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Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is a relatively common condition, with some people going on to have surgery for pain relief.

 The carpel is the collective name for the group of small bones (CARP) which are found at the heel of our hand. They rest in two rows of 4 bones. These bones together form many joints and in part allow our hands to mould around objects. They are held together in an arch and with a thick band of fascia (connective tissue) that runs from side to side of the wrist where they form a tunnel.

 The tendons that make our finger and thumb curl up (Long Flexor Tendons) along with one of the nerves passing into our hand all pass through this tunnel.

 The main signs a person will report will be discomfort at the wrist and possible radiation of this feeling up the arm to the shoulder. This pain is often felt more notably at night or when resting.

 Numbness around the palm, index and thumb can be reported along with a weakness in these digits if the symptoms are marked or have been occurring for some time without relief.

 The main culprit for causing this syndrome is over use of the finger flexors, such as using shears (garden industry workers), or heavy repetitive pressure on this part of the hand such as over leaning on a stick or resting the heel of the hand on a flat hard surface whilst using a computer mouse.

 We are always taught to check neck and elbow to rule out other areas of nerve entrapment. The person leaning down hard a stick for instance may well also be bending their head forward to look at the floor rather than straight ahead. This was thought to cause irritation at the neck end of the nerve, which would then spread out down the arm giving rise to possible “tennis” elbow or carpel tunnel syndrome. However, whilst the nerve may well be irritated the main culprit we now understand to be the connective tissue pathways from neck to wrist.

 Any local irritation from pressure or over use will prevent the connective tissue from moving freely within this limb. The discomfort felt in the early stages is a message from your body for you to change how you are doing what you are doing and to help the connective tissue move freely again. 

 With Carpal Tunnel Syndrome there is always an underlying postural component and may also be an over sensitivity of a person’s connective tissue to external stresses. “It ain’t what you do it’s the way that you do it” is a good line to think of here. Check how you are sitting, have you supported your wrist when using the mouse; what position is your neck held in? If you are using shears for cutting flowers etc are you looking down constantly? Are you holding the rest of your arm too stiffly? Can you perch on a high stool to stop your neck bending forwards? Change how you hold the flowers; say every 4th or 5th bunch make a subtle adjustment to your posture.

 First aid treatment of gels with local pain relief (ask your chemist) and using a wrist splint may give temporary relief whilst you work on the bigger picture. You may need to strengthen shoulder and back muscles to provide a better “coat hanger” for your arm to be supported; you may be able to give yourself posture advice and stretches; it may require deeper connective tissue mobilisation for long term relief.
 Steroids, wrist splints and surgery will offer only localised, temporary relief as they all address only the local area of pain and not the bigger picture. This is your task! Ask a person who works in a more global posture and connective tissue view point for some assistance in your pathways to recovery. Aim for quick, short term pain relief whilst you take the time to work on the whole you!

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