Carpal tunnel syndrome (CTS) is a common condition that causes pain, numbness, and tingling in the hand and arm. The condition occurs
when one of the major nerves to the hand – the median nerve – is squeezed, irritated, inflamed or compressed as it travels through the
wrist. In most patients, carpal tunnel syndrome gets worse over time, so the earlier it’s diagnosed and treated, the better. Many sufferers are offered steroid injections or surgery, without realising that physiotherapy can often help without needing these invasive techniques.
The carpal tunnel is a narrow passageway in the wrist, about an inch wide. The floor and sides of the tunnel are formed by small wrist bones called carpal bones.
The roof of the tunnel is a strong band of connective tissue called the transverse carpal ligament. Because these boundaries are very rigid, the carpal tunnel has little capacity to
“stretch” or increase in size.
The median nerve is one of the main nerves in the hand, originating from a group of nerve roots in the neck.
These roots come together to form a single nerve in the arm. The median nerve goes down the arm and forearm, passes through the carpal tunnel at the wrist, and goes into the hand.
The nerve provides feeling in the thumb and index, middle, and ring fingers. The nerve also controls the muscles around the base of the thumb.
Tendons that bend the fingers and thumb also travel through the carpal tunnel. These tendons are called flexor tendons.
CTS occurs when the tunnel becomes narrowed or when tissues surrounding the flexor tendons swell, putting pressure on the median nerve.
When there is swelling, it takes up space in the carpal tunnel and, over time, crowds the nerve, putting pressure on it which results in pain, numbness, tingling, and
weakness or clumsiness in the hand.
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