Carpal Tunnel Syndrome: Symptoms and Treatment
· Manual Therapy
Carpal tunnel syndrome is a common condition in which pressure on the median nerve leads to numbness, tingling and weakness in the hand. The median nerve travels down the arm, passes through a channel in the wrist called the “carpal tunnel” and reaches the hand, where it is involved in the sensation and movement of the thumb, index finger, middle finger and part of the ring finger.
Symptoms
Symptoms usually appear gradually and are most often felt at night first. Common symptoms include:
- Numbness, tingling, burning or pain in the thumb, index and middle fingers
- Electric-shock-like sensations radiating into the fingers
- Discomfort that can spread from the forearm towards the shoulder
- Weakness in the hand, difficulty holding objects
Sleeping with the wrist bent, or prolonged fixed grips such as holding a phone or steering wheel, can worsen the complaints. In later stages, thinning of the hand muscles and reduced grip strength may be seen.
Causes and risk factors
The exact cause is not always known; it is related to increased pressure on the median nerve and the tendons around it. The main risk factors are:
- Wrist injuries and jobs requiring repeated forceful gripping
- Frequent use of vibrating tools
- Thyroid conditions, diabetes and some metabolic conditions
- Inflammatory joint conditions such as rheumatoid arthritis
- Fluid retention related to pregnancy or menopause
Diagnosis
The diagnosis is evaluated through the person’s history and a physical examination. Where needed, a nerve conduction test, EMG or imaging may be requested by a physician. Distinguishing conditions that can produce similar symptoms, such as rheumatoid arthritis and tendinitis, is also part of this evaluation.
The physiotherapy approach
In carpal tunnel syndrome, physiotherapy is planned according to the level and course of the complaints. At our clinic, the approach includes assessment along the path of the nerve and, where needed, the neck region as well:
- Manual therapy: Addressing the load on the nerve with neuromobilisation along the path of the median nerve.
- Exercise: Individually planned nerve gliding, stretching and strengthening exercises.
- Activity adjustments: Reducing repetitive movements and making ergonomic adaptations.
Exercises should be individualised and carried out as part of the physiotherapy process. For the most suitable programme, it is advisable to consult your physiotherapist. For details, see our Manual Therapy page.
If you have ongoing numbness or weakness in your hand, you are welcome to contact us for an assessment.