A nerve running down the arm and into the palm of the hand – the median nerve – is relatively vulnerable to compression at the wrist. When this happens, you may experience pain, numbness, weakness, or tingling in the hand. This is carpal tunnel syndrome, and although there are many possible causes, one common mechanism is repetitive movements involving a lot of wrist flexion: bending the wrist so the palm is closer to the forearm. This movement causes direct compression to the carpal tunnel itself, through which the nerve runs.
The carpal tunnel is found on the palmar side of the wrist and is made of the bones of the wrist deep in the hand and a set of ligaments close to the surface. As the wrist is flexed, the softer ligaments are compressed but the wrist bones stay put, meaning the tunnel and its contents are squashed. This can cause irritation to the median nerve over time. Nerves can continue to react once a stimulus is removed, so improvement may take time.
Pregnancy can increase the likelihood of a patient developing carpal tunnel syndrome as general fluid retention increases the pressure within the wrist, meaning less compression is required to affect the median nerve. Similarly, local swelling caused by trauma, or conditions like lymphedema can add pressure to the carpal tunnel.
The symptoms can be confused with other conditions, for example Thoracic Outlet Syndrome, where a nerve is irritated on its route around the neck and shoulder. Your osteopath will be able to use hands-on testing to work out where the irritation is coming from, and therefore work out which area needs to be treated.
Osteopathic treatment may involve techniques to reduce swelling, using a wrist splint overnight, or working out how to alter daily life to avoid excessive wrist flexion for a mechanical cause as described above, however advice and treatment plans will vary from patient to patient.
medscape, carpal-tunnel.net, NHS
reviewed 10/10/17
