Carpal Tunnel & Nerve Compressions

Nerve compressions are common conditions that occur when a nerve is pinched or compressed, leading to pain, numbness, tingling, and weakness in the affected area. These conditions often develop gradually and can severely impact daily activities. The most common nerve compressions include carpal tunnel syndrome (CTS). Other nerve compressions include cubital tunnel syndrome, and radial nerve palsy.

Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is the most well-known and common nerve compression condition. It occurs when the median nerve, which runs from the forearm to the hand through the carpal tunnel in the wrist, becomes compressed. The carpal tunnel is a narrow passageway in the wrist that houses the median nerve and tendons, and when pressure builds up in this area, it can lead to nerve compression.

Carpal tunnel syndrome often develops due to repetitive motions, such as typing, gripping, or using tools that strain the wrist, as well as medical conditions like arthritis, diabetes, and pregnancy. Additionally, trauma to the wrist from fractures or sprains can contribute to swelling, leading to compression of the median nerve.

Symptoms of Carpal Tunnel Syndrome

Patients with carpal tunnel syndrome typically experience:

Numbness or tingling in the thumb, index, middle, and part of the ring finger.
Pain or an aching sensation that may radiate from the wrist to the forearm.
Weak grip strength, making it difficult to perform fine motor tasks like buttoning a shirt or holding small objects.
Clumsiness or dropping objects due to a weakened pinch or grip.
Worsening symptoms at night or upon waking, due to the wrist’s position during sleep.

Over time, if left untreated, carpal tunnel syndrome can cause damage to the median nerve, resulting in muscle weakness and loss of hand function.

Hand Therapy for Carpal Tunnel Syndrome

Non-surgical hand therapy is an effective first-line treatment for managing carpal tunnel syndrome. In many cases, it can alleviate symptoms without the need for surgery. The role of a hand therapist includes assessing the severity of the condition, educating patients on activity modifications, and implementing therapeutic interventions aimed at reducing symptoms and preventing further progression of the condition.

Wrist Splinting and Bracing: Wearing a wrist splint is often recommended to keep the wrist in a neutral position, especially during activities or while sleeping. This helps prevent excess pressure on the median nerve, reducing pain and numbness.
Activity Modification: Our hand therapy experts educate patients on how to modify daily tasks that may aggravate the condition.
Exercises and Stretching: Hand therapy also includes exercises designed to glide the median nerve and enhance blood flow. These exercises can help alleviate compression

When to Consider Surgical Options for Carpal Tunnel Syndrome

If non-surgical treatments, including wrist splinting, exercises, and activity modification, do not alleviate symptoms within a few months, surgical intervention may be considered. The surgery, known as carpal tunnel release, involves cutting the ligament that forms the roof of the carpal tunnel to relieve pressure on the median nerve. Our hand therapist collaborates closely with Sydney hand surgeons to determine the appropriate course of action if surgery is required.

Cubital Tunnel Syndrome

Cubital tunnel syndrome is caused by the compression of the ulnar nerve as it passes through the cubital tunnel at the elbow. This nerve controls sensation in the small and ring fingers and provides motor function to certain muscles in the hand. When compressed, it leads to pain, numbness, and weakness along the ulnar side of the hand.

Symptoms of Cubital Tunnel Syndrome

Common symptoms include:

Numbness or tingling in the ring and small fingers.
Pain along the inner side of the elbow.
Weakness in the grip, causing clumsiness or difficulty holding objects.

Hand Therapy for Cubital Tunnel Syndrome

Non-surgical hand therapy can help alleviate symptoms of cubital tunnel syndrome through:

Nighttime bracing to keep the elbow straight and reduce pressure on the ulnar nerve during sleep.
Activity modification to avoid prolonged elbow bending or direct pressure on the elbow.
Nerve gliding exercises to improve flexibility and reduce nerve irritation.

If conservative treatments do not improve the symptoms, surgery may be necessary to reduce pins and needles or numbness.

Radial Nerve Palsy

Radial nerve palsy occurs when the radial nerve, which controls the muscles that straighten the wrist and fingers, becomes compressed or injured. This condition can result from humerus fractures, prolonged pressure on the arm, or trauma. Patients may have difficulty straightening their wrist or fingers and experience numbness along the back of the hand.

Symptoms of Radial Nerve Palsy

Weakness in the ability to straighten the wrist and fingers.
Numbness along the back of the hand and forearm.
Difficulty grasping or releasing objects.

Hand Therapy for Radial Nerve Palsy

Treatment focuses on restoring function while the nerve heals. Hand therapy includes:

Custom splint to support the wrist and fingers, allowing for improved grasp and release during daily activities.
Exercises to maintain flexibility in the joints and strengthen the muscles as the nerve recovers.

Nerve compressions, such as carpal tunnel syndrome, cubital tunnel syndrome, and radial nerve palsy, can significantly impact daily life by causing pain, numbness, and weakness in the hands and arms. Hand Therapy Experts offer comprehensive hand therapy services to help manage these conditions effectively, using non-surgical treatments like splinting, exercises, and activity modifications to reduce symptoms and improve function. If conservative treatments fail, we work closely with hand surgeons to coordinate surgical intervention when necessary.