What is Carpal Tunnel Syndrome

Figure 1: Carpal Tunnel Syndrome - Physio Frenchs Forest, Physio Macquarie Park

Carpal tunnel syndrome (CTS) is a condition involving the median nerve being compressed as it runs through the wrist. The compression of the nerve results in pain, tingling, pins + needles into the hand, and a loss of grip strength. The change is sensation is often in the thumb, index and middle finger.

 

What causes carpal tunnel syndrome?

  • Over-use of the wrist and fingers – e.g. gripping a power tool or paint brush

  • Previous wrist fracture

  • Pregnancy

  • Diabetes

  • Arthritis

 

How do we assess carpal tunnel syndrome?

When assessing for CTS a nerve conduction is used to assess how efficient the messages are when transferred from one end of the nerve to the other. The results will show the stages of the condition and if surgery is indicated or not.

The other tests a physiotherapist can perform are compression tests of the median nerve. This can be performed by a phalen or reverse phalen test, or by simply compressing the nerve with one finger. The physiotherapist will consider these tests positive for carpal tunnel syndrome if their is reproduction of your symptoms.

 

Image 2 - Carpal Tunnel Syndrome - SIM Physio

What is the treatment of carpal tunnel syndrome?

  • Take regular breaks when loading the hand and wrist

  • Avoid activities that will require strong gripping

  • Apply cold pack to reduce any swelling

  • Manual therapy (massage) of the thenar and wrist flexor muscles to help reduce any compression on the nerve

  • Night splinting (possibly day as well) - This is the most effective non-surgical treatment. The splint prevents the wrist from flexing and extending, therefore opening up the tunnel of the carpal tunnel. The splint should be applied from a physiotherapist to ensure it is the correct splint.

 

When is surgery required for carpal tunnel syndrome?

  • 3-6 Months of failed conservative management

  • The symptoms have been chronic (years)

  • Severe loss of strength and sensation in the fingers

  • Severe nerve conduction findings

  • Tumours or growths that need removing

See our expert Physiotherapy team at Frenchs Forest and Macquarie Park!

Reece Jonesfrenchs forest, macquarie park, physio, physiotherapy, hand therapy, carpal tunnel syndrome, wrist splint