Conquering Carpal Tunnel Syndrome: A Physio Approach to Relief and Recovery
Carpal Tunnel Syndrome (CTS) is a common and often debilitating condition that affects millions worldwide. Characterised by pain, tingling, and numbness in the fingers and hand, CTS can significantly impact daily activities and overall quality of life.
Carpal Tunnel Syndrome (CTS) is a common and often debilitating condition that affects millions worldwide. Characterised by pain, tingling, and numbness in the fingers and hand, CTS can significantly impact daily activities and overall quality of life. Whether you’re an office worker, an avid gardener, or a new mum, understanding and addressing CTS can help you regain control and comfort.
Here, we’ll explore what CTS is, how to recognise it, and the physiotherapy techniques that can alleviate its symptoms and promote recovery.
Understanding Carpal Tunnel Syndrome
CTS occurs when the median nerve, which runs from the forearm into the palm, is compressed at the wrist. This nerve compression can result from various factors, including:
Overloading the wrist and/or fingers
Previous wrist fracture or injury
Pregnancy
Diabetes
Arthritis
With a prevalence of 3-4%, CTS is most common among individuals aged 40-60 and affects women ten times more frequently than men. Certain occupations and repetitive hand movements often exacerbate the condition, I’m looking at you carpenters!!
Identifying Carpal Tunnel Syndrome
Diagnosing CTS involves a combination of patient history, clinical symptoms, and diagnostic tests. Key assessment tools include:
History and Symptoms: Patients typically report pain, tingling, and numbness in the thumb, index, middle, and ring fingers. Symptoms may worsen at night and can radiate up the forearm.
Physical Examination: A comprehensive hand and wrist assessment is performed, alongside, nerve provocation and sensitivity testing. Your physio will also screen neck, thoracic, and shoulder to rule out possible contributing factors.
Boston Carpal Tunnel Questionnaire (BCTQ): Assesses symptom severity and functional status.
Electroneurography (ENG): The most accurate diagnostic test, measuring nerve conduction and identifying disease stage.
Ultrasound Imaging: A cost-effective and rapid diagnostic tool, though less sensitive than ENG.
Effective Physiotherapy Treatments for CTS
Physiotherapy offers a range of non-invasive treatments that can effectively reduce CTS symptoms and enhance hand function. Here are some of the most recommended strategies:
1. Night Splinting
Wearing a wrist splint at night for ten weeks helps keep the wrist in a neutral position, reducing pressure on the median nerve. This simple intervention can significantly alleviate nighttime symptoms and improve sleep quality. Brace selection is crucial, as to not further compress the nerve, your physio will guide you in this process.
2. Nerve Gliding Exercises
Nerve gliding exercises, or neuromobilization, promote the movement of the median nerve through the carpal tunnel, preventing adhesion and reducing inflammation. These exercises can restore nerve function and alleviate symptoms.
3. Activity Modification
Modifying daily activities to reduce wrist strain is essential. This includes taking frequent breaks, adjusting ergonomic setups, and avoiding repetitive movements that exacerbate symptoms. Occupation-specific interventions are also critical, such as vibration reduction hammers, and tools.
4. Manual Therapy
Manual therapy techniques, such as soft tissue mobilization and joint manipulation, can relieve pain and improve wrist function. These techniques address muscle imbalances and reduce tissue tension around the median nerve.
Supplementary Treatments and Considerations
Kinesiotaping: Applying kinesiotape can support the wrist and reduce strain during activities, often used in conjunction with exercise therapy.
Yoga-Based Interventions: Stretching, strengthening, and relaxation techniques from yoga can improve posture, reduce pressure on the wrist, and enhance overall nerve function.
Surgical Intervention
In severe cases or when conservative treatments fail, surgery may be necessary. Carpal tunnel release surgery involves cutting the transverse carpal ligament to relieve pressure on the median nerve. Post-operative rehabilitation focuses on restoring strength and mobility while minimizing scar tissue formation.
Conclusion
Carpal Tunnel Syndrome doesn’t have to be a life sentence of discomfort and limitation. Through targeted physiotherapy interventions, individuals can manage symptoms effectively and regain hand function. If you suspect you have CTS or need professional guidance, consulting with a physiotherapist is a crucial step towards recovery. Embrace these strategies, and reclaim the comfort and dexterity in your hands.
Feel free to reach out with any questions or to schedule a consultation. Your journey to recovery starts here!
Written by Michelle O’Leary
Principal Physio & Director of Fleurieu Coast Physio
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