Carpal tunnel - physiotherapy

It is a fairly common condition. It can cause pain, numbness, tingling or burning sensation in your hands and fingers. Some people also get weakness in their fingers and, or thumb and find it difficult to write.

Your median nerve runs through the carpal tunnel, which is in your wrist (see picture). When it is squashed or compressed then you can get the symptoms described above.

Symptoms can vary from mild to severe and can affect one or both hands. At first symptoms come and go, often they are worse at night and when you wake up. Often people find themselves raising the hand up or hanging it down or shaking their wrist to give some relief.

It is not always known why it happens. It is thought that some inflammation develops in the tendon going through the carpal tunnel. This causes swelling and squashing of the nerve.

It can be more common:

• during pregnancy
• if you are overweight
• if you have diabetes
• if you are going through the menopause, or
• it can be the side effect of some drugs
• Some of these cause water retention.

• Your doctor or physiotherapist may give you a splint to keep your wrists in a fixed position. This should be worn for periods of time over several weeks, especially at night.
• It is also important not to over use your wrist. So, avoid prolonged gripping or squeezing.
• If you work at a computer, it is important to look at the position of your wrists when using the keyboard. Get a wrist rest if there is any excess pressure. Make sure your posture at your workstation is suitable.
• Ask your line manager or an occupational nurse for advice if you are not sure.
• If these changes do not help, your doctor may suggest further tests or steroid injections. Remember, though that the above changes can take several weeks to improve your symptoms.

Forearm supported on a table, hand relaxed over the edge.
Extend your wrist and clench your fist - relax and let your hand drop.
Repeat 10 times, 3-4 times a day.

Place your forearm on a table with the back of your hand facing up. Hold a small weight in your hand, for example a can of food.
Slowly bend your wrist up as far as possible then relax back down as far as comfortable.
Repeat 5 -10 times, 3-4 times a day.