We have all had pins and needles at some stage – you sit on your leg for too long and end up with a tingle in your foot. It’s painful and annoying, but if you wiggle it around a bit, it goes away after not too long. But what if it the tingling didn’t go away, or if it keeps coming back for no apparent reason?
People with Carpal Tunnel Syndrome experience a nasty tingling in their hand. For some, it comes and goes, for others, it sets in and becomes a constant, irritating companion.
Carpal Tunnel Syndrome is a condition with many theories on causes and contributing factors. There is one causative factor, however, that is often mentioned – repetitive activity with the hands.
The base of our hand (the part just past the wrist) consists of two rows of small bones. They are known collectively as the carpal bones. The rows of carpal bones fuse together with ligaments to form a small arc (with the apex facing the back of our hand).
A ligament complex then encloses the open end of the arc (on the palm side of our hand), and this is carpal tunnel!
The carpal tunnel is a motorway in demand. The tendons that curl the fingers and thumb pass through the tunnel, as well as the median nerve, which supplies sensation to part of the hand, and power to some thumb muscles.
All of these structures are tightly packed into the tunnel, with only just enough room to move.
What goes wrong?
If the hand is used a lot, the tendons that move the fingers can become swollen. This can mean they are swollen as they pass through the carpal tunnel. Because the tunnel is boundaried mainly by the carpal bones, there is no way for the tunnel to grow or expand to accommodate the extra bulk. It is ‘peak hour’ in the tunnel, and it creates a traffic jam! The enlarged tendons therefore squash the softest structure in the carpal tunnel. The softest structure happens to be the median nerve. It is the ‘squashing’ of the median nerve that causes the tingling, and weakness in some of the thumb muscles. As the swelling in the tendons settles with rest, the nerve decompresses, and the symptoms often go away.
In pregnancy, a woman often has more fluid on board, and this can cause carpal tunnel symptoms, even with no change in hand use.
For some, the symptoms are worst at night time, when inflammation from the days activities can cause swelling, or fluid pools in the limbs.
Take Action Before You Break
The avoidance of Carpal Tunnel Syndrome revolves largely around managing repetitive loads. Ensure that the ergonomics of your repetitive activities are as ideal as possible. Then, break up your repetitive activity as much as possible, by regularly taking breaks or changing activities.
Ensure that the tendons that pass through your Carpal Tunnel are flexible and mobile, with simple stretches.
Injury Proof Toolkit
1) Change Your Environment
If you work on a computer, make sure it is set up well.
2) Change Your Habits
Take at least 10 minutes break for every hour of repetitive activity, for no more than 4 hours a day, 5 days a week.
1. Take one arm out in front of you, palm up
2. Using the other hand, pull the fingers and hand back and down
3. You should feel a stretch in your wrist or forearm
4. Hold for 30 seconds. Repeat twice each arm
If you suspect you may have Carpal Tunnel a Physiotherapist can assess the symptoms and rule out other causes, suggesting an action plan to assist the problem.