What is Carpal Tunnel Syndrome?

Carpal tunnel is a narrow channel on the side of your wrist near the palm, the tunnel is no longer than the width of your thumb. This tunnel is supposed to protect your median nerve and the tendons that bring your fingers together.  Carpal Tunnel Syndrome is caused by pressure being placed on the nerve which causes pain and weakness in the wrist and hand and even numbness or tingling in some of your fingers.  Crowding or irritation of the median nerve in the root cause of Carpal Tunnel Syndrome (CTS).

How did this happen?

The most common causes of CTS are due to keeping your wrist in an extreme position for long periods of time, as well as a lot of use of your figures, especially if there’s a lot of force or vibration, for example, holding the shaky steering wheel for a long period of time.

If you work in an assembly-line, for example, meat packing; or jobs requiring the use of hand tools, especially vibrating hand tools, then you are at risk to developing Carpal Tunnel Syndrome.

What about Keyboard Use?

Yes, excessive keyboard and computer use is an often contributor of CTS, but those performing assembly line work are up to 3 times more likely to develop CTS than people who perform data entry jobs.

What about daily hobbies and activities?

In our experience, some activities can also create CTS, such as excessive sewing, sports involving the wrist such as racquetball and handball, and even playing a string instrument such as the violin.

Health Conditions that can lead to CTS:

    • Inflammation and swelling of the tendons of the wrist
    • Injuries to the wrist (strain, sprain, dislocation, fracture)
    • Hormone or metabolic changes (pregnancy, menopause, thyroid imbalance)
    • Fluid retention (eg, during pregnancy)
    • Diabetes
    • Use of steroids or other medicines alike
    • Degenerative and rheumatoid arthritis



CTS gradually develops and will begin with a pins and needles sensation in your hand.  You will feel burning, tingling and numbness in the palm of the hand and fingers. Symptoms are often more extreme during the night, and people often complain being startled awake in the middle of the night with symptoms.

As the CTS progresses further, it will become harder do simple tasks with your hand such as holding items like a heavy book or a hairbrush.  Your hand will become weaker and more extreme numbness can occur if the pressure on the nerve is not treated.  It’s not uncommon to suddenly drop objects unexpectedly or have a weak grip.

How Is It Diagnosed?

We work closely with you and your health care provider to accurately diagnose CTS. Symptoms of CTS are generally easy to diagnose, and it is possible to diagnose it without the need of extensive tests such as X-rays.  The purpose of a Physical Therapist is that they are experts in the human anatomy and the movement and function of the body.  We will conduct a full evaluation to determine any factors that may be causing this condition.

How do we diagnose your Carpal Tunnel?:

  • First we examine your upper body and neck to rule out any other possible conditions.
  • We then test the grip strength of your fingers and thumb
  • We may need to perform Sensory tests
  • We then check the range-of-motion in your hand and wrist
  • We then preform a Wrist Flexion (Phalen) Test


How Can a Physical Therapist Help?