Carpal Tunnel Syndrome - Overview
Anatomy of the Median Nerve
The median nerve runs from the shoulder down to four fingers of the hand (the thumb to half of the ring finger). The median nerve provides motor movements in the forearm and hand, as well as sensation in the hand. Some nerve fibers of the median nerve pass under the transverse carpal ligament at the wrist before they enter the palm of the hand. It is the compression of the median nerve at the wrist through the carpal tunnel that causes Carpal Tunnel Syndrome.
What is Carpal Tunnel Syndrome?
The Carpal Tunnel is formed between the transverse carpal ligament and the carpal bones at the wrist. Carpal Tunnel Syndrome is the compression and reduction of blood supply to the median nerve as it passes through the carpal tunnel at the wrist. When an individual has irritation or swelling of one or more of the nine tendons that pass through the carpal tunnel, it compresses the median nerve which is felt as pain, numbness or tingling of the first four digits of the hand. The tendons in this tunnel are what allow your fingers to flex, so movements that have lots of repetition such as typing can cause inflammation within the carpal tunnel; compressing the median nerve. Early diagnosis and treatment is beneficial to prevent nerve damage and worsening symptoms.
What factors contribute to developing Carpal Tunnel?
- Prolonged or repetitive movements of the hands/fingers
- Hormonal or metabolic changes
- Fractures/strains/sprains around the wrist that narrow the carpal tunnel, reducing the space for median nerve to remain uncompressed
- Diabetes causing nerve damage
- Exposure to repetitive vibration
- Family history
- Women are more likely to develop carpal tunnel.
- Women can develop carpal tunnel syndrome during pregnancy, which may improve after delivery. These individuals will have a higher risk of developing carpal tunnel syndrome later in life.
Prevention:
- Keep keyboard height at or slightly below elbow height.
- Do not droop the wrist, or lift the wrist too high for long periods of time.
- Maintain wrist strengthening exercises with proper form.
- For tasks that are longer duration such as work tasks, consider a more ergonomic set up.
- With exposures to vibration, take short breaks frequently.
- Reducing activities that produce the symptoms of CTS as these show there is aggravation of the nerve.
- Carpal Tunne Wrist Brace.
Function of the Median Nerve:
- Innervates flexion muscles of forearm, wrist and first four digits of the hand
- Enables the thumb to move by innervating the muscles at the base of the thumb
- Sends sensation feelings from the forearm, hand and fingers to the brain.
Symptoms of Carpal Tunnel Syndrome
- Tingling, numbness and pain of the thumb, index, middle and ring finger
- Chronic Carpal Tunnel Syndrome can cause weakness and muscle loss
What Brace is Best for Carpal Tunnel Syndrome?
An immobilizing brace for night time use is a common option to keep the wrist at a neutral position to prevent the wrist from going into a flexion/extension position that can compress the medial nerve in the carpal tunnel. As some individuals wake up from night time pain, these braces are used to reduce strain on the wrist and pressure in the carpal tunnel. Here are some bracing options that we like:
The Wrist Lacer II provides equal tension across all four laces offering supreme comfort, immobilization and ease of application. The polypropylene felt liner and perforated suede allow moisture to evaporate away from the skin.
Latex Free
Bauerfeind ManuLoc Long Plus Wrist Brace:
The ManuLoc long Plus immobilizes the entire hand up to the thumb and reliably restricts stretching, bending, and rotating movements by also stabilizing parts of the forearm. The removable finger support fixes the long fingers in the outstretched hand or intrinsic plus position. The orthosis is lightweight, breathable, and easy to put on with one hand.
MedSpec Compressor Wrist Support:
The Compressor wrist support provides excellent comfort and compression along the carpal region. The strap retention system on the end of the Compressor strap allows for ease of application. Our recommendation if you're in need of a brace that still allows you to perform activities such as typing, but provides some resistance to flexion/extension.
Latex Free
MedSpec GelFlex Wrist Support:
Have an upcoming decompression surgery for carpal tunnel? The GelFlex Wrist significantly reduces scarring at the incision site following carpal tunnel surgery. The contoured polymer gel pad is specially formulated to aid in healing and decrease the skin's external forces, thereby reducing discomfort associated with hypersensitivity.
Latex Free
Reminder: Don't forget to consult your physiotherapist or healthcare practitioner for more information on how to alleviate the pain and numbness. Together with physical therapy, a brace and the right exercises may alleviate pain associated with Carpal Tunnel Syndrome.
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