Carpal Tunnel Syndrome is a fairly common condition that affects the hand and wrist. It is the largest cause of occupational illness. It is a condition that commonly affects individuals who work at computers, typists, construction workers or anything that involves repetitive stress to the wrist. But are these occupations causes of the problem? Not necessarily. If so, then everyone that involved themselves in these professions would be affected, but they aren’t. This illustrates that certain people are predisposed to developing the condition e.g. those with small bone structures.
The “carpal tunnel” is a passageway formed by the bones and muscles of the wrist. The median nerve, which passes through the middle of the forearm, enters the hand through the wrist joint along with all the flexor tendons to the fingers.
This condition is characterized by pain and numbness in the hands/wrist and in severe conditions, weakness and decrease in fine motor skills of the hands/fingers. This is caused when inflamed and swollen tendons in the wrist compress the median nerve. Because the nerve is softer than the tendons, it is subjected to considerable pressure causing numbness, and/or pain, tingling, weakness, temperature changes of hands and fingers and loss of function. Symptoms often strike at night and awaken the sufferer.
In the early stages of the condition, swelling and irritation begin due to repetitive hand use in a bent wrist position. It may also happen after repetitive activity or repeated forceful movements. At this point, tingling and numbness in fingers and thumb may begin with a return to normal feeling after a rest period.
In the intermediate stage, increased swelling causes constant pressure on the nerve. Pain and tingling can be present even when the hand is at rest. Scar tissue is beginning to form around the irritated nerve and tendons. Pain may now radiate into the forearm, you may wake up at night with tingling fingers and there may be loss of coordination and increasing clumsiness.
At the advanced stage continued, chronic swelling and scarring cause permanent damage to the blood vessels, nerve and tendons in the carpal tunnel. Because of nerve damage, grip strength is lost and coordination is greatly reduced. At this point, there is an advanced loss of hand function. It now becomes difficult to hold tools or objects and an inability to grip or use hand for more than a few seconds or minutes. There is also a highly uncomfortable combination of numbness, tingling, pain and thickness.
This condition does not have to become debilitating if you are aware of the early symptoms and potential risk factors at work and home along with high risk activities e.g. heavy use of hand tools, repetitive keyboarding, sewing, assembling and cutting.
You must take responsibility for your own health. Learn how to use your hands to avoid injury. Exercise and stretch to maintain function, strength, and full motion. Take rest breaks when doing repetitive work. If your fingers tingle, STOP! Don’t push early signs and symptoms into a bigger problem. Seek attention from a medical professional that understands CTS. Your physical therapist can perform a functional evaluation to determine the problems of upper extremity overuse. If CTS symptoms are present, the therapist will begin to make recommendations to reduce CTS.
If any of these symptoms are present with you or if you have questions or concerns regarding this condition then feel free to contact us at COAST Physical Therapy Services at 464-1212 and we would be glad to answer any of your questions.