Hands go numb at night? It might not be carpal tunnel

Hello, this is Janne. Have you ever heard the term carpal tunnel syndrome? In this video I'm going to cover the prevalence of it, what the typical symptoms are, how to prevent it, and how to ease irritation of the median nerve. Let's dive in.

Carpal tunnel syndrome is the most common upper limb nerve entrapment, and it causes issues with the median nerve. The median nerve goes underneath the transverse carpal ligament of the wrist. The structure starts from cervical spine levels 6, 7, 8 and from thoracic level T1, and it goes down to our upper limb - the median nerve innervates the pronator and most of the anterior part of the forearm, except flexor carpi ulnaris.

How common is carpal tunnel syndrome? The prevalence is around 10% during a lifetime, and it increases a lot if the client has diabetes. In a large Finnish population study, Health 2000, carpal tunnel syndrome affected 2.1% of males and 5.3% of females.

Nerves really don't want to be irritated - for example, the weight of a pencil on top of a nerve will start increasing the tension of the nerve and cause issues. Common risk factors in the background are: being overweight, pregnancy, diabetes, rheumatoid arthritis, hypothyroidism, and kidney disease - the last two are known to cause fluid retention in the body, which is a risk factor for entrapments. Smoking increases the risk of carpal tunnel syndrome and other upper extremity issues. If we think about risk factors in everyday life and at work: typical repetitive movements, difficult wrist postures, gripping and pinching, and vibration are the most common things that might provoke symptoms on their own or when combined with each other.

Typically the symptoms follow a dermatome pattern - if you want to find out more about peripheral neurogenic pain, go check the related video. Symptoms are presented in the thumb, index, and middle finger area on the palmar side of the hand. Symptoms typically increase during the night, and shaking the hand eases the pain. If symptoms have been present for a longer period, you might get atrophy in the palmar side of the thumb - carpal tunnel syndrome might also affect the motor control of the hand, and you might get issues with buttoning a shirt or loss of force while pinching with the thumb.

If you are pregnant, or have had overuse of the hands, symptoms in most cases lessen with time. If you want to ease night symptoms, night splints are a good way to reduce the issue - in a 2012 study with 1,190 patients, they found that if you want to use night splints, use them for at least four weeks in a row.

It's also good to find out what kinds of movements or exercises provoke symptoms during the day, and calm those down, or ease the movement of the wrist and force needed for tasks. For keyboard and mouse use, prefer using keyboard arrow keys, use a touchscreen or a mouse with the non-dominant hand, and get a keyboard with low activation force needed. An ergonomically shaped keyboard or a vertical mouse might also calm down the issues - try to get that kind of unit to test out.

If the issue seems to come from the neural structures, in most cases there is a nerve provocation test where you can find out if the current nerve is irritated. If you get common typical symptoms, or if there is a big limitation in movement in this test, then you want to try out neurodynamic exercises to restore symmetry. ---