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What is carpal tunnel syndrome and how is it treated?

Définition: Carpal tunnel syndrome is a neuropathic condition, meaning it affects the median nerve when it passes through the little tunnel in the wrist, the carpal tunnel.

Physiopathology: The carpal tunnel is formed by the carpal bones that form an ark and the carpal ligament which closes the ark. Several structures pass through this narrow channel, such as the median nerve. Consequently, as soon as there is inflammation of one of the structures included in the channel or mobility loss one of the carpal bones, the median nerve is at risk of being compressed. In response to compression, the signals sent by the median nerve are impaired, which may cause symptoms such as numbness and pain.

Contributive factors: 

Frequent wrist traumas

  • Bad wrist positioning (especially at night)
  • Repetitive movements
  • Pregnancy
  • Type II diabetes
  • Gout
  • Rheumatoid arthritis
  • Sarcoidosis
  • Tuberculosis
  • Acromegaly (gigantism)
  • Hyperthyroidism
  • Hypothyroidism
  • Tumor
  • Amyloidosis

Possible signs and symptoms:

Here are the major signs and symptoms of carpal tunnel syndrome:
Thumb index and middle finger pins and needles at night (nocturnal paresthesias). Pain can also be present at this same location accompanied by strength loss at the wrist, hand and fingers level, especially the thumb.

*Other conditions that can cause similar symptoms: Be aware that the median nerve can be compressed or irritated anywhere along its pathway in the armpit to the forearm and that nerve roots emerging from the neck can also be inflamed and cause symptoms that resemble those of median nerve compression.

 

Diagnosis: The official diagnosis is made by medical imaging. However, the tests performed during the physiotherapy assessment can provide insights on the possible presence of carpal tunnel syndrome or other conditions that can cause similar symptoms.

Treatment: Treatment may vary depending on the contributing factor of carpal tunnel syndrome. It may include joint mobilization to clear the canal, relaxation techniques and stretching techniques to relax the tissues and reduce the compression, neural mobilization techniques, advice on how to stop the irritating movements, anti -inflammatory drugs, and as a last resort surgery. Except for taking anti-inflammatory drugs and surgery, just named techniques can be performed in physiotherapy and the results are generally favourable.

If you recognize yourself in what has been mentioned above, please contact us for an assessment today!