Carpal Tunnel Syndrome is a condition where the median nerve which travels through the wrist is being compressed, causing pain and numbness in the hand. The carpal tunnel contains tendons that control finger movement. Carpal Tunnel Syndrome stems from prolonged repetitive use causing an irritation or compression of the median nerve.
The compression present in carpal tunnel syndrome (or ‘pinched nerve’) does not always occur at the wrist. A pair of nerve roots emerges from the spinal cord at each vertebral level of the spine and the median nerve is formed by several nerve roots emerging from the lower part of the neck. From there, the median nerve travels down the arm to the wrist and hand and can become entrapped anywhere along its path.
Symptoms of Carpal Tunnel Syndrome
There are many identifiable symptoms of Carpal Tunnel Syndrome. These include painful tingling in the hands, weakness in fingers, feelings of swelling in fingers with no apparent swelling, and shooting pain through the wrist and hand. This pain is most often at its worst in the evening, and particularly affects the thumb and first two fingers.
Carpal Tunnel can originate from a number of activities, the most common of which being repetitive keyboard typing. Carpal Tunnel Syndrome develops most commonly in people aged 40-60, particularly women. Certain lifestyle factors can also influence Carpal Tunnel Syndrome, such as cigarette smoking and high caffeine and alcohol use.
It is important to remember that not all wrist pain is attributable to Carpal Tunnel Syndrome. Symptoms of Carpal Tunnel Syndrome such as shooting pain, weakness and tingling may also be the result of an irritation of the nerves in the neck, nerve entrapment in the elbow or a previous autoimmune injury. Thorough examination by a chiropractor can determine whether your wrist pain is due to Carpal Tunnel Syndrome or another musculoskeletal condition.
Carpal Tunnel Syndrome Treatment
There are many helpful Carpal Tunnel Syndrome treatments. While some medical professionals suggest surgery to remove the pressure on the nerves, more conservative and less invasive and painful options are available. Treatment by the Chiropractors at Back to Basics may involve joint manipulation or mobilisation, massage, stretching, trigger point therapy, splinting, rehabilitative exercises, ice and heat.
Splinting of the wrists is common for Carpal Tunnel Syndrome, to stabilise the wrist and prevent further damage from excessive movement. While this can provide relief to symptoms, it can occasionally result in the wrist muscles becoming weak and lazy. A chiropractor can monitor the progress of any splinting, and recommend alternative treatments if splinting is not the preferred option. Behaviour modification may be necessary, and advice can be given by your chiropractor as to how to implement changes in your work and daily life. Paying attention to proper ergonomic principles and posture can also help overcome Carpal Tunnel Syndrome.
Current evidence1 shows significant short-term benefit from oral steroids, splinting, ultrasound, yoga and carpal bone mobilisation.
1. Cochrane Database Syst Rev. 2003;(1):CD003219.Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome. O’Connor D, Marshall S, Massy-Westropp N.
FAQs
What is carpal tunnel syndrome?
Carpal tunnel syndrome is a condition where the median nerve is compressed as it travels through the wrist’s carpal tunnel. This nerve controls sensation and movement in parts of the hand. When compressed, it can cause tingling, numbness, pain, and weakness, especially in the thumb, index, and middle fingers.
What causes carpal tunnel syndrome?
Common causes include repetitive hand movements, prolonged wrist positioning, inflammation, or underlying conditions like diabetes and arthritis. Typing, assembly work, and tool use can increase risk. In some cases, pregnancy or fluid retention can temporarily compress the nerve and lead to symptoms.
What are the early signs of carpal tunnel syndrome?
Early symptoms include tingling, numbness, or a "pins and needles" sensation in the fingers, particularly at night. Some people notice weakness in the hand or a tendency to drop objects. If left untreated, the symptoms can progress and affect hand function more severely.
How is carpal tunnel syndrome diagnosed?
Diagnosis typically involves a physical exam, symptom history, and nerve conduction studies. These tests assess how well the median nerve is functioning. In some cases, ultrasound or MRI imaging is used to check for swelling or anatomical abnormalities in the wrist.
Can carpal tunnel syndrome be reversed?
If diagnosed early, symptoms may improve with rest, splinting, or activity modification. Anti-inflammatory treatments and wrist braces are commonly used. In more severe or persistent cases, surgical intervention to release pressure on the nerve may be required. The earlier it's treated, the better the outcome.
Is surgery the only option?
No, many cases are managed successfully without surgery. Treatment may include wrist splints, corticosteroid injections, physical therapy, and ergonomic adjustments at work. Surgery is typically reserved for cases where conservative measures have failed or nerve damage is progressing.
Can I still work with carpal tunnel syndrome?
It depends on your job and symptom severity. Many people continue working with modified duties, ergonomic tools, and scheduled breaks. Early intervention is key to preventing further damage. If symptoms persist, medical advice should be sought to develop a treatment plan that supports ongoing work
What exercises can help with carpal tunnel syndrome?
Gentle stretches and nerve-gliding exercises can help relieve pressure on the median nerve. Examples include wrist flexor stretches and tendon gliding. These exercises should be done under professional guidance to avoid aggravating the condition. Strengthening and mobility work can support long-term recovery.
