Carpal Tunnel Syndrome

Many times patient complains about their tingling sensation on hands and also complains that he/ she can’t hold things for a minimum time. It mainly happens because of pressure on median nerve which runs the length of arm and goes through a passage in wrist called carpal tunnel.

Clinically Relevant Anatomy:

In human body for the protection of median nerve and flexor tendons there is a tunnel named carpal tunnel. The carpal tunnel includes the median nerve and nine flexor tendons.

Risk factors:

  • Frequent and repetitive movements of the hands and wrists.
  • Wrist fracture.
  • During pregnancy.
  • Being menopausal.
  • Obesity.
  • Certain medical problems including rheumatoid arthritis, diabetes, hypothyroidism or lupus.

Sign and symptoms for carpal tunnel syndrome:

  • Tingling sensation.
  • Numbness may notice in fingers or hand.
  • Weakness develops in hand. Sometimes objects may drop.
  • Pain may radiate up to the arm all the way to the shoulder.


  • X-ray: To rule out arthritis.
  • CTS: To create cross section image.
  • MRI: It is used to identify bone spurs.
  • Musculoskeletal ultrasound: To check out ligament, muscles and tendons tear.

Clinical examination:

Tinel’s & Phalen’s sign test: Patient should advised to hold arms out in front of him/ her and flexes wrists; letting hands hang down for about 30-60 seconds. If patient feels tingling, numbness or pain in the fingers within 60 seconds; it means patient has carpal tunnel syndrome.


If the problem is diagnosed earlier than neurological methods may help to improve the condition. For carpal tunnel syndrome there are different types of treatments. Such as:

  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Corticosteroids.
  • Surgery &
  • Physiotherapy.

Physiotherapy treatments:

For physiotherapy treatment patient should concern with a physiotherapist for better solution. A physiotherapist will apply two types of treatments.

They are:

  • Manual and
  • Electrical.


1: Activity modification: A physiotherapist will find out the improper techniques for which he/she suffers with the disease.  Also the physiotherapist will correct his/her functional techniques.

2: Range of motion improving exercises: After checking ROM of the affected region physiotherapist will improve the condition of restricted motion.

 3: Stretching exercises:

  • Shake hands out: This exercise is especially useful at night, when your symptoms can be worse. If you wake up with pain or numbness, just shake your hands out to get some relief.
  • Thumb Touches: One at a time, touch the tip of each finger to the tip of your thumb so they make an O-shape. Repeat a few times.
  • Wrist Stretching: For wrist stretching patient should sit on a chair. Rest his/her elbow and arm on the table and let the effected wrist hang over the side. Start with holding hand in a straight and neutral position Repeat 10 times. Do this up to three times a day.

Electrical: A physiotherapist will apply some electrical modalities. They are:

1: UST- It is a sound wave which passes through in deep tissues and also makes a resonance that increase blood circulation and release pain.

2: TENS- Electromagnetic wave that helps to reduce pain.

3: HIL- Helps in deep penetration and reduce pain.

4: ESWT- In case of chronic condition ESWT helps to create micro trauma and also helps in automatic healing.

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