Carpal tunnel syndrome is a condition caused by compression of the median nerve as it passes through the wrist. The median nerve runs the whole length of the arm and through part of the wrist called the carpal tunnel.

This nerve supplies the sensation feeling to the thumb and movement of the thumb and first three fingers. If this nerve is compressed, you may feel a tingling sensation, numbness or weakness in the thumb and fingers. Compression of the nerve in the carpal tunnel is usually caused by inflammation in the area.

This can be as a result of things such as:

  • Repetitive movement e.g. typing and use of hand tools (especially if the hands are positioned above the wrist)
  • Hypothyroidism
  • Obesity
  • Rheumatoid arthritis
  • Diabetes
  • Pregnancy

Without treatment, symptoms could come and go at first, but as the condition worsens these may become more constant. If symptoms are left to continue long term without treatment, then the muscles in your hand can begin to waste away (atrophy) and nerve damage may mean that sensation and strength in the hand may never fully return.

Treatment of carpal tunnel syndrome can depend on the cause. If the cause is not mechanical (so caused by conditions such as diabetes) then the underlying condition should be treated by your doctor first.

Once underlying conditions have been treated or ruled out, common treatment for carpal tunnel syndrome is to immobilise the wrist when possible – wearing a brace to prevent wrist movement.

Sometimes, if symptoms are severe, doctors may recommend surgery to cut the ligament that covers the carpal tunnel to decrease the pressure in the area. Evidence also suggests that manual therapy including massage, manipulation and acupuncture can also be useful for both treatment of carpal tunnel syndrome and for the recovery and rehabilitation once symptoms have subsided to prevent recurrence.

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