Carpal tunnel syndrome is a condition caused by compression of the median nerve of the hand as it passes through a tunnel in your wrist to reach your hand. The median nerve travels the entire length of the hand and is responsible for movement and feeling in your thumb and for movement of all the other fingers except the little finger (pinky). This compression causes various symptoms including burning in your palm and thumb, weakness of the hand, trouble maintaining a firm grip and a tingling sensation that travels up the arm. In this post we discuss how to treat carpal tunnel syndrome, including treatments that are applicable to mild, moderate and severe cases of the condition.
Carpal tunnel syndrome affects around 5% of the population (one in twenty individuals) and knowing how to treat the condition can have a material and positive impact on the quality of life of these individuals. Treatment of the condition in the mild to moderate stages can include the use of topical analgesics, medical tape like kinesiology tape and wrist braces or splints. We discuss these and the treatments for severe carpal tunnel syndrome cases in more detail below.
Before investigating how to treat carpal tunnel syndrome, it is important to be sure that the symptoms you are experiencing are indeed those of that condition. As mentioned above, carpal tunnel syndrome symptoms include burning in the palm and thumb, difficulty maintaining a strong grip and a tingling sensation throughout the length of your arm. You may also experience the following:
- Feeling as though your fingers have “fallen asleep” during the night, with a loss of feeling (numbness) in them. This may happen especially if you bend your wrists during sleep as many people do;
- Numbness and tingling when you wake up in the morning. These feelings may run the entire length of your arm, ending at the shoulder. They may also recur during the day when you are performing tasks that require bending your wrists, e.g. holding your car steering wheel or holding a knife and fork while eating. Initially, you may be able to relieve these symptoms by “shaking out” your hands. However, after a while, this may not work any longer;
- Difficulty using your thumb to execute a pinching action.
If you experience one or more of these symptoms, it is possible that you are experiencing carpal tunnel syndrome and will need to know how to treat this condition.
Diagnosis Of Carpal Tunnel Syndrome
A doctor will be able to help you confirm that you are suffering from carpal tunnel syndrome. This can be done using imaging tests such as X-Ray, ultrasound or MRI examinations. Doctors can also check for carpal tunnel using a test known as an electromyogram. This involves inserting a thin electrode into a muscle of the hand to check the level of electrical activity. In some cases, doctors use nerve conduction studies to make a diagnosis. This involves taping electrodes to your skin to measure nerve signals in your hand or arm.
Once you have confirmed that you are indeed suffering from carpal tunnel syndrome, it is time to learn how you can treat this condition
Use Of Wrist Braces Or Splints To Treat Carpal Tunnel Syndrome
For mild to moderate cases of carpal tunnel syndrome, a wrist brace can be used to effectively treat the condition. In most cases, these splints are best used during sleep. In this way, they will keep the wrists straight while the patient is sleeping and counteract the natural tendency many people have to bend the wrists during sleep.
The wrist splint optimally have a metal or plastic “stay” in it that will help keep the wrist straight while the patient is wearing it e.g. the Mueller Sports Medicine Wrist Brace With Splint or the BioSkin DP2. As a result, the patient will be able to avoid the painful experience of trying to straighten his or her wrists upon awakening in the morning.
Using a wrist splint to control the movement of the wrist allows the median nerve a chance to rest and recover. In fact, this is the goal of most of the conservative (non surgical) treatment options we discuss in this article. The only exception is the use of cold therapy or analgesics, which we discuss next.
Use Of Ice, Cold Treatments Or Analgesics
Another option for treatment of carpal tunnel syndrome involves inserting your wrist in an ice bath or using a cold compress to ease the pain. For effective use of these treatments, try them for 10-15 minutes every few hours with the first treatment upon awakening. Analgesics such as Motion Medicine may be effective options here.
Please keep in mind that these options may ease the pain of carpal tunnel syndrome but they do not address the underlying causes. Hence, to treat your carpal tunnel syndrome, you should combine use of these measures with the other treatments mentioned in this article.
Vary The Activities That Make Use Of Your Wrist
Carpal Tunnel Syndrome is usually aggravated when you hold your hand or wrist in the same position over a period of time. This is especially the case if you are bending your wrist while it is in this position. Try to keep your wrists straight and keep changing the position of your hands whenever possible. For example, make a point of stretching your hands every 30-60 minutes or so. If possible switch the hand you use for a specific task every 15-30 minutes.
In addition to the above suggestions, try to avoid gripping things too tightly for prolonged periods.
Avoid rolling your shoulders forward as this can sometimes force your hands and wrists into positions that can aggravate carpal tunnel syndrome.
Knowing how to treat carpal tunnel syndrome can require an awareness of your hand and wrist positions at all times and a sense of when it is time to change them.
Use Physical Therapy Exercises To Treat Carpal Tunnel Syndrome
Another option that you should investigate involves the use of periodic exercises to ease carpal tunnel syndrome. These include exercises such as a prayer stretch, wrist flexor stretch or wrist extensor stretch. The infographic to the right provides additional details on these exercises.
Other exercises that you may wish to consider include:
- Start with your hands together in the “praying”position;
- Spread your fingers as far apart as possible;
- “Steeple” your fingers by separating your palms as far as possible while keeping your finger tips pressed together;
- Repeat up to 10 times.
- Make a fist;
- Slide your fingers up until they point upwards (as if you are giving a stop sign);
- Repeat up to 10 times.
- Touch the tip of your little finger to the tip of your thumb, so that they make the shape of the letter ‘O’;
- Repeat for each of the other 3 fingers;
- Repeat 4-5 times.
These exercises to treat carpal tunnel syndrome can each be performed while you go about your regular daily functions and are unlikely to be recognized as unusual even by co-workers.
If you have tried the above options to treat your carpal tunnel syndrome for 6 months or more without success, you may wish to discuss surgical options with your doctor. There are 2 types of surgery to treat carpal tunnel syndrome. Under open surgery, your doctor will make an opening roughly 2 inches long between your wrist and your palm. He will use this opening to gain access to your carpal tunnel. Under endoscopic surgery, your doctor will instead make 2 smaller openings. He then inserts a tiny camera as well as other instruments to help perform the operation.
Both types of surgery involve making an opening between your wrist and palm. Your doctor will then cut the transverse carpal ligament positioned above the carpal tunnel. This relieves the pressure on the median nerve that passes through the tunnel. The ligament will eventually heal but there will be more room for the nerve to pass through the carpal tunnel.
If you feel your carpal tunnel syndrome is severe enough to consider the surgical option, you should discuss this with your doctor before making a final decision. This surgery may require local, regional or even general anaesthesia.
Although in most cases (even the most severe ones) surgery to treat carpal tunnel syndrome can help to reduce the pain, it is possible that it may not completely solve the problem.