Carpal Tunnel Syndrome: More Than Just Wrist Pain and How Osteopathy Can Help
That feeling of pins and needles, numbness, or aching in your hand, particularly at night, can be more than just an annoyance—it could be Carpal Tunnel Syndrome (CTS). A common condition affecting the hand and arm, CTS occurs when the median nerve is compressed as it travels through the wrist.
While often associated with repetitive computer use, the causes can be more varied. Osteopathy offers a holistic perspective on CTS, looking beyond the wrist to identify and treat the underlying factors contributing to nerve compression.
Key Facts About Carpal Tunnel Syndrome
A Nerve Compression Syndrome: CTS is not primarily a muscle or joint issue, but a problem where the median nerve is squeezed at the wrist.
Common and Impactful: It is one of the most prevalent peripheral nerve entrapment syndromes, significantly affecting hand function and sleep quality.
Not Always Work-Related: While repetitive strain is a key risk factor, many cases are linked to other health conditions, hormonal changes, or anatomical factors.
Common Causes and Risk Factors
The carpal tunnel is a narrow, rigid passageway in your wrist. Anything that reduces the space in this tunnel can irritate the median nerve. Common causes and risk factors include:
Repetitive Hand Movements: Jobs or hobbies involving prolonged typing, use of vibrating tools, or forceful gripping can inflame the tendons in the tunnel.
Anatomical Factors: A smaller carpal tunnel or a wrist fracture that alters the space can predispose you to CTS.
Health Conditions: Underlying issues such as diabetes, rheumatoid arthritis, and an underactive thyroid can increase the risk of nerve compression.
Fluid Retention: Hormonal changes during pregnancy, menopause, or due to other medical conditions can swell the tissues in the tunnel.
Obesity: Increased body mass index (BMI) is a significant risk factor.
Nerve Tension from Elsewhere: The median nerve originates from your neck. Stiffness or dysfunction in the cervical spine can make the nerve more susceptible to irritation further down the arm.
Common Signs and Symptoms
Symptoms often start gradually and may include:
Numbness, Tingling, or Burning: Primarily in the thumb, index, middle, and half of the ring finger (the distribution of the median nerve). The little finger is typically unaffected.
Night-Time Waking: Symptoms that flare up at night, often relieving by shaking or dangling the hand ("flick sign").
Radiating Sensations: Pain or tingling that may travel up the forearm.
Weakness and Clumsiness: A weakened grip, leading to a tendency to drop objects.
Sensory Changes: A feeling of swelling or that the fingers are useless, even if no visible swelling is present.
How Can Osteopathy Help with Carpal Tunnel Syndrome?
Osteopathic management for CTS focuses on reducing pressure on the median nerve by addressing contributing factors at the wrist, forearm, elbow, and neck. We use a gentle, whole-body approach to improve the environment through which the nerve travels.
During your initial consultation, we will:
Take a detailed history of your symptoms, daily activities, work ergonomics, and overall health.
Perform a physical examination including orthopaedic tests (e.g., Phalen's test, Tinel's sign) to assess nerve function at the wrist.
Conduct a comprehensive assessment of your neck, shoulder, elbow, and wrist to identify areas of joint restriction, muscle tension, or nerve irritation.
This is crucial because a "double crush" phenomenon—where the nerve is irritated at more than one point, such as the neck and the wrist—is common.
What Does Osteopathic Treatment Involve?
Using gentle, hands-on techniques, we aim to:
Reduce Local Compression: Gentle soft tissue massage and myofascial release to the forearm and hand muscles can decrease tension and improve fluid dynamics around the carpal tunnel.
Improve Joint Mobility: Gentle mobilisation of the wrist, elbow, and the joints of the hand can help create a more optimal space for the nerve and tendons.
Address the Neck and Upper Back: A primary focus is on improving mobility in the cervical and thoracic spine. Releasing tension here can significantly reduce overall tension on the median nerve.
Provide Personalised Advice and Rehabilitation: You will receive guidance on:
Ergonomics: Practical adjustments for your workstation, including keyboard, mouse, and chair height.
Nerve Gliding Exercises: Specific, gentle exercises to improve the mobility of the median nerve.
Activity Modification: Strategies to manage repetitive tasks and incorporate rest breaks.
Wrist Splinting Advice: Discussion on the potential benefits of wearing a neutral-position wrist splint at night.
When to Seek Immediate Medical Help
It is essential to get a proper diagnosis from a medical practitioner. Please consult your GP for a referral if you experience:
Constant numbness, weakness, or persistent pain that does not resolve.
A significant loss of grip strength or muscle wasting at the base of the thumb (thenar eminence).
Symptoms that began after a acute trauma to the wrist or neck.
Symptoms in both hands, which may suggest a systemic underlying condition.
Your GP can provide a definitive diagnosis and may discuss other management options, such as medication or a referral to a specialist for further investigation (e.g., nerve conduction studies) or treatment (e.g., corticosteroid injections or surgery), if conservative care is not sufficient.
Find Relief for Your Hands
Living with the discomfort of Carpal Tunnel Syndrome can impact your work, sleep, and daily life. Osteopathy provides a safe, non-invasive, and drug-free approach to not only alleviate your symptoms but also to address the underlying causes throughout your upper body.
Click here to schedule an appointment with one of our experienced osteopaths. Let us help you restore comfort and function to your hands.
References
*Wipperman, J., & Goerl, K. (2016). Carpal Tunnel Syndrome: Diagnosis and Management. American Family Physician, 94(12), 993-999. [Link: https://www.aafp.org/pubs/afp/issues/2016/1215/p993.html]*
*Huissetede, B. M., Hoogvliet, P., Randsdorp, M. S., Glerum, S., van Middelkoop, M., & Koes, B. W. (2010). Carpal tunnel syndrome. Part I: effectiveness of nonsurgical treatments—a systematic review. Archives of Physical Medicine and Rehabilitation, 91(7), 981-1004. [Link: https://www.archives-pmr.org/article/S0003-9993(10)00163-7/fulltext]*
*Page, M. J., O'Connor, D., Pitt, V., & Massy-Westropp, N. (2012). Therapeutic ultrasound for carpal tunnel syndrome. Cochrane Database of Systematic Reviews, (3). [Link: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009601.pub2/full]*
Disclaimer: This blog post provides general information only and is not intended as a substitute for professional health advice, diagnosis, or treatment. Always consult a registered health practitioner, such as your General Practitioner (GP) or osteopath, for diagnosis and treatment of health conditions. The information provided is based on the best available evidence at the time of publication but should not be relied upon as a sole source of information. Individual results from osteopathic treatment may vary based on the individual’s specific condition and response to care. In cases of severe or progressive nerve compression, prompt medical assessment is essential.