The median nerve is a nerve which runs from your forearm into the palm of your hand. It provides much of the signal to the front side of your forearm, and to your hand including your thumb, index and middle fingers. Sometimes, the median nerve can become compressed or entrapped in your wrist at the Carpal Tunnel, the passageway that connects your forearm to your hand (on the same side as the palm of your hand). This can be exacerbated by repetitive activities such as computer or mobile phone use that entail flexing your wrist for prolonged periods. Another potential cause is from wrist injuries such as sprains or fractures. Research indicates that there may also be a congenital predisposition to Carpal Tunnel Syndrome due to anatomical variation (that is, some people just have smaller carpal tunnels which are more likely to entrap the median nerve). Women get carpal tunnel syndrome three times more often than men. There are even links between Carpal Tunnel Syndrome and pregnancy, diabetes, thyroid disease and rheumatoid arthritis! So as you might gather, this is a very common condition.
When your median nerve gets compressed or entrapped in the carpal tunnel, the signal that travels along the nerve can be weakened or halted completely. Common symptoms of Carpal Tunnel Syndrome include:
Pain/aches in the wrist, forearm and hand
Numbness and/or tingling in the fingers (typically the thumb, index and middle fingers but sometimes also in one half of the ring finger)
Feeling like the affected fingers are swollen
In more advanced cases, weakness and loss of motor function in the affected hand and fingers *Photo from Academy Orthopedics*
Left untreated for too long, advanced cases of Carpal Tunnel Syndrome can lead to permanent nerve damage. But most cases start with mild symptoms and preventative treatment can stop things from getting to that point. If you work with a physical therapist, they can teach you how to avoid aggravating your median nerve, particularly
Making sure that you have a good ergonomic setup for tasks such as using a computer so you can avoid flexing your wrist severely
Instructing you in the use of wrist braces/splinting when you sleep to avoid bending your wrist for prolonged periods at night
Exercises for stretching your wrist that can help alleviate symptoms and prevent their recurrence
In especially acute cases, an injection of corticosteroids may be used to reduce inflammation of the connective tissues in the carpal tunnel to alleviate the compression. Depending on the severity of your symptoms, you may receive an electromyography to help rule out other causes.
If your Carpal Tunnel Syndrome is severe enough, you may require a surgical procedure known as carpal tunnel release. In this procedure, an incision is made in your transverse carpal ligament on the inside of your wrist, because this is the ligament which puts pressure on your median nerve. This can either be done endoscopically or via an open incision in your wrist. This is an outpatient procedure, so you can typically return home the same day. You will likely need to be in a splint for 1 to 2 weeks during which time you’ll be encouraged to move your fingers a lot to prevent stiffness.
After your immediate recovery, you will start work with a physical therapist who can work with you to do exercises to recover your strength. Wrist/finger bends, tendon gliding, and wrist curls are common exercises that your physical therapist will walk you through to help you recover your function and help prevent future recurrence of Carpal Tunnel Syndrome.