A massage therapist's guide to carpal tunnel syndrome- part 1

Wrist Brace

Carpal tunnel syndrome (CTS) is a common illness characterised by pain, stiffness, and discomfort in both the hands and the arms. CTS is caused by the squeezing and/or compression of the median nerve, the primary nerve of the hand, as it passes through the wrist.
It is thought to afflict between 4% and 5% of the population, primarily affecting those between the ages of 40 and 60, Despite the possibility of spontaneous reversion, the general rule is that the symptoms will increase. 
In the majority of the affected individuals, carpal tunnel syndrome worsens as time goes on. As a result of this, early diagnosis and treatment are vital. Initially, symptoms can often be alleviated by simple measures such as putting on a wrist splint or staying away from certain activities. However, in the event that the pressure on the median nerve persists, this can cause damage to the nerves and deterioration of the symptoms. In order to avoid permanent damage, in some patients, an operation to relieve the median nerve from pressure may be recommended. Some of those things that have been found to play a crucial role in the occurrence of carpal tunnel syndrome include and are not limited to the anatomy of the wrist, health problems and possibly repetitive movements of the hand.

WHAT ARE THE SYMPTOMS OF CARPAL TUNNEL SYNDROME?


The first and most noticeable symptoms often include numbness or tingling in the thumb, index and middle finger (areas of the hand that are innovated by the median nerve) These symptoms can seem to spontaneously appear and disappear.
Other common symptoms of carpal tunnel syndrome:

  • Occasional feelings of shock that spread to the thumb and forefinger, middle finger and ring finger

  • Pain or tingling that can radiate to the forearm towards the shoulder

  • Weakness and clumsiness in the hand – this could lead to difficulty in performing a simple task such as buttoning clothes

  • Dropping things as a result of weakness, numbness or a loss of proprioception

In some cases, the symptoms of carpal tunnel syndrome occur gradually without specific injuries. A number of patients have discovered that their symptoms come and go in the beginning. However, as the condition aggravates, symptoms may occur more often or may last longer.
Night symptoms are very common as many people sleep with their wrists bent, During the day, symptoms become noticeable when holding an object for a long period of time while the wrist is bent forward or in the backward direction ( both flexion and extension), typical examples are when using a phone, driving or reading a book.
Many patients find that their symptoms are alleviated by moving or shaking their hands.


WHAT ARE THE CAUSES OF CARPAL TUNNEL SYNDROME?


As mentioned earlier the major cause of carpal tunnel syndrome is pressure on the median nerve. The median nerve goes from the forearm through the passageway in the wrist (carpal tunnel) to the hand. It gives feeling to the palm side of the hand thumb and fingers, only the little finger is not affected. It is also responsible for nerve signals which contribute to the movement of the muscles around the base of the thumb (motor function).
As mentioned above, squeezing and irritation of the median nerve in the carpal tunnel space can also lead to the development of carpal tunnel syndrome. The narrowing of the carpal tunnel and irritation of the nerve can occur as a result of wrist fracture, the same way swelling and inflammation result in rheumatoid arthritis.
In many cases, there is no single cause. A combination of risk factors can contribute to the development of carpal tunnel syndrome.

 

WHAT ARE THE RISK FACTORS FOR CARPAL TUNNEL SYNDROME?


Carpal tunnel syndrome is caused by a variety of reasons. The following are some of the risk factors:

  • Anatomical factors. Fracture or dislocation of the wrist or arthritis that deforms the small bones (carpals) in the wrist, can affect the space within the carpal tunnel and exert pressure on the median nerve. Individuals with smaller carpal tunnels are at higher risk of developing carpal tunnel syndrome.

Sex. It has been found that carpal tunnel syndrome is more prevalent among women than men. This could be because of the smaller carpal tunnel area in women. Women with carpal tunnel syndrome may also have smaller carpal tunnels than those not affected.
Nerve-damaging conditions. There are some chronic diseases, such as diabetes, and others that increase the risk of nerve damage, including damage to the median nerve. 
Inflammatory conditions. Inflammatory illnesses, such as rheumatoid arthritis, can affect the wall of the wrist joint and exert pressure on the median nerve.
Changes in the balance of body fluids. The pressure within carpal tunnel syndrome can be increased due to fluid retention, which can also cause irritation of the median nerve. This has been found to be common among women mostly during pregnancy and menopause. Carpal tunnel syndrome associated with pregnancy usually disappears by itself after pregnancy.
Other medical conditions. Medical condition such as menopause, obesity, thyroid disorders, and kidney failure has been found to play a critical role in the occurrence of carpal tunnel syndrome.
Factors related to the workplace. Working with vibration tools or jobs that require prolonged or repeated bending of the wrist, can create harmful pressure on the median nerve or exacerbate existing nerve damage.
There has been a lot of research done to see if there is a link between computer usage and carpal tunnel syndrome. However, there was inadequate qualitative and consistent data to support extensive computer use as a risk factor for carpal tunnel syndrome, despite the fact that it can cause other types of hand pain.
 

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