Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) occurs when the median nerve, which runs through the wrist, becomes compressed inside the carpal tunnel a narrow passageway surrounded by bones and ligaments. This compression leads to numbness, tingling, pain, and weakness in the hand and fingers. CTS is common in people who do repetitive hand or wrist movements, such as typing, assembly work, or using tools, but it can also be related to medical conditions like arthritis, diabetes, or pregnancy-related swelling.
Diagnosis of CTS
Carpal tunnel syndrome is diagnosed with:
-
Medical history review (work habits, repetitive activity, or health conditions).
-
Physical exam:
-
Tinel’s sign (tapping over the nerve to produce tingling).
-
Phalen’s test (flexing wrists to reproduce symptoms).
-
-
Nerve conduction studies (NCS) or EMG to confirm slowed nerve signals.
-
Imaging (ultrasound or MRI) may be used to rule out other wrist issues.
Treatment for CTS
Physical therapy can effectively manage carpal tunnel symptoms and improve hand function, especially in mild to moderate cases. Treatment may include:
-
Manual therapy to improve wrist mobility and reduce tension around the carpal tunnel
-
Nerve gliding exercises to improve mobility of the median nerve
-
Strengthening exercises for hand, wrist, and forearm muscles
-
Stretching routines for the wrist flexors and extensors
-
Splinting (especially at night) to keep the wrist in a neutral position
-
Pain management with ultrasound, electrical stimulation, or cold therapy
-
Education on posture, ergonomics, and activity modification to reduce strain
In severe cases, surgical release of the carpal tunnel may be recommended, with PT essential afterward to restore strength and motion.
Symptoms of CTS
Typical symptoms of carpal tunnel syndrome include:
-
Numbness or tingling in the thumb, index, middle, and ring fingers
-
Hand pain that may extend up the arm
-
Weakness in grip strength
-
Dropping objects due to poor finger control
-
Nighttime hand pain or tingling that wakes patients from sleep
-
Symptoms that worsen with repetitive use of the hand/wrist
Prevention of CTS
To reduce the risk of developing carpal tunnel syndrome or prevent flare-ups:
-
Take frequent breaks during repetitive tasks
-
Maintain neutral wrist position while typing or using tools
-
Use ergonomic keyboards, mouse pads, or wrist supports
-
Stretch hands and wrists regularly
-
Strengthen grip and forearm muscles for better support
-
Address underlying health conditions that may contribute to swelling or nerve pressure