What Is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is a painful condition of the wrist, hand and fingers resulting from pressure on nerves that run through the wrist. Specifically the nerve that is the source of symptoms is know as the median nerve, in the wrist the median nerve passes over the carpal bones at the front of the wrist (palm side). And the median nerve lies in a tunnel created by these carpal bones at the back and soft tissues at the front of the tunnel (or what could be referred to as the floor and roof of the tunnel respectively). Soft tissue changes within the tunnel can potentially lead to compression on the median nerve, ultimately resulting in symptoms of carpal tunnel syndrome.
Carpal Tunnel Syndrome Symptoms
There are a number of symptoms that are considered common in someone suffering with carpal tunnel syndrome. Individuals may experience a variety of sensations ranging from pain, tingling, or burning sensations, to noticing weakness with their hand. Symptoms may be experienced in one, or both hands at the same time and are often worse at night. Other symptoms can include:
- The sensation of aching in the hand, that may can extend up into the forearm.
- Pain experienced may be just a “normal” pain, or may feel more like a burning sensation, something that is often associated with nerve irritation.
- Individuals may also notice tingling, pins and needles, or numbness usually felt in the thumb, index finger, middle finger, and the “thumb side” of your ring finger. However it should be mentioned here that an individuals nerve innervation to these areas varies from person to person, so this acts as a guide only.
- Weakness gripping, typically weakness associated with the thumbs contribution to gripping activities. A simple functional everyday activity like carrying a heavy bag will frequently be difficult if someone has had symptoms progress to the extent that there is weakness of the thumb muscles.
- In more long standing and severe cases of carpal tunnel the thumb may show evidence of muscle atrophy, visually these changes can be quite obvious in some people who have persisted without medical attention for an extended period.
What Causes Carpal Tunnel Syndrome?
The median nerve ultimately made up of cervical nerve roots joining to form the nerve travels down the arm from the neck making its way to the wrist and as mentioned earlier at the wrist passes through a narrow tunnel created by the bones and connective tissues of the wrist. If space in said tunnel becomes compromised due to bony, or soft tissue changes increasing pressure around the median nerve, this situation may in turn result in pain, tingling, numbness, weakness symptoms… associated with carpal tunnel syndrome.
There are a few medical conditions associated with an increased risk of suffering carpal tunnel syndrome, a few of these conditions include:
Diagnostic And Clinical Testing
Your doctor, or physiotherapist can assess you for signs of carpal tunnel syndrome. Often a clinical diagnosis where a thorough history, combined with a physical examination of the area including using a couple of special objective tests like the Phalen’s and Tinel’s signs are frequently sufficient to confirm a diagnosis without the need for any medical investigations.
Phalen’s test: Phalen’s tests is a test where the wrist is fully bent forward (fingers pointing downwards) and subsequently help in this position for 60 seconds. A positive test sign for carpal tunnel syndrome is considered where sustained positioning here reproduces symptoms.
Tinel’s sign: A positive sign for the Tinel’s test is when tapping over the median nerve at the level of the wrist (on the palm side) again reproduces symptoms including pain, or tingling to shoot from the wrist into the hand, or fingers.
Although not always necessary, the use of investigations can assist with diagnosis. Possible tests your doctor or physiotherapist may refer you for if diagnosis clinically is unclear, of if looking to rule out other causes may include:
Nerve conduction study: Nerve conduction testing is considered to be the definitive test used to diagnose carpal tunnel syndrome.
X-ray’s: An X-ray (or other investigations such as an MRI) may be used to help exclude other possible causes of your symptoms, more so than being used to confirm the diagnosis.
Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on Carpal Tunnel Syndrome should consult his or her general practitioner, physiotherapist or otherwise appropriately skilled practitioner.