By Sumaiya Farheen and Andrew Siyabalawatte, May 2023.
On the NHS, doctors treat carpal tunnel syndrome with surgery. First, they inject your wrist with a numbing solution to prevent pain, then make a small cut in your hand. They cut the carpal tunnel inside your wrist so it no longer puts pressure on the nerve.
Carpal Tunnel Syndrome (CTS)
Two conditions are often mistaken for carpal tunnel syndrome (CTS), which occurs when the main nerve running through the wrist becomes compressed, causing pain, numbness, tingling, and weakness in the hand and wrist.
What Jobs Cause Carpal Tunnel Syndrome?
Jobs that require repetitive hand movements can cause carpal tunnel syndrome. Examples include typing, using a computer mouse, or working on an assembly line.
Other jobs involve using vibrating hand tools or prolonged use of hand-held devices, such as smartphones. These activities can also increase the risk of developing carpal tunnel syndrome.
Professions at higher risk include computer programmers, cashiers, hairstylists, musicians, carpenters, and mechanics.
Can Carpal Tunnel Syndrome Start at the Neck and Armpit?
Nerves exiting the neck and armpit can become compressed, which can lead to CTS. When compression occurs at more than one location, such as the neck and wrist, doctors call it double crush syndrome.
How Can This Happen?
The median nerve is the primary nerve affected in carpal tunnel syndrome. It originates from a group of nerves called the brachial plexus.
The brachial plexus starts in the neck and axilla (armpit). It travels through the forearm, 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, repetitive hand and wrist movements common in certain occupations often cause CTS, so it can be considered an occupational disease.
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?
Two conditions that are often misdiagnosed as carpal tunnel syndrome include 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 often these two conditions that are often misdiagnosed as carpal tunnel syndrome
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 is the Phalen and Reverse Phalen test. In this test, patients flex their hands for at least one minute. 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 called ‘Nerve Flossing’ effectively mobilises irritated nerves and tendons. 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.
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.
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.