Carpal tunnel syndrome (CTS) is caused by cumulative trauma that results in a compression of the
median nerve. When this nerve is compressed it can cause a variety of symptoms including, weakness,
numbness and tingling, a loss of sensation and pain. These symptoms occur in the first three digits of the
hand, as these are innervated by the median nerve. There are a variety of activities that can cause the
trauma that results in CTS, it is often activities that require fine movements of the fingers, such as
typing.
Anatomy
In our wrists we have something referred to as the carpal tunnel. This tunnel is formed by structures
such as the flexor retinaculum and the carpal bones of the wrist. The “roof” is the flexor retinaculum
while the “floor” is comprised of the carpal bones. Passing between these structures are the median
nerve, blood vessels and muscle tendons. Swelling (caused by repetitive trauma) leads to compression
of these structures, resulting in the median nerve sending sensations of numbness, tingling and pain.
Medical Management
Treatment is aimed at decreasing pain, restoring normal function and improving function. Antiinflammatory medication is quite often used to help decrease inflammation. People may opt for the use
of braces and/or sprints to hold the wrist in a neutral position. This may help relieve compression on the
medial nerve. A surgery used to reduce compression is gaining in popularity although the results of the
surgery seem to be 50/50 at best and have an extended recovery period.
Treatment Options
Physiotherapy, Massage Therapy and when appropriate a properly designed exercise program can all
help relieve pain and restore function. Located in central Nanaimo, Pure Body Balance has several
practitioners who can help guide you on your path to recovery. Whether you choose to have a surgery
performed or want to manage CTS with a more natural approach seeing a qualified Physiotherapist such
as Bob Jacobsen, or Matthew Walters, should be your first step. Combined with treatment from a
Registered Massage Therapist aimed at promoting blood flow to the tissues and relieving tension in the
muscles and tendons, Patients can see optimal results.
Exercise
An often overlooked part of the recovery or management of CTS is exercise. It is important to increase
flexibility of the anterior (front) shoulder girdle, strengthen the posterior shoulder girdle and
improve/maintain neutral cervical and shoulder posture. Using larger grips and small grips or fine
movements of the wrist and fingers should be emphasized.
Stretches
Stretching should focus on deltoids, lats, pectorals, trapezius, and posterior shoulder girdle.
Strengthening
Strengthening should focus on strengthening of the forearm, the wrist, rotator cuff strengthening and
grip strengthening.
It is important to establish and maintain a proper exercise program as part of the recovery process.
Have more questions? Contact us and we will gladly answer any questions you may have for us.