndrome.
A positive test is one that reproduces the symptoms (pain, tingling, numbness) of this condition.
Carpal Tunnel Syndrome and Pregnancy
Carpal tunnel syndrome can occur as a result of you having more fluid in the body during pregnancy, which can result in a build up of pressure on the nerves in the hand and wrist.
Nerve Gliding Exercises for Carpal Tunnel Syndrome
Nerve gliding also known “Nerve Flossing” is an exercise effective at mobilising nerves and tendons that are irritated. This stretch can improve range of motion and relieve pain especially when combined with other treatments.
How Do We Help Treat CTS
Osteopathy is a form of manual therapy that involves gentle manipulation of the body’s musculoskeletal system to improve its function. This study, found osteopathic treatment to be effective in reducing pain and improving hand function in patients with CTS.
Dry needling is a technique in which fine needles are inserted into trigger points located in muscles, to relieve pain and improve range of motion. This study, concluded dry needling to be an effective alternative treatment for CTS.
Shockwave therapy is a non-invasive treatment that uses high-energy sound waves to stimulate the body’s natural healing processes. A study in 2020, found shockwave therapy to be an effective alternative treatment for CTS.
Low-level laser therapy (LLLT) has been shown to be an effective treatment for reducing pain and inflammation in various musculoskeletal conditions, including carpal tunnel syndrome (CTS).
Massage is a manual therapy that involves manipulation of soft tissues to relieve pain and improve function. It is a non-invasive and safe treatment option that has shown promising results in reducing pain and improving hand function in patients with CTS .
A study in 2008 identified that those with CTS treated with massage therapy, had resulted in an improvement of subjective measures associated with CTS.
Do you have pain in your hand? Book a session with us to find out why. We can help you correctly identify the cause and help provide a solution.