The Carpal Tunnel Clinic
about
The Carpal Tunnel Clinic
At your initial visit you will be assessed by our Specialist Clinical Practitioner to diagnose your condition and recommend the best form of treatment options for you. This may include specialised tests including imaging studies, nerve studies as well as clinical assessment.
If you already have a referral from your General Practitioner, we would still recommend a visit with our Specialist Clinical Practitioner, who may refer you for any of the above tests or studies.
If you required nerve conduction studies, we can arrange for these to be performed by one of our recommended Neurologists.
You can elect to be treated at a time that is suitable for you, within the fortnight,
if you require surgery.
Non -surgical treatment may be facilitated by Occupational Therapy or splinting and occasionally will require Injections.
Below is a diagram of the process that will take place when you start your journey at
The Carpal Tunnel Clinic.
Carpal tunnel syndrome is the most common nerve compressive condition in the arm. It affects the median nerve in the forearm.
Nerves generally have two components to the function. There is a sensory component, which picks up signals from the skin in the form of sensation and feeling amount other things, and motor function, which is basically the movement of muscles related to that nerve.
The median nerve arises from the neck through several branches that come together to form the main trunk of the nerve as it goes down the arm.
The muscles supplied by the median nerve are those around the thumb, and in particular one called the Abductor Pollicis Brevis muscle.
Median Nerve
Abductor Pollicis Brevis Muscle
The Characteristic Symptoms Are
1. Numbness and tingling in the median nerve distribution, usually the thumb, index and middle fingers.
2. Night numbness /tingling
3. Weakness/ wasting of the thumb muscles.
the median nerve is compressed between the hand tendons entering the wrist and the rigid ligament across the wrist called the flexor retinaculum, or transverse carpal ligament.
Apart from the tinging and numbness, patients can complain of pain around the carpal tunnel all the way up to the elbow sometimes. Waking from sleep or having a numb hand early in the morning is very common. Interestingly, the little finger and ring finger are often normal although patients often feel like it is the whole hand. The palm is usually not affected as this nerve comes off the median nerve before the tunnel and doesn't go through it.
It occurs with increasing age and is mostly what we term as "idiopathic" ie, no specific cause is identified.
It occurs 7 times more commonly in women and the risk factors for developing carpal tunnel include thyroid disorders, obesity, as well as tight gripping or jobs involving prolonged vibration / flexion of the wrist such as knife meat workers.
It does uncommonly occur with fractures of the wrist as well and swelling and tumours of the carpal tunnel.
Unfortunately, despite the urban myth, typing and administration work is NOT associated with an increase risk of developing the condition.
What Tests Are Recommended
After your questionnaire and history, nerve testing is often required to establish the severity of the condition and this also gives the opportunity to provide a baseline level if we need to recheck things after your treatment.
This involves a neurologist placing electrodes (rarely Needles) on your hand and forearm to assess the conduction of small electrical signals across segments of the nerve - a slowing of the these signals indicates the nerve is inefficient and unable to transmit the signals to muscles in the hand and receive sensation signals back to the brain. You will usually get a report suggesting normal, mild, moderate or severe.