Carpal Tunnel Syndrome (CTS)
By Daniel Jang
What is Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome (CTS) is condition in your wrist where the median nerve gets compressed / irritated at the Flexor Retinaculum (also known as transverse carpal ligament). The Flexor Retinaculum is a structure that crosses your hand bones and acts as a pulley for your wrist tendons while providing stability for the surrounding structures. 1-5% of the general population suffer from CTS at one point in their life. The most commonly affected people are 40-60 with females having a 3 times higher chance of getting CTS than males.
Contributing Factors
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CTS is often caused by mechanical trauma, repetitive movements, increased pressure into structures and ischemic damage affecting the median nerve directly. Sometimes the median nerve itself gets enlarged which can contribute to CTS.
There is no one pinpoint cause to why CTS is caused, although there are higher chances of CTS if you have an underlying systemic pathology such as diabetes, hypothyroidism, rheumatoid arthritis or if you have a wrist fracture. The cause for CTS is multifactorial - a mix of genetic predisposition, specific pathologies , social and environmental factors.
Symptoms
Because the median nerve is affected, pain or numbness and tingling in the first three fingers and half of the ring finger may be present. You may feel symptoms just in your wrist or in the hand as well, which may get worse at night. Symptoms might creep up to your forearm and arm but not your neck. Trouble turning keys, opening bottles buttoning clothes might be noticed, weakness and muscle wasting in the thumb might also be present and need urgent attention if you find you have noticeably less muscle bulk in your thumb.
In the long term you might bump into some complications such as irreversible nerve damage, decreased dexterity, chronic pain in wrist and hand which can lead to complex regional pain syndrome.
Treatment
Conservative treatment for CTS involves Physiotherapy - targeting nerves and muscles to help decrease pressure and tension in the local area as well as decreasing pain with hands on soft tissue massage, trigger point releases +/- needling. Also, making sure there are targeted exercises for the median nerve as well as advice around load management and patient education on carpal tunnel as well as activity modification. In the case that conservative treatment does not work and/or symptoms are severe, surgery may be warranted. The surgery focuses on decompressing the median nerve through incision of the affected structure which helps decrease pressure.
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​​​Need some help relieving that wrist / hand pain? Daniel is ready and waiting to help you with your recovery. If you would like to make an appointment, click here to make an online booking, or call (07) 3211 7011 to speak with our friendly reception staff.
