Carpal Tunnel Syndrome

The carpal tunnel is a small space in the palmar side of the wrist. It is surrounded by bones at the bottom, and soft tissues at the top. Tendons and nerves run through here, but may be compressed or irritated. This is carpal tunnel syndrome (CTS)

Symptoms of Carpal Tunnel Syndrome

The nerve that is compressed is usually the median nerve. This runs into the palm of the hand, supplying the thumb and first two or three fingers. It is in this area that you would experience your symptoms.

Common symptoms can be:

• pins and needles
• numbness
• weakness
• sharp or shooting pains

Causes of Carpal Tunnel Syndrome

Some cases of CTS are caused by a problem with the nerves. This could be as simple as a vitamin deficiency, or a complication of diabetes. If you find that your symptoms are relatively widespread, you might want to consult your GP to rule out anything systemic.

Symptoms can also be a result of compression of the nerve. Compression can be caused by something within the tunnel, or outside of it. Nerves can be compressed further up the arm or even in the neck, although the affected area will likely be slightly different if this is the case.

Internal Causes of Compression

Often the cause is a build up of pressure within the tunnel. This can be caused by fluid retention or local swelling from an inflamed tendon. Fluid retention can come with pregnancy, or be caused by some medications or health conditions. If you find you have a lot of general swelling and the skin “dents” without popping straight back when you press it, you should speak to your doctor.

Medications that can cause fluid retention include:

• statins
• blood pressure medications
• some steroids
• non-steroidal anti inflammatories (NSAIDs)

External Causes of Compression

Direct pressure on the wrist, such as from resting on a desk, can cause the same symptoms. Mouse mats with a cushion that are marketed as ergonomic can actually encourage excess pressure on the wrist itself. Your osteopath can give you advice for better ergonomics if you feel you need to rest your wrist on your desk. Ideally, your seat should be high enough that your shoulders are relaxed while your hands comfortably reach the table. This can be difficult when working from home, but there may be some changes that could benefit you.

Osteopathic Treatment

Your osteopath will want to treat both the cause (where applicable) and the symptoms of your CTS. One of the simplest scenarios is where muscles are the cause of compression. Muscles that act on the wrist are located closer to the elbow, and some of their tendons travel through the tunnel. When overworked, they can irritate structures in the tunnel, so we want to calm them down and prevent future episodes. The original cause may be from a change of demand. Starting a new activity or suddenly increasing frequency or intensity can upset the muscle. Your osteopath will work to relax the muscle, as well as advising you on a safer return to exercise.

Book an appointment in Farnborough for your hand pain here.