Carpal tunnel syndrome is surprisingly common and occurs when the nerve that passes from the arm down into the hand gets compressed within the constricted space that passes into the hand from the forearm.
This tunnel is formed by a “ring” of bones on 3 sides (which you can feel on the back of your wrist) and a very strong band of ligament, which does not stretch:
Carpal tunnel syndrome happens when the nerve get’s squeezed - this occurs when the muscle tendons inside the tunnel become inflamed.
There are 9 muscle tendons passing from the forearm into the hand through the carpal tunnel. These muscles control flexion of the fingers: the action of clenching your fist, and of bending your fingers.
So people who’s work or hobbies involve constant repetitive flexing of fingers, or unusual loading (weight bearing) on their fingers may find that they suffer from carpal tunnel syndrome, for example:
chainsaw operators (or operators of other heavy vibrating tools)
computer keyboard users
When a person's fingers are in constant repetitive use like this (often weight-bearing), then the protective sheaths that surround the tendons become inflamed through overuse.
Now inflamed, the tendons take up more space within the tunnel than they did before - and more space than there is room for. The result is that these muscle tendons start to rub up against the nerve that also travels through the carpal tunnel and compress it, causing pain.
For reasons that aren’t clear, other groups of people are more prone to carpal tunnel syndrome:
pregnant women: around 50% of pregnant women feel the symptoms of carpal tunnel syndrome at some point during their pregnancy
diabetes patients and those with arthritis have a higher incidence of carpal tunnel syndrome than the general population.
The nerve that runs through the carpal tunnel with the 9 muscle tendons is called the median nerve.
As the diagram shows, the median nerve (in yellow) runs all the way from deep within the shoulder down through the carpal tunnel into the hand.
Nerves send electrical impulses: in the case of the median nerve, electrical impulses which innervate (that is, stimulate) the hand and fingers.
When the tendons in the carpal tunnel become inflamed and compress the median nerve, a number of symptoms can occur:
Numbness or tingling in the following fingers:
half of the ringer finger (the half closest to the middle finger)
Ache or pain in the forearm
Discomfort in the upper arm
Symptoms often start off being worse at night or when the person wakes up. As the condition progresses, the symptoms remain for longer periods during the day.
The first thing to say is that since carpal tunnel syndrome is caused by inflammation of the tendons - traditional massage (i.e. repeated rubbing) of the area isn’t a good idea as it will just make things worse.
That said, remedial massage may be able to offer some real help.
Since the inflammation of the tendons within the tunnel is caused by overuse of muscles, deep massage of the muscles within the forearm will help to loosen those tight muscles.
Given the path of the median nerve from the shoulder through the upper arm, sports massage techniques on the upper arm might also help relieve discomfort.
Massage of the thumb and forefingers, together with some rehabilitative stretching either side of the carpal tunnel can really help too.
A good remedial massage therapist will also help you think about exercises and stretches that you can do, as well as discuss with you any changes to the way that you use your wrists, in order to lessen the symptoms.
As ever, if you think I can help, let me know.