Carpal tunnel syndrome is caused by compression of the median nerve. Normally, median nerve passes through the wrist’s carpal tunnel. Carpal tunnel syndrome is a nerve entrapment neuropathy. The median nerve supplies the muscles in front of the forearm and feeling of thumb. The early signs are pain, numbness, weakness in the hand and arm. If these symptoms continue for long time, it can lead to damage the nerve and pain can radiate up the affected arm.

Symptom

  • Tingling or numbness on the palm side (thumb or index and middle fingers)
  • Aggravation of symptoms with gripping of something for long time such as a phone
  • The symptom may worse during the night because normally you holding your hand while you sleep.
  • Wake up with numbness and tingling in your hands in the morning
  • Feeling better after shaking or flicking of the hand in the early stage
  • Tingling and numbness may constant and feeling like a burning pain if CTS still progresses.
  • The final symptom is weakness due to atrophy of muscles of the thumb and hand (palm side). After this result may affected to loss the grip strength and dropping things

Causes

Normally, the function of median nerve is controlling hand movement, especially thumb and also connect the sensation of hand on the palm side (thumb, index and middle fingers). Median nerve passes through the carpel tunnel, which have tendon and ligament on the top of carpal tunnel and also have pieces of wrist bone in the lower part. Anything that can compress on the median nerve in carpal tunnel may lead to carpal tunnel syndrome.

  • Swelling or thickening of tendon from repetitive hand use with the same hand and wrist motions for a long time can aggravate that tendon has swelling and pressure on the median nerve. The repetitive wrist movements is typing or machine work.
  • Injuries on the wrist both acute and chronic
  • Health conditions are associated with carpal tunnel syndrome such as diabetes, rheumatoid arthritis, and thyroid gland imbalance.
  • Hormonal changing during pregnancy can cause swelling in the body which can have more pressure on the wrist too.

Treatments

Carpal tunnel syndrome should get the treatment as soon as possible.

  1. Wear a wrist support (wrist splint) can help to straight wrist which helps to decrease pressure on the median nerve. Should wear it during the night
  2. Stretching and strengthening exercises can help to improve wrist, hand, and finger more flexibility and also strengthen muscles.
  3. Cold and heat treatments use to relieve pain.
  4. Ultrasound therapy is a deep heating used to increase the temperature of a targeted area for reducing the pain.
  5. Patient education:
    • Avoid bending wrist for long time
    • Good posture especially neck and upper back posture
    • Small breaks during work or daily routine.
    • Reducing or avoiding activities that increase symptoms until feeling better
    • Changing keyboard position to avoid in a bent-wrist
    • Avoid sleeping on the hands

Exercise

  1. Finger bend (tendon gliding exercise): hook, duck, straight fist and full fist hold in each positions for 5 seconds
  2. Wrist flex: hold for 15-30 seconds
  3. Wrist extend: hold for 15-30 seconds
  4. Hand squeeze: squeeze the rubber ball by holding for 5 seconds

All of exercise should do for 3 sets 10 repetitions

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