There are many different causes for pain in the hand and wrist. Some conditions are caused by trauma, and some are caused by a slow, persistent build up of factors that eventually become symptomatic.
In the case of trauma, the obvious differential diagnoses include wrist sprain or fracture. In the case of a slow build up of pain with no obvious event of injury, carpal tunnel syndrome is a common and somewhat frustrating condition for patients to experience.
What is Carpal Tunnel Syndrome?
The carpal tunnel is formed by some bones in our hand and the soft tissues in our palm. It is a tunnel. Our bones are on the roof of the tunnel, and connective tissue is on the floor of the tunnel.
What passes through the tunnel are tendons for our fingers and the median nerve. The median nerve is the structure that is primarily at risk with carpal tunnel syndrome. It innervates the palm of your hand and most of the second and third fingers. When our tendons enlarge and fibrotic tissue takes up space in the tunnel, the median nerve gets squished.
Like stepping on a garden hose, we get symptoms on the other side of the entrapment, and our hand gets numb. Common symptoms of carpal tunnel syndrome are numbness, tingling, a feeling of pins and needles, weakness, and achy pain. Carpal tunnel syndrome is the most common neuropathy of the upper limb.
Quite often, patients attend our clinic and report that they have surgery planned for their carpal tunnel syndrome. They often seem surprised that they may have other options for treatment! Although surgical release of the carpal tunnel can change the size of the carpal tunnel (and it works for many people), surgery is usually a last resort.
An interesting 2018 study published in the journal Musculoskeletal Science and Practice investigated the effects of manual mobilization on healthy people with no symptoms of carpal tunnel syndrome.
They found that manual therapy can change the shape of the carpal tunnel and increase the space available for the median nerve. When we compare manual therapy and surgery, manual therapy is obviously a more conservative approach and therefore carries less risk. Manual therapy can be performed by various professionals, including massage therapists, chiropractors, and physiotherapists.
If you’re experiencing pain in the hand and wrist and need some assistance in diagnosis and treatment, we can help! Please contact us if you have any questions about your condition and your treatment options.
Bueno-Gracia E, Ruiz-de-Escudero-Zapico A, Malo-Urries M et al. Dimensional changes of the carpal tunnel and the median nerve during manual mobilization of the carpal bones. Musculoskeletal Science and Practice 2018; 36: 12-16.