Carpal tunnel syndrome results from compression of the median nerve at the carpal tunnel. The carpal tunnel is a system that allows nerves and tendons to efficiently travel from the arm to the hand.

Symptoms

• Numbness in thumb, index, middle, and radial aspect of ring finger
• Weakness
• Sharp/Shooting pain
• Muscle atrophy of the thenar eminence
• Pain and sensitivity to wrist and thumb

Pathology

Each tunnel is a very tight space. Sometimes when there is swelling or inflammation of tendons or nerves, there’s not enough space in the tunnel to to accommodate for this swelling, which leads to compression resulting in numbness, loss of dexterity, weakness, and tingling (Cooper, 2014).
The most common areas people feel numbness are in the thumb, index, and middle fingers. Other symptoms include occasional shooting pains in the wrist/palm. These symptoms can also be caused by Thoracic Outlet Syndrome.

Treatments

Conservative treatment for carpal tunnel syndrome often involves gentle stretching, activity modification, and modalities. These help reduce compression of the median nerve that could be caused by tendon, ligament, or muscle tightness.

Surgical intervention known as carpal tunnel release is often a successful option for more severe cases. This is when the transverse carpal ligament is cut (as shown in the picture). This decompresses the carpal tunnel allowing the median nerve to function more effectively. Soft tissue buildup along the median nerve branches is often removed to improve nerve conductivity and mobility as well (Mayo Foundation for Medical Education and Research, 2020).

Reference

Cooper, C. (2014). Fundamentals of hand therapy: Clinical reasoning and treatment guidelines for common diagnoses of the upper extremity (2nd edition). Elsevier Mosby.

Mayo Foundation for Medical Education and Research. (2020, February 1). Carpal tunnel syndrome. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/symptoms-causes/syc-20355603.