Carpal Tunnel Syndrome (CTS) is a set of signs and symptoms caused by pressure on the median nerve as it passes through the carpal tunnel.
The carpal tunnel is located at the base of the hand – it is the narrowing at the wrist formed by the carpal bones and the transverse carpal ligament (also called the flexor retinaculum).
CTS, is the most commonly diagnosed peripheral nerve compression syndrome and is an occupational hazard for anybody performing repetitive tasks with their hands for several hours each day. This includes those who use tools, computers, or machines.
The median nerve supplies sensation to the thumb, index, middle and lateral aspect of the ring finger.
Symptoms can include pain, loss of sensation and loss of grip strength in the affected part of the hand. The classic, tell-tale sign is waking up during the night with a numb hand. It’s common to compress the median nerve when sleeping, if the wrist is flexed – often sufferers will wear a splint at night to keep their wrist in a neutral angle.
The severity of the symptoms can vary and will gradually worsen if the factors which are causing it continue to be an issue. Prolonged compression of the nerve will eventually lead to muscle wasting.
- Stretching and exercises to mobilize wrist tendons
- Use of a splint to maintain neutral wrist position
- Corticosteroid injections to reduce inflammation
- Medications for pain and inflammation
- Complementary medicine, e.g. remedial massage, acupuncture etc
- Surgery – cutting the flexor retinaculum to relieve the pressure on the nerve
CTS is just one of several nerve entrapment syndromes that can produce symptoms in the hand, therefore it can be difficult to make a definitive diagnosis. The signs and symptoms could be coming from other sources or could be a combination of problems.
Massage can play a valuable role in the management of CTS by addressing all of the muscles and soft tissues that may be compressing the median nerve.
Done correctly, massage has been shown to improve CTS symptoms, and specific work on the entire median nerve territory (shoulder – hand) may provide relief by helping to decompress the nerve.
Remedial massage treatments focus on techniques to the wrist and finger flexor muscles, and address the neck and upper extremity including the scalenes, pectoralis minor, biceps brachii, coracobrachialis and pronator teres. Goals include reducing swelling, fascial restrictions, trigger points, adhesions and muscle hypertonicity.
Your MT can also provide advice on safe and effective remedial exercises including which muscles to strengthen and which to stretch and appropriate posture when preforming activities that aggravate the condition.
Werner, R. (2013). A massage therapist’s guide to pathology (5th ed.). Wolters Kluwer Health/Lippincott Williams & Wilkins.
Lowe, W. (2006). Orthopedic assessment in massage therapy. Daviau Scott.