The carpel tunnel is a narrow bony and soft tissue passageway at the wrist which allows certain nerves and other soft tissue vessels to pass through into the hand. Sometimes pressure can build up in this tunnel causing pressure on the soft tissue structures and often in particular on the nerves passing through. This can cause numbness, pins and needles and often pain.  It is commonly seen during pregnancy or those with excessive fluid.  It is commonly a problem at night due to resting positions of the wrist. Physiotherapy can be of benefit and treatment can be successful with conservative treatments.  We always use our hands!  So living with pain and stiffness in this area can be difficult. 

Sometimes surgery is necessary.   Surgery release of this tunnel involves a small operation where they release some of the soft tissue structures in order to take the pressure off these vessels.   Following surgery it will take some time for swelling and pain to settle.  The hand is a complex structure which tends to stiffen up very easily with minimal effort.  Some advice following surgery:

*gently massage in a little emu oil or moisturizer into the scar and the swollen aspects of the hand and wrist.  Do this two to three times a day if possible.  Use your thumb in a circular motion to break down any adhesion’s that may be forming from the scar tissue.
*Perform gentle stretches to the wrist and fingers.   Don’t push past pain, rather stretch to a stiffness sensation.  Curl your fingers into a fist and open regularly throughout the day. Practice playing a pretend piano and practice taking each finger to the thumb to create the pincer grip.
*Don’t try to perform heavy lifting or difficult tasks for the initial 6-8 weeks until you are confident of strength and function
*Don’t try to do repetitive tasks for long periods of time.  Vary activity regularly.

Physiotherapists understand the importance of getting normal range and function back into this area with or without surgery.  See a specialist if things don’t improve.  Physiotherapy is recommended for best results.  Sometimes it is only possible to stretch your hand so far and treatment with your physiotherapist is needed in order to regain full movement and function.  

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