What is Carpal tunnel syndrome

Carpal tunnel syndrome occurs when the median nerve passing through the wrist is pinched or compressed. The carpal tunnel is a narrow passageway connecting the arm and hand in which nine tendons and the median nerve travel through. The carpal tunnel is comprised of the carpal bones and transverse carpal ligament.

Carpal tunnel syndrome is often caused by a combination of events or situations. Some people have smaller carpal tunnels and are therefore more likely to have pressure on the median nerve. Injury to the wrist can cause swelling in the carpal tunnel, resulting in compression of the nerve. Other factors such as arthritis, thyroid disease, diabetes, pregnancy, repetitive use of vibratory tools or prolonged bending of the wrist can all result in compression and irritation of the median nerve, causing carpal tunnel syndrome.

What do I feel?

  • Waking with tingling sensation and numbness in the palm of the hand at night – particularly in the thumb, index, middle and part of the ring finger
  • Aches or sharp pains in the hand, wrist, or forearm
  • Weakness with grip and pinch activities such as opening jars
  • Clumsiness and reduced coordination of the hand resulting in dropping items
  • Difficulty or pain when holding a phone or book, gripping a steering wheel, or buttoning a shirt

What can I do?

  • Frequent rest breaks and avoidance of aggravating activities
  • Cold packs to reduce swelling
  • Wrist splinting – particularly at night
  • Avoid sleeping on your hands
  • This condition is very common in pregnancy and usually resolves after breastfeeding
  • Engage with a hand therapist for guidance and advice

Who should I see?

The management of carpal tunnel syndrome generally consists of approx. four weeks of night-time wrist splinting and guidance with lifestyle changes associated with the condition. A hand therapist can provide you with education, a plan for management, splints and exercises. This is often a good place to start. Referral for Ultrasound scan and to a specialist for further investigation and treatment advice can be made if necessary.