Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is a common peripheral nerve disorder resulting from compression of the median nerve as it passes through the carpal tunnel, a narrow passageway in the wrist formed by the carpal bones and transverse carpal ligament. The compression of the median nerve leads to a constellation of symptoms, including pain, numbness, tingling, and weakness in the thumb, index, middle, and radial half of the ring finger. While CTS can have multifactorial etiology, manual therapy has emerged as a promising adjunctive treatment modality to alleviate symptoms and improve hand function.
The pathophysiology of CTS is complex and involves mechanical compression, ischemia, and inflammation of the median nerve within the carpal tunnel. Predisposing factors such as wrist anatomy, repetitive hand movements, trauma, hormonal changes, and systemic diseases contribute to the development of CTS. Compression of the median nerve leads to impaired nerve conduction, demyelination, and axonal degeneration, resulting in sensory and motor deficits in the affected hand.
CTS predominantly affects individuals engaged in repetitive hand and wrist movements, as well as those exposed to occupational or recreational activities that involve prolonged wrist flexion or extension. Thus, certain demographic groups are more susceptible to developing CTS, including:• Working Professionals: Occupations that involve repetitive or forceful hand movements, prolonged computer use, or vibrating tools predispose individuals to CTS. Office workers, assembly line workers, musicians, and those in the construction industry are at increased risk.
• Women: Studies have shown that women are more likely to develop CTS compared to men, possibly due to hormonal factors, smaller carpal tunnel dimensions, and increased susceptibility to soft tissue swelling during pregnancy.
• Aging Population: Older adults are at higher risk of developing CTS due to age-related changes in soft tissues, decreased nerve elasticity, and underlying degenerative conditions such as arthritis and ligamentous laxity.
• Individuals with Comorbidities: Systemic conditions such as diabetes, obesity, thyroid disorders, and rheumatoid arthritis are associated with an increased risk of developing CTS due to their effects on nerve health, tissue inflammation, and fluid retention.
Manual therapy encompasses a variety of hands-on techniques aimed at addressing musculoskeletal dysfunctions, improving joint mobility, and reducing soft tissue restrictions. In the context of CTS, manual therapy interventions target the underlying anatomical and biomechanical factors contributing to median nerve compression. Common manual techniques employed in the treatment of CTS include:
• Soft Tissue Mobilisation: Manual manipulation of the muscles, tendons, and fascia surrounding the carpal tunnel aims to reduce adhesions, improve tissue extensibility, and alleviate pressure on the median nerve.
• Nerve Gliding Exercises: Specific exercises designed to mobilise and stretch the median nerve can help reduce neural tension, improve nerve conduction, and alleviate symptoms of CTS.
• Joint Mobilisation: Gentle mobilisation of the wrist, hand, and adjacent joints aims to improve joint mobility, reduce stiffness, and optimise the biomechanics of the upper extremity.
• Therapeutic Exercises: Strengthening and stretching exercises targeting the muscles of the forearm, hand, and wrist can help improve grip strength, enhance proprioception, and promote functional recovery in individuals with CTS.
If you or someone you know are dealing with CTS, musculoskeletal pain, or even myofascial trigger points, book in an appointment to see us now for an initial consultation so we can assess your condition and come up with an appropriate and tailored treatment plan to manage your pain.
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