Carpal tunnel syndrome (CTS) is a cause of pain and other symptoms in the palm of the hand. It can be associated with lifestyle, including the angle at which you hold your wrist at your desk if you are office based.
Why It Happens
The carpal tunnel is a small space in the palmar side of the wrist. One side is bordered by the wrist bones, and the other is contained by ligament-like soft tissue. This tissue is what is often cut during surgery for CTS. Structures running through the tunnel include blood vessels, muscle tendons, and nerves. If the area becomes compressed, the nerve can be irritated, and lead to the symptoms of CTS.
Compression can be caused by pressure from outside the tunnel, such as positioning. If your armrests at your desk are too high or low, they can put the tunnel on stretch, or compress the area and encourage the forearm muscles to tighten up. Similarly, sleeping with your wrists flexed can cause compression overnight, and may lead to an increase of symptoms first thing in the morning. A sudden increase in sport or activity could also play a role.
Symptoms of Carpal Tunnel Syndrome
Symptoms are typically isolated to the area supplied by the affected nerve, below the point at which it is irritated. For most people, that encompasses the palm of the hand, from the thumb to halfway along the width of the ring finger.
As this is a nerve problem, symptoms might include tingling or pins and needles, numbness, weakness, and pain. The pain might be described as sharp and shooting or dull, deep, and persistent. Some people compare it to a toothache in nature.
Fluid Retention and Carpal Tunnel Syndrome
People who have more fluid in their tissues than is typical are at higher risk of developing carpal tunnel syndrome. This is because there is more pressure within the tunnel, and the nerve is more likely to be irritated. This includes people who:
have lymphoedema in the arm
are pregnant, especially in the third trimester
have heart failure or kidney problems that cause fluid retention
Diagnosis and Treatment
The first thing your osteopath wants to know is “is it really carpal tunnel syndrome?”. There are other causes of hand pain that can present very similarly- occasionally we see patients who have had surgery for CTS only to find that the problem starts higher up the arm, and the symptoms have not changed. Diagnostic tests to determine if the irritation truly is in the wrist are a good place to start, but we will also use your case history to work out what the most likely causes are.
Depending on the factors that have led to your pain, treatment might be focused on:
reducing tension in the forearm muscles
encouraging drainage in the wrist area
stretching and exercising the wrist into a more neutral position
Sometimes it is also a good idea to work on the hand itself, or the elbow. Your osteopath will explain this to you in your appointment, and they may provide you with exercises or other changes to make at home or work.
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