Carpal Tunnel Syndrome: Symptoms, Diagnosis & Treatment
Numbness, swelling and pain in the fingers or arms? Maybe it’s Carpal Tunnel Syndrome (CTS). We go over symptoms, diagnosing, and possibly treatments.
Where is the Carpal Tunnel located?
The Carpal Tunnel refers to the area near the wrist creases, where the wrist bones and the carpal tunnel ligament are. Within the carpal tunnel lies the median nerve, which is often the main culprit of Carpal Tunnel Syndrome (CTS) pain. Pain is produced when the median nerve is either compressed or pinched.
(Genova et al., 2020)
Common Symptoms of Carpal Tunnel
Common signs of CTS are;
- Numbness in the fingers or arms in various positions
- Numbness in the fingers or arms in various positions during consecutive activities
- A burning or prickling sensation at night
- A sensation of swelling over the median nerve area of the hand.
The symptoms are often more intense at night than in the daytime (Malakootian et al., 2023; Wright &; Atkinson, 2019).
Diagnosing Carpal Tunnel Syndrome
To diagnose CTS, first, the clinician will;
- Go through your medical history
- Conduct an assessment of the strength,
- Characteristics of symptoms and their distribution throughout the hand, and whether or not the pain travels up the arm.
Other Possible Ways to Confirm Carpal Tunnel Syndrome Diagnosis
Depending on the clinician, there are multiple ways to confirm a diagnosis of CTS such as;
- Nerve conduction tests
- Magnetic resonance imaging
- Provocative tests such as the Tinel sign and the Phalen manoeuvre
Testing Positive for Carpal Tunnel Syndrome
In simple terms, positive results are considered when the repetitive tapping and flexing of the wrist to 90° reproduces the symptoms.
How to manage Carpal Tunnel Syndrome
The management of CTS is dependent on the severity of pain/symptoms.
Non-surgical Carpal Tunnel treatments
In mild and moderate cases, non-surgical approaches are usually trialled first.
- Physical therapy
- Therapeutic ultrasound
- Laser therapy
- Musculoskeletal manipulations
Carpal Tunnel Release Surgery
When conservative management is not effective, the next step would be to consider carpal tunnel release surgery, which is done by cutting the transverse carpal tunnel ligament.
According to Malakootian et al. (2023), Wright and Atkinson, (2019), CTS is more prevalent in those who are;
- Over 55 years of age
- Having a high body mass index, obesity, and diabetes
- Has any of the following (thyroid disease, pregnancy, renal failure, alcoholism,
- primary amyloidosis, and drug toxicity)
- Regular use of vibratory tools, increased hand force, repetitive wrist motion,
- and extreme flexion/extension of the wrist
- Traumatic experience involving direct compression or indirect compression of
- the nerve via hematoma and/or soft tissue swelling.
- Overall, CTS is 10 times more prevalent in females than in males
Please visit a GP/clinician if in doubt.
Written by Oscar Mah, PT4 student, Monash University for Physio and Fitness Clinic.
Baylor College of Medicine. (2019). Carpal Tunnel Release Surgery. Healthcare:
Aesthetics and Plastic Surgery. Retrieved from https://www.bcm.edu/healthcare/specialties/aesthetics/hand-surgery
Genova, A., Dix, O., Saefan, A., Thakur, M., & Hassan, A. (2020). Carpal tunnel syndrome: a review of literature. Cureus, 12(3).
Malakootian, M., Soveizi, M., Gholipour, A., & Oveisee, M. (2023). Pathophysiology, diagnosis, treatment, and genetics of carpal tunnel syndrome: a review. Cellular and Molecular Neurobiology, 43(5), 1817-1831.
Wright, A. R., & Atkinson, R. E. (2019). Carpal Tunnel Syndrome: An Update for the Primary Care Physician. Hawaii journal of health & social welfare, 78(11 Suppl 2), 6–10.