Carpal tunnel syndrome is caused by compression of the median nerve in the carpal tunnel of the wrist. The carpal tunnel is a small passageway formed by the wrist bones and ligaments. The tunnel protects the finger flexor tendons and the median nerve that pass through it.

Risk factors:
• Injury: Wrist fractures or dislocations may decrease the size of the tunnel
• Gender: Females are more likely to get carpal tunnel, possibly from a smaller size of the tunnel
• Alteration in body fluid: Water retention, common in menopause and pregnancy, may increase the pressure within the carpal tunnel irritating the nerve
• Workplace factors: Working with vibrating tools, on an assembly line, or with a computer for extended periods of time requires prolonged and repetitive flexion of the wrist which may increase the pressure in the carpal tunnel, irritating the nerve.

Common symptoms:
• Numbness and tingling sensations on the palm of the hand
• Symptoms worse at night
• Driving, typing, holding items exacerbate symptoms
• Shaking out the hand relieves symptoms
• Hand weakness/clumsiness (difficulty with grip, dropping keys, etc.)

Tips:
• Take frequent breaks when performing activities that require prolonged wrist flexion such as typing
• Avoid sleeping on your hands
• Wear a night splint to keep your wrists in a neutral position while you sleep

 

Treatment:
• Nonsurgical
o Night splint: Wearing a splint with the wrist in neutral to 15degrees of extension maintains the carpal tunnel in the most open position to decrease pressure on the nerve
o Ergonomic education: Workstations should be altered in order to reduce repetitive postures and maintain the wrist, elbow, head, and neck in neutral positions
o Tendon glides: Isolated tendon glides should be performed (see exercise section)
o Anti-inflammatories: Corticosteroids may be prescribed to decrease the inflammation
• Surgical
o If symptoms continue to be severe and persistent after trying nonsurgical methods, surgery may be indicated to relieve pressure in the carpal tunnel by releasing the ligament over the tunnel.

Exercises
Carpal tunnel exercises: Flexor tendon gliding: Perform each position for 5 seconds, 5 repetitions, 5 times every day.

 

 

 

 

 

 

 

If you are experiencing symptoms of carpal tunnel, schedule an appointment with a physical therapist in your area.  A referral is not needed for treatment in Ohio. Click here to search for a physical therapist in your area.

References:

https://www.ktph.com.sg

http://goo.gl/hCtBRu

 

Becky Parr PT, DPT, CAFS is a physical therapist at Avida Physical Therapy. She graduated from the University of Dayton with her Doctorate in Physical Therapy. She has received advanced training in biomechanics from the Gray Institute and specializes in orthopedic rehabilitation with a special interest in lower extremity conditions.