Managing Carpal Tunnel Syndrome with Physiotherapy in Singapore

COVID-19 has laid the foundation for a new norm: social distancing, mask on at all times, increased hygiene routines, hand sanitising, and perhaps the biggest adaptation of all, working from home (WFH). There is no doubt that the WFH arrangements pose plenty of perks, safe distancing and less commuting stress. While these new changes have been graciously welcomed, many have learned that WFH brings several downsides, namely aches and pains. These WFH-related ailments arise mainly due to increased sedentary lifestyles and unergonomic office setups. Aside from the increasingly worrying spike in lower back pain and neck pain, there has been an increase of cases in carpal tunnel syndrome.

If you experience sharp pains in your wrist(s), here are a few ways you can find relief.

Carpal Tunnel Syndrome

The main cause of these sharp pains is known as Carpal tunnel syndrome. It is a common peripheral nerve entrapment syndrome that occurs when there is a localised compression of the median nerve at the wrist(s). The median nerve is a peripheral nerve responsible for your ability to move your upper extremities, including your forearm, wrist, hand, and fingers. The impairment of the median nerve often results in adverse  dexterity, strength, and mobility in the upper extremities. Other symptoms include pain and paresthesia (burning or prickling sensation) in the area, which may also radiate to the forearm, elbow, and shoulder.

There are several causes behind the development of carpal tunnel syndrome, one of which is nonspecific flexor tenosynovitis (inflammation of the tendon sheath). However, many conditions, including aberrant anatomy, infections, inflammations, nerve damage, fluid retention, and metabolic disorders, can also cause and further worsen the condition.

Prevention

Unfortunately, there are no proven methods to prevent carpal tunnel syndrome. Nevertheless, patients may mitigate the risk by minimising stress on their hands and wrists by reducing force and relaxing grip. Always take precaution of form and avoid bending wrists all the way up or down. Ensure to maintain a good posture as a poor posture will roll shoulders forward, effectively shortening neck and shoulder muscles. This leads to the compression of nerves in the neck. Considering that upper extremities share the same muscles and nerves, this may affect not just the neck, but also the wrists, fingers, and hands. Finally, as a rule of thumb, make certain that the patient’s workstation is as ergonomic as possible to prevent worsening of the condition.

Managing Carpal Tunnel Syndrome

If you are experiencing persistent pain in your wrists, perhaps it is time to consider treatment options to alleviate the pain and discomfort. The treatment options are as of follows:

Wrist Splinting

A wrist splint is a brace designed with a rigid splint that helps restrict motion and provides additional support. It stabilises your wrist in the straight and bent-back position, minimising the pressure on the median nerve. This offers a period of relative rest from movements which can worsen the syndrome.

Depending on your symptoms and preferences, splinting options may vary. Typically, wrist splint is used during sleep, to prevent prolonged wrist flexion or extension. Studies have shown that continuous night use for four consecutive weeks drastically reduced symptoms in comparison with having no treatment at all.

Oral Medications

Oral medication such as Nonsteroidal anti-inflammatory drugs (NSAIDs), diuretics, and corticosteroids have been used to treat carpal tunnel syndrome, each with varying degrees of success. However, a recent systematic review claimed that NSAIDs and diuretics are not any more effective than a placebo in terms of alleviating symptoms. On the other hand, orally administered corticosteroids have been shown to be more effective than NSAIDs and diuretics for short-term temporary relief. Patients opting for this route of treatment are highly recommended to use it alongside wrist splinting and ergonomic adjustments to fully reap its benefits.

Physical Therapy

Those with mild to moderate symptoms can consider physiotherapy treatments. Physiotherapists can offer professional advice on activities, workplaces, and habitual alterations. They may also apply manual therapy techniques, including mobilising soft tissue, carpal bone, and the median nerve. Gentle movements of the arm and neck may help improve the movement of the median nerve and assist with the healing of the compressed nerve which is the root cause for discomfort. An added benefit of gentle movements may also increase blood flow to the nerve, which helps the nerve heal and further alleviate the symptoms.

Surgery

Patients with severe nerve entrapment who are not responding to treatment may consider carpal tunnel release surgery. Carpal tunnel release surgery is a procedure that severs the transverse carpal ligament which applies pressure on the carpal tunnel. The procedure will allow more room for the median nerve and tendons to pass through the tunnel, resulting in reduced pain and increased function.

Ease Your Aches and Pain at Rapid Physiocare

At Rapid Physiocare, we urge you to find the best solution to treat your carpal tunnel syndrome before it is too late. With an extensive range of physiotherapy treatments, we promise a holistic physiocare approach to ensure that you can recover in the safest manner possible. Be sure to book an appointment with us or head to any of our clinics in Singapore today!

 

References:

Gerritsen, A. A., De Krom, M. C., Struijs, M. A., Scholten, R. J., De Vet, H. C., & Bouter, L. M. (2002). Conservative treatment options for carpal tunnel syndrome: a systematic review of randomised controlled trials. Journal of neurology, 249(3), 272-280.

Viera, A. J. (2003). Management of carpal tunnel syndrome. American family physician, 68(2), 265-272.