Carpal tunnel syndrome (CTS) is compression of the median nerve as it passes through the wrist. The median nerve is one of the nerves that travel down the arm, across the wrist and into the fingers. As the median nerve crosses the wrist into the hand, it must pass through a tight canal called the carpal tunnel.
The carpal tunnel is a space 1-2 inches long and is surrounded by wrist bones on the back side and a tight ligament on the top side. The median nerve gives us sensation, or feeling in the thumb, index, long and partial ring fingers. The median nerve also helps move the thumb.
If there is swelling in the wrist and carpal tunnel, the tunnel becomes tighter and the median nerve becomes pinched causing it to not function properly.
Early symptoms of carpal tunnel syndrome may include: decreased sensation in the thumb, index, long and ring fingers. Frequent complaints include tingling, numbness and pain. As the condition progresses, there may be hand weakness, specifically in the thumb during pinching movements and activities. The individual may also note difficulty with small object manipulation and coordination activities due to the loss of feeling and weakness in some small muscles of the thumb and hand.
What to expect from therapy
If you are referred to a therapist for treatment of carpal tunnel syndrome, you will be given education regarding the condition to assist you in getting well. Initially, you may be given wrist splints to protect the position of your wrist to reduce the swelling and minimize the pressure on the median nerve.
Other elements of early conservation treatment include: exercises to maintain mobility and normal tendon gliding through the wrist, stretching exercises, nerve mobilization exercises. To assist in reducing the inflammation, the therapist may utilize treatment modalities including ice, ultrasound, electrical stimulation and manual techniques.
Education to assist in symptom reduction, modification of household items or work tools and activity modification and/or avoidance are integral components in the treatment program. Finally, once the inflammation has reduced and the early symptoms are improved, you may be instructed in strengthening exercises to improve strength and coordination again.