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GENERAL INFORMATION, SIGNS & SYMPTOMS, OSTEOPATHIC AND SELF MANAGEMENT OF
  Carpal Tunnel Syndrome

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Carpal Tunnel Syndrome is defined as a "compression neuropathy" indicating that signs and symptoms are as a result of a compression of a nerve. The nerve that becomes compressed is the "median nerve" that runs down the arm and through the "carpal tunnel" of the wrist.

Causes
Carpal Tunnel Syndrome is called a "syndrome" due to there being known and theorised causes.
  • Generally the cause is "anything that causes compression of the median nerve"  including arthritis, fractures, infection and inflammation.
  • There are varying reports and widespread debate on repetitive strain being another possible cause(1)
  • Carpal tunnel syndrome is also associated with certain conditions (e.g. diabetes and hyperthyroidism)
  • Pregnancy can also be a cause of carpal tunnel syndrome.
  • An Idiopathic cause (unknown cause) is also listed as a cause of carpal tunnel syndrome.
Signs and Symptoms
  • Symptoms commonly come on gradually
  • Pain can become moderate to severe in some cases
  • Numbness, pins and needles, altered sensation and pain are commonly in the 1st and 2nd fingers.
  • There may be some swelling in the hand
  • Pain is often worse at night.
  • Weakness can develop and you may begin to lose dexterity (e.g. may find it difficult to button shirt or brush hair).
  • In some chronic cases there may be some muscle wasting in the hand.
Treatment
  • Osteopathic approach is based on past medical history and examination to determine treatment and management. 
  • Generally treatment is aimed at reducing pressure on the nerve through direct treatment to the wrist and also treatment to the elbow, shoulder, neck and general body.
  • Your osteopath will also prescribe you with stretching exercises with an aim to reduce pressure within the carpal tunnel.
Management
  • Your osteopath will perform a past medical history and physical examination with an aim to determine the cause.
  • A short course of pain and anti-inflammatory medications may be indicated as directed by your doctor or pharmacist.
  • Your osteopath will assist in identifying the activities that may be aggravating your carpal tunnel syndrome and will work on a management strategy to reduce these factors. This will include lifestyle, work and ergonomic factors.
  • Your osteopath may refer you to a specialist/general practitioner for investigative testing such as imaging, nerve conduction studies, blood testing etc.
  • Splint: a splint can be applied over a relatively short course (commonly <1-2 weeks) to settle the wrist pressure down. It is commonly worn at night to avoid accidental changes in wrist motion that may cause extra pressure.
  • Click Here for stretches for The Wrist and Hand
  • Click Here for strengthening for The Wrist and Hand

References

1. The American Society for Surgery of the Hand has has issued a statement that the current literature does not support a causal relationship between specific work activities and the development of diseases such as Carpal Tunnel Syndrome. Reference: www.assh.org