Carpal Tunnel Syndrome – Painful Wrist & Hand

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is a common condition affecting hand and wrist. It occurs most frequently in middle and old age. It is one of the widely known neuropathy (nerve related) condition. The nerve affected in Carpal tunnel syndrome is known as Median nerve. The median nerve is responsible for sensation over the palm side of thumb and three fingers (index, middle and ring)(fig. 1). It also supplies to the small muscles in hand, which controls the function of the thumb and fingers. After running in arm and forearm, median nerve enters the hand through a narrow passage known as carpal tunnel. Carpal tunnel is formed by bones and ligaments. Tendons of the forearm muscles attaching to the fingers and median nerve pass through this tunnel.

median nerve supply

fig. 1

When the space in the canal is compromised, it causes compression and reduced blood flow to median nerve. The reasons for reduced space can range from swelling and other structural changes such as thickening of the tendons. It can be unilateral affecting one side or bilateral (both hands). Usually the symptoms may include pain, pins and needles, numbness, weak grip and burning sensation. Affected area is the area where the nerve supplies – thumb and index, middle and ring finger. Symptoms tend to worsen overtime following a gradual onset.  Carpal tunnel Syndrome is also characterized by its Nocturnal Symptoms (Symptoms occurring/aggravated in the night). Other aggravating factors include, repetitive wrist movements, writing, typing prolonged flexion or extension position of wrist, gripping and driving a car.


  • Wrist injuries/fracture
  • Jobs involving use of vibrating tools (e.g. Drilling machines)
  • Office jobs involving use of computer
  • Fluid retention from pregnancy or menopause
  • Tendon inflammation
  • Congenital predisposition – born with a smaller carpal tunnel
  • Obesity
  • Rheumatoid Arthritis
  • High blood pressure
  • Thyroid Dysfunction
  • Diabetes
  • Cyst or tumor

Treatment options – Next page

1 reply
  1. Greg Mirt says:

    Strech the flexors on your brachium and extensor as weel. Like flexor radialis longus, flexor ulnaris longus, extensor radialis longus et brevis and extensor ulnaris. The ultimate strech is if you abduct the arm into 90 degrees,supinate the arm and pull it back. Do not extend the neck while doing the technique.


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