Carpal Tunnel Syndrome is caused by compression of the median nerve at the wrist. It causes numbness and/or tingling on the palm side of the thumb, index and middle fingers. These symptoms are usually worse at night or first thing when you wake up in the morning. You might feel like you have to shake your hands out to wake them up. It can also cause you to have poor fine motor skills and weak pinch strength.
So why does this happen? The median nerve starts in your neck and travels down into your hand. At the wrist it travels through the “carpal tunnel” which is a small tunnel that homes several tendons as well as the median nerve. The roof of this tunnel is called the flexor retinaculum. When this tunnel becomes too tight or narrow it can essentially squish this nerve which leads to your symptoms. There are many reasons this tunnel and nerve can become irritated, these reasons include but are not limited to:
Sleep positions (wrists bent and fingers curled into a fist)
Vibratory tools
Pregnancy (water retention)
Work positioning/ergonomics
Prevention or management of carpal tunnel syndrome is all about protecting the median nerve and allowing it to calm down. If you are experiencing the most symptoms at night, try wearing a wrist brace while you sleep to hold your wrist in a nice neutral position (an occupational therapist can also make you a custom splint for the perfect fit). Symptoms when using vibratory tools? Purchase a pair of anti vibration gloves. Pain when working on the computer all day? Check your ergonomic set up: place your keyboard low or even in your lap to allow your wrists to be straight, not bent. Purchase an ergonomic mouse and focus on your posture.
Additionally, exercises of the wrist important to maintain/improve range of motion and strength as well as to ensure proper alignment at the carpal bones. This can improve symptoms and help you to decrease your pain.
Still having pain? Next step would be to schedule a visit with your doctor. They can order tests of the nerve to see how severely damaged/compressed the nerve is by measuring its conduction velocity. If you demonstrate compression of the nerve they can complete a carpal tunnel release. This is a simple surgery where they cut the roof of the carpal tunnel we talked about above (the flexor retinaculum) to allow for more space for that nerve to be comfortable. Occupational therapists can help you to recover from this surgery, regain motion and strength to get you back to function.
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