Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

Tingling and pain down the arm and into the wrist / fingers are symptoms of Carpal Tunnel Syndrome.

Therefore…….

All tingling and pain down the arm into the wrist / fingers is Carpal Tunnel Syndrome?

True or False?

What is it?

Carpal Tunnel Syndrome (CTS) is the most commonly known, diagnosed and disabling condition of the upper extremities. It accounts for about 90% of all entrapment neuropathies.

True carpal tunnel syndrome is the compression of the median nerve as it goes through the carpal tunnel. 

Median nerve????? Carpal tunnel?????

The median nerve is one of five main nerves originating from the brachial plexus (nerve bundle responsible for skin and muscular innervation of the entire upper limb) that travels down the arm, it is the only nerve to travel through the carpal tunnel. The median nerve innervates the thumb, first, second and lateral side of the third finger.

The carpal tunnel is found at the base of the palm. On one side eight carpal bones and on the other a tough fibrous roof called the transverse carpal ligament. It houses the wrist flexor tendons and the median nerve so it is pretty tightly packed. Inflammation of these tendons puts pressure on the nerve which has nowhere to go so gets compressed, which impairs function.

The carpal tunnel

Do I have it?

Symptoms of Carpal Tunnel Syndrome include:

  • Hand and wrist pain
  • Parasthesias (strange sensations e.g. tingling) into the thumb, first, second and lateral side of the third finger
  • Burning sensation
  • Loss of grip strength
  • Pain is often worse at night
  • Pain may travel up the arm and even into the shoulder
  • Pain is worse after repetitive movements

If you think you have CTS go to your GP for diagnosis.

Phalen’s Test

An orthopaedic test for CTS that can be used at home.  

Carpal Tunnel Syndrome

  • Push the dorsal (back) surfaces of hands together so both wrists are in flexion and hold for 30-60 seconds.
  • If symptoms (burning, tingling, numbness) occur / increase the test is positive for Carpal Tunnel Syndrome.
  • If symptoms don’t become noticeable then the nerve entrapment is potential further up the chain (chest, neck).

People most at risk of developing Carpal Tunnel Syndrome:

  • Family history of CTS
  • Pregnant women – normally subsides within 3 months of baby being born
  • Wrist injuries / trauma
  • Underlying health conditions such as diabetes and rheumatoid arthritis
  • Strenuous, repetitive work

What else could it be?

  • Thoracic Outlet (Inlet) Syndrome
  • Pectoralis Minor Syndrome
  • Trigger Points – sore spots in muscle / fascial tissue that refer pain in a predictable pattern

Trigger Points

Scalenes

  • Muscles on the lateral side of the neck

Trigger point pain pattern scalenes

 

Pectoralis Minor

  • Muscles in the chest, deep to pectoralis major

Trigger points in pectoralis minor have similar symptoms to Carpal Tunnel Syndrome, however the numbness and tingling tends to travel down the medial side (pinky finger side) of the arm and into the ring and pinky fingers (CT = thumb, first, second and lateral side of third finger).

Trigger point pain pattern for pectoralis minor

 

It’s Carpal Tunnel Syndrome – What next??

The standard treatments suggested by the NHS are:

  • Wrist splints – keeping the wrist in a neutral position
  • Corticosteroid injections – you can only have two
  • Surgical release – soft tissue that forms the roof of the carpal tunnel is cut, symptoms may recur once the tissues have healed and scar tissue formed

Massage!

A 2013 study showed that massage was a viable, non-invasive treatment for CTS. Patients were massaged for 30 minutes, twice a week and generally started to show improvements after two weeks. 

  • Trigger point therapy to release sore spots in muscles
  • Stretching the forearm flexors and extensors
  • Calms the nervous system
  • Results within 1-6 weekly treatments
  • Non-invasive


Jemma Fordham is a clinical massage therapist who specialises in the treatment of chronic pain conditions based in Brighton. She works with her clients to help facilitate their bodies own healing through bodywork, exercise and education.

If you would like more information or need to book an appointment please call 07843 666 806 or use this form.

Posted in massage, Pain, Pathology, Self Care.

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