Carpal Tunnel

Occasionally, the carpal tunnel may narrow resulting in compression of the median nerve.
Carpal tunnel syndrome normally occurs following damage to the flexor tendons within the carpal tunnel. This results in swelling and inflammation of the tendons, thereby reducing the dimensions of the carpal tunnel, compressing the median nerve.
Causes

Overuse of the forearm flexors - When this tension is excessive due to too much repetition or high force, damage to the tendons may occur. This is usually due to gradual wear and tear associated with overuse, however, it may also occur traumatically due to a specific incident.

Greater prevelance in over 50
Women more common than men
And dominant hand more susceptible

Treatment

Remove biomechanical overload if this is the cause, only do pain free movements.

Activities which place large amounts of stress through the forearm flexors should be minimized, these include: racquet sports, gripping activities, opening jars, cans or doors, carrying or lifting.

Resting from aggravating activities ensures that the body can begin the healing process in the absence of further tissue damage.

Once the patient can perform these activities pain free, a gradual return to these activities is indicated provided there is no increase in symptoms.

Ignoring symptoms or adopting a 'no pain, no gain' attitude is likely to lead to the problem becoming chronic. Immediate, appropriate treatment in patients with this condition is essential to ensure a speedy recovery. Once the condition is chronic, healing slows significantly resulting in markedly increased recovery times.

Patients with carpal tunnel syndrome will usually benefit from following the R.I.C.E. Regime. The R.I.C.E regime is beneficial in the initial phase of the injury (first 72 hours) or when inflammatory signs are present (i.e. morning pain or pain with rest). This involves resting from aggravating activities (often with the use of a splint or Wrist Brace), regular icing, the use of a compression bandage and keeping the arm elevated. Anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation.

Patients with carpal tunnel syndrome should perform pain-free flexibility and strengthening exercises as part of their rehabilitation to ensure an optimal outcome.

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