What is Carpal Tunnel?
The carpal tunnel is a small tunnel in your wrist that contains nine finger tendons and the median nerve. Wrist bones form the floor of the tunnel and a thick ligament covers the top. The size and shape of the tunnel is not flexible but is a rigid structure. So, carpal tunnel is not a condition, it's a part of everyone's anatomy.
What is Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome is an overuse injury caused by repetitive movements of the hand and wrist. With overuse, the tendons or their linings become inflamed or swollen, taking up more space in the tunnel. This places pressure on the median nerve, resulting in pain and pins and needles in the thumb, index, middle, and ring fingers.
What Causes Carpal Tunnel Syndrome?
Carpal tunnel syndrome is widely known as a repetitive strain disorder because it is most often caused by repetitive movements of the wrist and hand. Sustained gripping, like when using tools, or sustained pinching, like when knitting can also contribute. Other causes include external pressure to the wrist, for example, poor form at the computer, and exposure to vibration, like when using machinery. Trauma, such as a broken wrist, and systemic conditions, like diabetes or rheumatoid arthritis, can be also associated with carpal tunnel syndrome. Due to increased fluid volume and hormonal changes, the condition can also occur during pregnancy.
Symptoms of Carpal Tunnel Syndrome:
One of the first signs of carpal tunnel syndrome that people notice is their hand falling asleep at night. As it progresses, you may notice pins and needles during the day, especially with repetitive activities. Pain is usually localized to the wrist and hand but may radiate to the forearm and shoulder. Dropping objects can be a common occurrence, as well as feeling uncoordinated. Further progression can lead to weakness of the hand, especially grip and pinch, and obvious wasting of the thumb muscles in the palm.
Carpal Tunnel Treatment Myths:
- Carpal Tunnel Syndrome will go away on it's own.
For some, carpal tunnel syndrome may resolve without treatment if the aggravating activity was temporary. Unfortunately, this is not the case for most people. Because it is a progressive condition, it's best to seek treatment in the early stages. Non-surgical treatment, including Treat Yourself Therapy's video, is most successful for people with mild to moderate severity, as determined by a clinical diagnosis or a nerve conduction study. If allowed to progress to moderate to severe levels, non-surgical treatment may not be effective. When the syndrome is ignored, it can progress to the point of permanent nerve damage.
- Squeezing a ball will cure carpal tunnel syndrome.
Squeezing a ball is a good example of a repetitive, resistive activity that you should avoid when treating carpal tunnel syndrome, because it can make your symptoms worse. In the early stages, true muscle weakness is not a factor. Weakness can be attributed to pain during the activity. With treatment, as pressure on the nerve is reduced, grip and pinch strength will return without strengthening exercises. In the later stages, when true muscle weakness is evident by wasting of the thumb muscles, strengthening will only increase symptoms and place more pressure on the nerve. Safe exercises that are appropriate for rehabbing carpal tunnel syndrome are covered in depth in the video. Watch one of the exercises in the video clip on the free tip tab.
- There is a quick fix for carpal tunnel syndrome.
As hand therapy specialists who have years of clinical experience treating people with carpal tunnel syndrome, we know recovery takes time and patience. There is no quick fix or one-step cure. The video uses a multi step process to educate you on exercises as well as identifying and modifying the factors contributing to your symptoms so you can begin to recover.
What is the Purpose of a Carpal Tunnel Brace?
The purpose of a carpal tunnel brace or splint is to keep the wrist in a straight position, which places the least amount of tension on the median nerve. Wearing a brace acts as a good reminder to limit repetitive wrist motion. To prevent wrist stiffness, be sure to remove the brace or splint every hour or so to move your wrist. There are many commercial brace options for carpal tunnel syndrome. Detailed suggestions of when it is appropriate to wear a wrist splint and how to get a proper fit are covered in the video.
What is Pronator Syndrome?
Pronator syndrome can easily be confused with carpal tunnel syndrome but is less common. For this syndrome, the median nerve is compressed, but not at the level of the wrist. The compression occurs higher up on the forearm. If your doctor has diagnosed you with pronator syndrome, Treat Yourself Therapy's video for carpal tunnel syndrome has a separate section that focuses on this condition.