Carpal tunnel syndrome- what is it and what can be done to help the condition

The carpal tunnel is a narrow passage formed by small bones in your wrist (below) and the tough band of tissues that control the tendons which move your fingers (ontop). In this condition there is compression of one of the nerves (the median nerve) that controls sensation and movement in the hand. The exact reason as to why the nerve becomes compressed is not known, but there are some things that make you more prone. These include repetitive work with the hands, rheumatoid arthritis, pregnancy, diabetes, hypothyroidism, obesity, injuries to the wrist and a history of carpal tunnel. There is also a slight increase in prevalence if other members of your family have also suffered with the condition, although it is not understood exactly why this is. Jobs which involve a lot of gripping, vibrational tool use and repeated wrist movements like manual labouring, assembly packing and tool users are most prone.

Commonly symptoms of carpal tunnel tend to come on gradually, usually starting at night or 1st thing in the morning. The main symptoms tend to be pain, numbness and tingling, especially of the thumb, index, middle finger and ½ of the ring finger. These feelings can occur in one or both hands.

There may also be more distant symptoms like aching and pain in the forearm and arm, alongside weakness and wasting of the muscles at the base of the thumb. This can in turn cause weakness and dexterity problems with your grip and hand movements. Symptoms tend to be worse after the hand is used and especially with repetitive movements.

Diagnosing carpal tunnel may consist of performing tests such as simple orthopaedic tests to ascertain whether symptoms can be reproduced, blood tests, nerve conduction tests and ultrasound scanning.

Treatment

This involves assessment of the most likely causal factors and addressing these. This may mean changes to your work pattern, splints and supports and manual therapy like osteopathy and massage. Steroid injections and surgery are also options of treatment, if symptoms do not resolve.

One of the main roles of a manual therapist, such as an osteopath, is to examine the exact cause of your symptoms through careful case history and examination. Similar symptoms to carpal tunnel may arise for many other reasons, such as nerve irritation from the neck, so this needs to be assessed and then a treatment or management plan can be made. Early intervention is the key to a faster recovery and better prognosis.