Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment condition in the world, which can cause pain, numbness, and tingling in the wrist and fingers area. CTS is particularly prevalent in women aged 45-65, occurring approximately four times more often in women than in men. (1,2,3) The condition is usually idiopathic, meaning we generally do not know exactly what causes CTS. Risk factors include wrist overuse, exposure to vibration, diabetes, obesity, and pregnancy. (1,2,3) In this blog post, we will take a closer look at what carpal tunnel syndrome is, its symptoms, causes, and treatment options.
What is it?
Carpal tunnel syndrome, also known as carpal canal syndrome or median nerve entrapment syndrome, is a condition caused by compression of the median nerve in the carpal tunnel. The carpal tunnel is a narrow passageway located on the inner side of the wrist, surrounded by bones and tendons. The median nerve passes through this tunnel, enabling sensory perception and muscle control signals to the hand. (1,3)
In the initial stage, individuals typically wake up during sleep with numbness and pain in the wrist. The pain can be mild or severe and may extend to the shoulder. Shaking the hand usually relieves the pain fairly quickly. In the second stage of pain, numbness, and/or tingling also occurs during the day, usually during repetitive wrist movements. Additionally, clumsiness in the hand and fingers may occur, and items such as a coffee cup or pen may accidentally drop due to impaired fine motor skills. In the third stage, there may be atrophy of the thumb muscles, indicating muscle wasting. (3)
Symptoms
Pain and tingling: Pain and tingling are common symptoms of carpal tunnel syndrome. These sensations can extend to the area of the hand and fingers, especially around the thumb, index finger, middle finger, and ring finger. Radiating pain may extend up to the shoulder. (1,3,4)
Muscle weakness: Patients may experience weakness in the hand and have difficulty holding objects, opening jars, or performing other precise finger movements. (1,3,4)
Numbness in the hand and fingers: Numbness in the hand may occur, especially at night or after prolonged wrist exertion. (1,3,4)
Decreased sensitivity in the fingers: Compression of the median nerve can lead to decreased sensitivity in the fingers and difficulty distinguishing between touch and temperature differences. (1,3,4)
Causes
The exact cause of carpal tunnel syndrome is not always clear, but it can be due to several factors, including:
Anatomy of the carpal tunnel: Some individuals naturally have a narrower carpal tunnel, which increases the risk of compression of the median nerve. (3)
Repetitive strain: Jobs that require repetitive wrist movements can increase the risk of developing carpal tunnel syndrome. This applies particularly to workers who handle computers or perform repetitive hand movements. (1,3,4)
Pregnancy: During pregnancy, the body undergoes many changes, and as a result, pressure may increase in the carpal tunnel, becoming a risk factor for the development of the syndrome. (1,2)
Management
The treatment of carpal tunnel syndrome depends on the severity and duration of symptoms. Treatment options may include:
Patient education: Initially, it is often important to avoid repetitive movements and activities that may exacerbate symptoms. (2)
Wrist splints: A wrist splint that supports the wrist in the correct position can help alleviate symptoms, especially at night. (2)
Exercise therapy: Exercise therapy guided by a physiotherapist/osteopath can help strengthen hand muscles and improve symptoms. Massage and joint treatments may also be tried for pain relief. (2)
Corticosteroid injections: Some patients may benefit from corticosteroid injections for pain relief. (2)
Surgical treatment: In severe cases, surgical treatment in the form of carpal tunnel release surgery may be considered. (1,2)
It is important to remember that carpal tunnel syndrome is usually very treatable, and most patients experience significant relief with the right treatment. If you have symptoms suggestive of carpal tunnel syndrome, contact a competent professional in the field.
Joonas Virtanen
Osteopath, sports massage therapist & physical trainer
Ilari Keckman
Osteopath, sports massage therapist & educator
References
4. https://www.ncbi.nlm.nih.gov/books/NBK448179/
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