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carpal tunnel | wrist pain | tingling hand

What is Carpal Tunnel Syndrome and How Does it Develop?

Written by Boroondara Osteopathy

A well-known clinic in Melbourne’s eastern suburbs founded by Dr Katie Willy (Osteopath)

Carpal tunnel syndrome is the most common nerve entrapment condition of the upper limb.

The Mayo clinic states the most common symptoms of carpal tunnel usually start gradually and include:

  • pain, numbness, tingling and weakness in the hand. Specifically, it affects the thumb, the pointing finger, middle finger and half the ring finger on the affected hand because this is where the median nerve innervates. These symptoms often occur while holding a steering wheel, phone, or newspaper, or may wake you from sleep.
  • You may experience weakness in your hand and drop objects

Many people “shake out” their hands to try to relieve their symptoms. The numb feeling may become constant over time.

The carpal tunnel itself is a canal created in the wrist by carpal bones being the sides and the floor, the roof of the tunnel is the “flexor retinaculum” which is a sheath of tissue kind of like a piece of cling wrap. Inside the tunnel are 9 tendons (which attach the forearm muscles to the bones) and the median nerve. The muscles help move the wrist and fingers, and the median nerve powers the muscles and gives feeling to the fingers.

It is a tight tunnel with those 10 structures going through and any change may result in compression of the tendons and nerve. Repetitive activities and using vibratory tools seem to increase the chances of getting carpal tunnel syndrome. Women are 3 times more likely to be affected, with swelling and fluid retention in pregnancy which is not uncommon may be contributing to this figure. Some inflammatory disease may be a factor as well, diabetes, obesity, hypothyroidism, and rheumatoid arthritis all seem to be a risk factor for developing carpal tunnel.

What can osteopaths do for carpal tunnel?

With any part of the body that is swollen or there is overuse, these must be a reason why that happens. If someone has swelling in the wrist, we look further up the chain to see why that fluid might not be moving or draining. If there is tightness through the muscles around the armpit, then this crucial drainage are wont be able to drain fluid as well as possible. These can hamper efforts from the body to move fluid away from the wrist.

If the elbow, shoulder, or rib cage has had previous injury, these joints may not be working as well they should, in repetitive movements the wrist may be taking up the slack because the elbow is not able to move at its best. This means the muscles through the carpal tunnel are overused and potentially could be inflamed and increase the pressure on the median nerve, resulting in carpal tunnel syndrome.  

References:

  1. Presazzi et al. Carpal tunnel: Normal anatomy, anatomical variants and ultrasound technique. Journal of ultrasound, 2011 March, 14 (1) 40-46
  2. Van Suchtelen et al. Progression of Carpal Tunnel Syndrome According to Electrodiagnostic Testing in Nonoperatively Treated Patients. The archives of bone and joint surgery journal, 2014 Sep 2(3): 185-191.

 

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