A nerve running down the arm and into the hand is relatively vulnerable to compression at the wrist. Tis is the median nerve, which supplies most of the palm. When this happens, you may experience pain, numbness, weakness, or tingling in the hand. This is carpal tunnel syndrome. Although there are many possible causes, one common mechanism is repetitive movements involving a lot of wrist flexion. This movement causes direct compression to the carpal tunnel itself, through which the nerve runs.
The carpal tunnel sits on the palmar side of the wrist. The base is formed by the bones of the wrist, and the ceiling by a set of ligaments. As you flex your wrist, the softer ligaments are compressed, meaning the tunnel and its contents are squashed. This can cause irritation to the median nerve over time. Nerves can continue to react once a stimulus is removed, so improvement may take time.
Symptoms typically include pain, pins and needles, numbness, or weakness in the area illustrated above.
Pregnancy and Carpal Tunnel Syndrome
Pregnancy can increase the likelihood of a patient developing carpal tunnel syndrome. Fluid retention increases the contents and pressure within the wrist, meaning less compression is required to affect the median nerve. The symptoms typically dissipate within a few weeks of giving birth, and they typically respond to exercises in the meantime. Similarly, local swelling caused by trauma, or conditions like lymphedema can add pressure to the carpal tunnel.
Diagnosis and Treatment
The symptoms can be confused with other conditions, for example Thoracic Outlet Syndrome. Here a nerve is irritated on its route around the neck and shoulder. Your osteopath will be able to use hands-on testing to work out where the irritation is coming from. Sometimes both areas are compressing nerves, in which case we can treat both.
Osteopathic treatment may involve techniques to reduce swelling, and to reduce the demand on the wrist. Sometimes stiffness in the elbow leads you to overwork the wrist without realising. So it may be appropriate to recommend you use a wrist splint overnight, or alter your desk set up to keep your wrist more neutral at work. Advice and treatment plans will vary from patient to patient.
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