Carpal Tunnel Syndrome is very, very common with nearly 50% of all work-related injuries linked to carpal tunnel syndrome. Fortunately, there are effective and evidence-based Carpal Tunnel syndrome exercises and conservative treatment that can help fix carpal tunnel pain and avoid surgery! (1)
The Carpal Tunnel is a channel at the front of your wrist which is covered by a band of strong connective tissue (retinaculum). Through the tunnel that is formed, runs tendons, a blood vessel, and your median nerve. Carpal tunnel syndrome occurs when these structures don’t slide nicely through your tunnel and with repetitive or sustained tasks, can lead to pain, numbness, and weakness.
Note that symptoms are variable due to the different structures that pass through the tunnel – Sometimes there is more median nerve involvement that tendons and vice versa.
What causes it:
Anything that causes compressed, irritates or effects mobility of the median nerve in the carpal tunnel can cause this which can be from a huge number of causes, with many cases not having a clear cause.
Carpel Tunnel syndrome can be caused by wrist or hand sprain and fractures, inflammation involved with rheumatoid arthritis and commonly certain activities or jobs that require a lot of bending of the wrist, gripping or vibration, among other things.
Some known risk factors are
- diabetes – a chronic (long-term) condition caused by having too much sugar (glucose) in the blood
- any kind of arthritis – a condition where the joints become painful and inflamed
- hypothyroidism – an underactive thyroid gland
- obesity in young people
- some drugs used to treat breast cancer – such as exemestane (Aromasin)
Carpel tunnel syndrome can be treated with Physiotherapy or surgery, with surgery often only for the more severe or unresponsive cases as one-third of patients don’t return to work within 8 weeks after an operation as it has a significant recovery period and is not always straight forward and the quick fix that people want as surgery can lead to scarring.
The main aspects of non-surgical treatment that need to be covered for best results are:
- Brace: Wearing a splint during aggravating activities and at night time can be very beneficial and help speed up recovery by decreasing load on the wrist and holding it in the optimal position for maximal space in the carpal tunnel. The best braces have a metal bar in the palmar aspect specific to carpal tunnel syndrome, so ideally don’t just get any old wrist brace. A good example of one is theMueller Carpal Tunnel Brace
- Reduce load: Even though there is often 1-2 risk factors such as swelling in pregnancy, inflammation from a fracture close by or a congenitally narrower tunnel – That does not often cause carpal tunnel syndrome by itself. In the majority of cases, you still need repetitive or sustained movement of the wrist or hand, more that it is used to. So, to give the wrist a chance to settle down, you need to figure out what it was that over-loaded the wrist, whether it be using a hammer a lot, writing or typing all day or obsessively cleaning your house and then decrease how much you do that where possible. You don’t need to completely stop the task often, just change how you’re doing it, decrease it and maybe even become a little ambidextrous for a while.
- Exercises to improve: The third and final thing is home exercises to address any excessive neural tension, muscle tension or lack of joint mobility. The exercises should look to address:
- Muscle tension and nerve mobility through the side of your neck
- Forearm muscle flexibility
- Nerve and tendon mobility/gliding through the carpel tunnel
- Grip and thumb strength
So there you have it, a rough blueprint on helping lessen the pain from carpal tunnel and start on the road to recovery. We will be putting up another post in in two weeks detailing effective home exercises for Carpal tunnel pain so stay tuned!