CARPAL TUNNEL SYNDROME

Carpal tunnel syndrome (CTS) is a common condition that occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes compressed or squeezed at the wrist. This compression can lead to pain, numbness, tingling and weakness in the hand and fingers. CTS is often associated with repetitive motions of the hand and wrist, such as typing, using a computer mouse, repetitive assembly line work or due to fluid retention related to pregnancy.

Understanding Carpal Tunnel Syndrome:

1. Anatomy: The carpal tunnel is a narrow passageway in the wrist formed by bones and ligaments. The median nerve and tendons that control finger movement pass through this tunnel. When the tunnel becomes narrowed or inflamed, it can compress the median nerve, leading to symptoms of CTS.

2. Symptoms:

• Numbness, tingling, or burning sensation in the thumb, index finger, middle finger and half of the ring finger.

• Pain or discomfort in the hand or wrist that may radiate up the forearm.

• Weakness or clumsiness in the hand, making it difficult to perform fine motor tasks such as gripping objects or buttoning clothes.

1. Risk Factors:

• Repetitive hand or wrist movements.

• Prolonged or awkward wrist positions (e.g. typing with improper ergonomics).

• Pregnancy, which can lead to fluid retention and swelling.

• Diabetes, arthritis or thyroid disorders that affect nerve function.

How Physiotherapy Can Help with Carpal Tunnel Syndrome:

Physiotherapy plays a vital role in the management of carpal tunnel syndrome by addressing symptoms, reducing nerve compression and improving wrist and hand function. Here are ways physiotherapy can help:

1. Education and Ergonomic Advice: Physiotherapists educate patients about proper ergonomics and wrist positioning to reduce strain on the median nerve. This includes recommendations for workstation setup, keyboard and mouse usage and posture modifications.

2. Splinting: Customised wrist splints or braces are often prescribed to keep the wrist in a neutral position, relieving pressure on the median nerve during activities and while sleeping. Splinting can help reduce symptoms of numbness and tingling.

3. Manual Therapy: Techniques such as soft tissue mobilisation, joint mobilisations and nerve gliding exercises are used to improve wrist mobility, reduce inflammation and alleviate nerve compression around the carpal tunnel.

4. Stretching and Strengthening Exercises: Physiotherapists prescribe specific exercises to stretch tight muscles and tendons in the wrist and forearm as well as strengthen muscles that support the wrist joint. This helps improve flexibility and reduce pressure on the median nerve.

5. Modalities: Therapeutic modalities such as ultrasound, electrical stimulation or cold therapy may be used to reduce pain, inflammation and promote tissue healing in the wrist and hand.

6. Activity Modification: Physiotherapists work with patients to modify activities that aggravate symptoms of CTS, providing alternative techniques or tools to reduce strain on the wrist and hand.

7. Functional Rehabilitation: Focus on restoring functional activities such as grasping, gripping and fine motor tasks to improve independence and quality of life.

Benefits of Physiotherapy for Carpal Tunnel Syndrome:

• Conservative Management: Physiotherapy offers non-invasive treatment options to manage symptoms and improve function without surgery.

• Individualised Care: Tailored treatment plans based on the severity of symptoms, functional limitations and patient goals.

• Preventive Strategies: Education on ergonomic principles and activity modification to prevent recurrence and promote long-term wrist health.

In summary, physiotherapy plays a crucial role in the management of carpal tunnel syndrome by providing comprehensive, personalised treatments aimed at reducing symptoms, improving wrist function and enhancing overall quality of life for individuals affected by this condition. Early intervention with physiotherapy can lead to effective symptom relief and functional improvement, helping patients to regain optimal hand and wrist function.