What Aggravates Carpal Tunnel Syndrome? | Physiotherapy

Carpal Tunnel Syndrome

What is carpal tunnel syndrome?

Carpal tunnel syndrome, also called median nerve compression, could also be a condition that causes numbness, tingling, or weakness within the hand.

It occurs because of pressure on the median nerve, which runs through the entire arm, through a passage within the wrist called the carpal tunnel, and ends within the hand. The median controls the movement and feel of your thumb and thus the movement of all of your fingers except your pinkie.

Alternate name

Carpal tunnel syndrome, also called median nerve compression.

Causes of carpal tunnel syndrome

Carpal tunnel syndrome is caused when the space (the carpal tunnel) within the wrist narrows. This presses down on the median nerve and tendons (located inside the carpal tunnel), makes them swell, which cuts off sensation within the fingers and hand.

Often, people do not know what brought on their carpal tunnel syndrome. It is often due to:

  • Repetitive movements, like writing, or any wrist movement that you simply do over and once more. this is often very true of the things you’re doing when your hands are but your wrists.
  • Conditions like hypothyroidism, obesity, rheumatoid arthritis, and diabetes

Risk factors for carpal tunnel syndrome

You may have a far better risk of developing carpal tunnel syndrome if:

  • you’re a lady. Women are 3 times more likely than men to urge it. this could be because they need a bent to possess smaller carpal tunnels.
  • Have a beloved with small carpal tunnels.
  • Features employment where you’re doing the same arm, hand, or wrist movements over and once more, like an assembly line worker, sewer or weaver, baker, cashier, barber, or musician.
  • Fracture or dislocate your wrist

Symptoms of carpal tunnel syndrome

Carpal tunnel symptoms include:

  • Numbness with burning, tingling, or itching within the palm and thumb or index and middle fingers
  • Weakness within the hand and difficulty holding things.
  • Concussion-like sensations moving toward your fingers
  • Tingling moving up your arm

You may first notice that your fingers “go to sleep” and go numb within the dark. it always happens thanks to the way you hold your hand while you sleep.

In the morning, you’ll awaken with numbness and tingling in your hands which can reach up to your shoulder. During the day, your symptoms may flare up while holding something alongside your wrist bent, like when driving or reading a book.

Early within the condition, shaking your hands may assist you are feeling better. But after a brief time, the numbness won’t escape.

As carpal tunnel syndrome worsens, you will have less grip strength because the muscles in your hand shrink. you’ll even have more pain and muscle cramps.

Your median nerve cannot function because it should thank the irritation or pressure around it. This leads to:

  • Slower nerve impulses
  • Less sensation within the fingers
  • Less strength and coordination, especially the facility to use the thumb to pinch

Diagnosis of carpal tunnel syndrome

The diagnosis of carpal tunnel syndrome is suspected as supported symptoms and thus the distribution of numbness within the hand. An examination of the neck, shoulder, elbow, pulses, and reflexes could even be performed to exclude other conditions that can mimic carpal tunnel syndrome. The wrist is often examined for swelling, warmth, tenderness, deformity, and discolouration. Sometimes touching the front of the wrist can reproduce a tingling within the hand and is known as Tinel’s sign of carpal tunnel syndrome. Sometimes the examiner can also reproduce symptoms by bending the wrist down (known as a Phalen manoeuvre).

The diagnosis is strongly proposed when a nerve conduction velocity test is abnormal. This test involves measuring the speed of electrical impulses as they travel through a nerve. In carpal tunnel syndrome, the drive slows down because it passes through the carpal tunnel. Sometimes a test of the muscles within the limb, the electromyogram (EMG), is completed with the nerve conduction velocity test to exclude or detect other conditions that might mimic carpal tunnel syndrome.

Blood tests are often done to identify medical conditions associated with carpal tunnel syndrome. These tests include hormone levels, complete blood counts, and blood sugar and protein tests. X-ray tests of the wrist and hand can also be helpful in identifying abnormalities of the wrist bones and joints.

Carpal tunnel syndrome Treatment options

Although it is a gradual process, for several people, carpal tunnel syndrome will worsen over time without some kind of treatment. For this reason, it is vital that your doctor evaluate and diagnose you early. within the first stages, it’s getting to be possible to slow or stop the progression of the disease.

Non-surgical treatment

If diagnosed and treated early, the symptoms of carpal tunnel syndrome can often be released without surgery. If your diagnosis is undefined or if your symptoms are mild, your doctor will recommend nonsurgical treatment first.

Non-surgical treatments can include

  • Reinforcement or splinting. Wearing a brace or splint in the dark will keep your wrist from bending while you sleep. Keeping the wrist during a straight or neutral position reduces pressure on the nerve within the carpal tunnel. It can also be helpful to wear a splint during the day when doing activities that aggravate your symptoms.
  • Non-steroidal anti-inflammatory drugs (NSAIDs). Medications like ibuprofen and naproxen can help relieve pain and inflammation.
  • Activity changes. Symptoms usually appear when the hand and wrist are within an equivalent position for too long, especially when the wrist is flexed or extended.
  • If your work or recreational activities aggravate your symptoms, changing or modifying these activities can help slow or stop the progression of the disease. In some cases, this might involve making changes to your workplace or workstation.
  • Nerve gliding exercises. Some patients may enjoy exercises that help the median nerve to manoeuvre more freely within the confines of the carpal tunnel. Your doctor or therapist can recommend specific exercises.
  • Steroid injections. Corticosteroid, or cortisone, could also be a strong anti-inflammatory agent which can be injected into the carpal tunnel. Although these injections often relieve painful symptoms or help calm a flare-up of symptoms, sometimes their effect is simply temporary. Your doctor also can use a cortisone injection to help diagnose your carpal tunnel syndrome


If nonsurgical treatment doesn’t relieve your symptoms after a period of some time, your doctor may recommend surgery.

The decision to possess surgery is based on the severity of your symptoms – what proportion of pain and numbness you’ve in your hand. In long-lasting cases with constant numbness and atrophy of the thumb muscles, surgery could even be recommended to prevent irreversible damage.

Surgical procedure

The surgery performed for carpal tunnel syndrome is known as “carpal tunnel release.” There are two different surgical techniques to undertake to the present, but the goal of both is to alleviate pressure on the median nerve by cutting the ligament that forms the roof of the tunnel. This increases the size of the tunnel and reduces pressure on the median nerve.

Prevention of carpal tunnel syndrome

Median nerve compression often difficult to prevent. The disease often caused by numerous different activities during an individual’s lifestyle that prevention often challenging. Changes within the work station (proper seating, hand, and wrist placement) can help decrease some factors which can cause median nerve compression. Other preventive methods include:

  • Appear the hay your wrists straight.
  • Keep your wrists straight when using tools.
  • Avoid flexing (curling) and increasing your wrists repeatedly.
  • Decrease the repetitive/strong grip with the wrist during a flexed position.
  • Take frequent breaks from repetitive activities.
  • Perform conditioning and stretching exercises before and after activities.
  • Properly monitor and treat medical conditions related to carpal tunnel syndrome.

Complications of carpal tunnel syndrome

If you’ve median nerve compression and don’t treat it, the symptoms can last an extended time and acquire worse. they could also leave than come. once you receive an early diagnosis, the condition is easier to treat. you’ll prevent permanent muscle damage and keep your hand working the way it should.

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