Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome (CTS)?

Carpal tunnel syndrome is a condition that causes pain, numbness, tingling, and weakness in the hand and wrist. It mainly affects:

  • Thumb

  • Index finger

  • Middle finger

  • Sometimes the ring finger

     

CTS occurs when the median nerve, which runs through a narrow passage in the wrist called the carpal tunnel, becomes compressed or irritated.

The median nerve provides:

  • Sensation to most of the fingers

  • Motor control to some hand muscles

When pressure builds up inside the carpal tunnel, the nerve cannot function properly, leading to symptoms.

Common Symptoms of Carpal Tunnel Syndrome

  • Numbness or tingling in the hand or fingers

  • Wrist or hand pain

  • Burning or electric-shock sensations

  • Weak grip strength

  • Difficulty holding objects (phone, pen, steering wheel)

  • Clumsiness with fine movements (buttoning clothes, using keys)

     

Symptom Pattern

  • Symptoms usually start gradually

  • Often worse at night and may wake you from sleep

  • Over time, symptoms may occur during the day, especially with repetitive activities like typing or tool use

 

What Does Carpal Tunnel Syndrome Feel Like?

  • Pins and needles

  • Fingers feeling “asleep”

  • A deep ache or burning pain inside the wrist or hand

  • Relief by shaking the hand

  • Reduced grip strength or dropping objects unexpectedly

 

What Causes Carpal Tunnel Syndrome?

CTS is caused by increased pressure on the median nerve within the carpal tunnel.

Common causes include:

  • Repetitive hand or wrist movements

  • Arthritis

  • Wrist sprains

  • Wrist fractures

  • Ganglion cysts

  • Swelling or inflammation in the wrist

 

Risk Factors for Carpal Tunnel Syndrome

Anyone can develop CTS, but higher risk groups include:

  • People doing repetitive hand work (typing, hammering, tool use)

  • Users of vibrating tools (drills, jackhammers)

  • Pregnant women

  • Women

  • Adults over 40

  • People with a family history of CTS

     

Medical Conditions That Increase Risk

  • Rheumatoid arthritis

  • Gout

  • Hypothyroidism

  • Diabetes

  • Obesity

  • Amyloidosis

How Is Carpal Tunnel Syndrome Diagnosed?

Diagnosis is based on:

  • Clinical history

  • Physical examination

  • Special tests

Management and Treatment of Carpal Tunnel Syndrome

Treatment usually begins with conservative (non-surgical) options.

Non-Surgical Treatments

  • Wrist splinting (especially at night)

  • Physiotherapy to improve strength, flexibility, and nerve mobility

  • Posture and workstation modification

  • Activity modification

  • Pain relief medication (NSAIDs or paracetamol – short term only)

Physiotherapy Exercises for Carpal Tunnel Syndrome

Further Options

  • Corticosteroid injection (if symptoms persist)

  • Surgery (considered if injection treatment fails)

Chronic Carpal Tunnel Syndrome Causes Muscle Atrophy of Thenar Eminence making it challenging to recover from Injection or even Surgery in some cases, Hence exercises with conservative management hold high importance