Carpal tunnel syndrome: symptoms, causes and treatment

Carpal tunnel syndrome is a condition in which the median nerve is compressed as it passes through the narrow bony and fibrous canal on the palm side of the wrist. Through this tunnel, together with the nerve, run the tendons that bend the fingers. When the space in the tunnel narrows or the surrounding tendons swell, the pressure on the nerve causes numbness, tingling, pain and weakness in the hand. Carpal tunnel syndrome is one of the most common causes of hand complaints and, if recognized in time, is most often successfully resolved without surgery.

Symptoms of carpal tunnel syndrome

Symptoms develop gradually and at first appear occasionally, only to become constant over time. Typical symptoms of carpal tunnel syndrome are:

• numbness and tingling in the thumb, index, middle and part of the ring finger,
• pain that spreads from the hand up toward the forearm,
• symptoms pronounced at night that wake the patient and force them to shake the hand,
• a feeling of a swollen or clumsy hand and dropping objects,
• weakening of the grip and, in the advanced stage, weakening and wasting of the muscles at the base of the thumb.

It is characteristic that the little finger is spared, because it is supplied by a different nerve, which helps to distinguish carpal tunnel syndrome from other conditions of the hand and neck.

Causes and risk factors

Carpal tunnel syndrome develops when the space for the nerve narrows or the tendons in the tunnel swell. The most common causes and risk factors are:

• repetitive hand movements and long work at a keyboard and mouse,
• work with vibrating tools,
• fluid retention in pregnancy,
• thyroid disease, diabetes and rheumatic conditions,
• injuries and fractures of the wrist that change the shape of the tunnel.

How the diagnosis is made

The diagnosis is based on the symptoms and the exam, with tests that provoke the symptoms by bending or lightly tapping the wrist. In unclear or more severe cases, electromyoneurography (EMNG) is done, which measures the speed of conduction through the nerve and objectively shows the degree of pressure. Early recognition allows treatment without surgery, while in the late stage full function returns more slowly.

Treatment of carpal tunnel syndrome

Treatment of carpal tunnel syndrome at the Dynamic Fizio center, in the earlier and middle stages, is carried out without surgery through physical therapy that reduces the pressure on the nerve and eases the symptoms. The plan most often includes:

• electrotherapy and ultrasound to reduce pain and swelling,
• tecar therapy to speed tissue recovery,
• nerve and tendon gliding exercises that free the median nerve,
• forearm stretching and advice on correct hand position, with a night splint that keeps the wrist in a neutral position.

What you can do yourself

Changing habits also helps a lot: taking breaks during computer work, adjusting the height of the keyboard and mouse so the wrist stays flat, avoiding sleeping with a bent hand and wearing a splint at night. These simple measures often significantly reduce night symptoms and slow progression.

How treatment works at our center

The first examination is free, and at it we assess the severity of the symptoms, the strength of the hand and the movements that trigger them, as well as risk factors such as computer work or an underlying illness. Based on that we build an individual plan that reduces the pressure on the median nerve and eases numbness and pain. Therapy is done in a series and combines devices with nerve gliding and stretching exercises, and we also teach you how to unload the joint with hand position and a night splint.

Frequently asked questions

Does carpal tunnel syndrome have to be operated on? Not always. In the early and middle stage the symptoms often settle with physical therapy, exercises and a night splint. Surgery is considered with pronounced muscle weakness and when conservative treatment does not help.

Why are the symptoms worse at night? During sleep the hand unconsciously bends, which further narrows the tunnel and presses the nerve, so numbness and pain increase.

Does pregnancy cause carpal tunnel syndrome? Fluid retention in pregnancy can temporarily cause symptoms, which often settle by themselves after delivery, supported by exercises and a splint.

Can carpal tunnel syndrome occur in both hands? It can, and it is not rare, especially in people who expose both hands to repetitive movements or with general causes such as thyroid disease.

Can the thumb muscles regain strength? If treatment is started before pronounced muscle wasting, strength most often returns. In the late stage recovery is slower, which is why coming early matters.

Does adjusting the workstation help? Yes, a flat wrist position, a support for the hand and regular breaks significantly reduce pressure on the nerve during work.

If you feel numbness, tingling and pain in the hand, book a free first examination at 060/134-3303.