Causes of carpal tunnel syndrome
The most common causeof carpaltunnel syndrome is
idiopathic(whichmeans that the exact aetiologyis
• In general, anything thatcrowds, irritatesor compresses the
median nerve in the carpaltunnel space can leadto carpal
Anything that aggravates and inflames the
tendons can cause carpal tunnel syndrome,
including repetitive hand movements,
pregnancy and arthritis.
• Numbness Pins and needles Pain, particularly at night
• Darting pains from the wrist
• Radiated or referred pain into the arm and shoulder
• Weakness of the hand and Decreased grip strength
• The little finger and half of the ring finger are
• Swollen fingers
• Inability to differentiate between hot and cold by
A common test for nerve entrapment is
Tinel’s sign. Tapping or ‘percussing’ is
performed on the surface of the skin along the
nerve pathway over the suspected area of the
lesion. If this produces a tingling sensation
then the test is positive.
Non-steroidal anti-inflammatory drugs,
such as :
• Aspirin and ibuprofen can manage carpal
tunnel syndrome symptoms that have been
present for a short time.
• Corticosteroids can be injected directly into
the wrist to provide relief to persons with mild
Exercise for Carpal Tunnel Syndrome
• Straighten both wrists and relax fingers.
• Make a tight fist with both hands.
• Then bend both wrists down while keeping
• Hold for a count of 5.
• Straighten both wrists and relax fingers,
for a count of 5.
• Repeat 10 times.
The following orthoses help manage the carpal
tunnel syndrome pain:
– Wrist hand orthosis
– Thumb spica splint
– Cock-up wrist splint
– Decrease pain and swelling
– Prevent deformity progression
– Prevent Movement
– By restrict flexion movement of wrist
– Main objective is to position wrist in neutral but
preferably slight extension to get pressure off of
– Static low profile wrist supports often used to position
Carpal tunnel releasesurgery
Cut The Ligament
Surgery is one treatment option for carpel tunnel
syndrome. The surgeon makes an incision (cut) less than 5 cm
long in your palm, and perhaps into the wrist as well, to
expose the transverse carpal ligament. The surgeon then cuts
the ligament to reduce pressure on the underlying median
nerve. The incision in the palm is sutured (sewn) closed
• Surgery is usuallysuccessful.In some cases it does not
completely relieve the numbness and pain in the fingers or
hand. Thismay be the case if there has been permanent nerve
damage caused by long-standingcarpal tunnelsyndrome or
by other health problems such as diabetes.
Complications from surgery
• Although complications are possible with any
surgery, your doctor will take steps to
minimize the risks. The most common
complications of carpal tunnel release surgery
• Nerve aggravation or injury
Risk factors of carpal tunnel syndrome*
1-Alterations inthe balanceof body fluids. Certain conditions such
as pregnancy, obesity, thyroid hormone disorders and kidney failure,
can affect thelevel of fluids inyour body.
Fluid retentioncommon during pregnancy, for example may increase
the pressure withinyour carpal tunnel,irritating the median nerve.
Carpal tunnelsyndrome associated with pregnancy generally
resolves on its own after the pregnancy is over.
2-Nerve-damaging conditions. Some chronic illnesses,
such as diabetes and alcoholism, increase your risk of nerve
damage,including damage to your median nerve.
3-Inflammatory conditions. inflammation,such as
rheumatoidarthritis or an infection,can affect thetendons in
your wrist, exerting pressure on your median nerve.
4-Anatomic factors.A wrist fracture or dislocation thatalters
the space withinthe carpal tunnelcan create extraneous
pressure on themedian nerve.