Carpal Tunnel Syndrome

You are at your workstation when a sudden, lancinating pain radiates from your wrist into the thumb and hand. A brief respite and self‑directed stretches afford no relief. You may be manifesting carpal tunnel syndrome—a compressive median neuropathy often encountered in occupations demanding repetitive manual tasks or exposure to vibratory instruments.

Clinically, Carpal Tunnel Syndrome (CTS) is characterised by nocturnally exacerbated paraesthesia—numbness and tingling—in the distribution of the median nerve: the palmar thumb pad, index, middle and radial half of the ring fingers. Patients frequently report diminished precision grip (e.g. buttoning garments) and weakened pinch strength; chronic cases may exhibit thenar eminence muscle atrophy.

Aetiological factors

• Unavoidable: gestational fluid retention and endocrine fluctuations (e.g. hypothyroidism, acromegaly), congenital osseous canal stenosis.

• Modifiable: sustained wrist extension during keyboard use, forceful gripping of machinery, assembly‑line repetitive movements, manual handling of heavy loads with wrist deviation, prolonged use of vibratory tools.

Management
Non‑surgical strategies begin with nocturnal wrist splinting to maintain neutral carpal alignment, coupled with targeted segmental correction to address dysfunction at C6–T1 motion segments and adjunctive infrared phototherapy to attenuate local inflammation.