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The carpal tunnel is a narrow passageway in the wrist, about an inch wide. The floor and sides of the tunnel are formed by small wrist bones called carpal bones. Carpal tunnel syndrome is a common condition that causes pain, numbness, and tingling in the hand and arm. The condition occurs when one of the major nerves to the hand — the median nerve — is squeezed or compressed as it travels through the wrist via the carpal tunnel.

Signs & Symptoms

  • Symptoms which affect mainly the thumb, index finger, and middle finger

  • Burning discomfort

  • Pins and needles (often at night)

  • Numbness

  • Pain up the arm to the neck

  • Weakness of grip

  • Clumsiness

  • Easing of symptoms by shaking hands

What Causes It?

  • The median nerve can get compressed in the carpal tunnel.

  • In the carpal tunnel the median nerve passes between the tendons of flexor muscles of the wrist.If the muscles are tight or there is swelling, compression can occur.

  • More common in diabetics and pregnant females

How to Self Manage

  • R.I.C.E protocol

  • Anti–inflammatory medication to reduce the swelling

  • Use of a wrist splint to provide protection and enforce rest


  • Corticosteroid injection if conservative management is unsuccessful.

  • Surgery may also be indicated following an unsuccessful cortisone injection.

How Physio Helps

  • Assessment to establish if symptoms are positive with Tinel’s test

  • Soft tissue massage to release tight muscles, and to shift swelling

  • Electrical therapies to reduce swelling

  • Nerve mobilisation to reduced tension of the median nerve

  • Provision of stretches and home exercises for rehabilitation

  • Provision of splint if required

  • Review of workplace/sporting ergonomics

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