Carpal Tunnel Syndrome

by Kellye Olson, OTD, OTR, CHT

Everyone knows someone who has had or does have carpal tunnel syndrome. The first question I usually get asked when people find out that I’m a hand therapist is, “do you think the pain in my hand could be carpal tunnel?” Carpal tunnel syndrome (CTS) is very common in the hand, but just because you have pain in your hand doesn’t always mean you have CTS. There are not only more specific symptoms you can have other than just pain, but those symptoms occur in specific parts of your hand. Look down at your right wrist, palm side up. At the bottom of your palm, just above where your wrist and hand meet lies your carpal tunnel.

The carpal bones of your wrist serve as the floor of the carpal tunnel. Passing through the carpal tunnel and over the carpal bones are nine flexor tendons and the Median nerve. Everything is held nice and tight within the carpal tunnel by the Transverse carpal ligament that spans over the top of the nerve, tendons, and carpal bones.

Diagnoses such as arthritis, pregnancy, and diabetes can cause the pressure within the carpal tunnel to increase and cut off nutrition to the nerve. Other times, the wrist is held in a flexed position for long periods of time and the nerve gets compressed within the carpal tunnel, also cutting off nutrition to the nerve. People who fold their hands into their blankets at night are prime candidates to have symptoms of CTS. They tend to sleep with their wrists in this flexed posture, compressing the Median nerve for a prolonged period of time, and waking up because their hand is still very soundly, and very painfully, asleep. When the nutrition to the Median nerve is compromised, it can send out distress signals in the form of pain, but more specifically people feel numbness and tingling in the thumb, index, and long fingers.

The CTS is usually pretty easy for a Certified Hand Therapist to diagnosis and treat. Therapy for CTS spans from learning how to do the appropriate stretches and changing positions all the way up to custom splinting to allow the median nerve time to rest and recover.