Carpal Tunnel Syndrome occurs when the median nerve gets compressed in the carpal tunnel - which is in the wrist at the base of the hand. The bones of the wrist form the bottom of the tunnel and a ligament called the flexor retinaculum forms the roof of the tunnel. 

The nerve gets compressed by bending the wrist all the way forwards or backwards repetitively, external pressure or trauma over the base of the hand (carpal tunnel).
 

Symptoms

People experience many different symptoms but commonly report the following in the thumb, pointer finger, middle finger and half of the ring finger:

• ‘Funny feeling’

• Tingling

• Numbness

• Burning

• Itching

• Pins and needles

• Pain over the front of the wrist

• Dropping things

• Unable to feel things properly

Diagnosis

Health professionals can perform a number of different tests to diagnose Carpal Tunnel Syndrome:

• They will hold your wrist in different positions and 'tap' over the nerve

• Nerve conduction studies

• Ultrasound over the carpal tunnel

• MRI

Treatment

We have very good success rates with conservative treatment and I would always recommend trying conservative treatment first. Some of the things a hand therapist can do are:

• Finding out how the nerve is getting compressed in the first place and working with you to prevent this

• Splinting – either at night time only or at risk times, to prevent ongoing compression of the median nerve

• Median nerve exercises

• Tendon gliding exercises

• Pain management

• Activity modification

Should the condition be too severe for conservative treatment we can help to refer you to the best specialist to help. Some of the next steps can include:

• Surgical release of the ligament that forms the 'lid' of the carpal tunnel

• Corticosteriod injection into the carpal tunnel