Pain and numbness in the thumb, index and middle fingers, often worse after sleeping for a few hours. If all fingers are numb then there is another condition present, and its cause must be found. Numbness may be transitory, lasting minutes until the arm can be mobilised when woken by the symptoms or when the problem has existed for a long time, numbness can be 24hrs per day. The more time the hand is numb would parallel the level of damage of the median nerve.
CTS is caused by compression of the Median nerve at the wrist as the nerve travels through the canal to the hand. The compression causes the blood supply to the nerve to be compromised, thus causing nerve dysfunction and ultimately degeneration. Therefore reducing compression and restoring circulation to the nerve are essential to effective treatment.
Triggers for CTS can be repetitive work with the hands such as in manual workers, including all levels of loading from heavy labour to typing. Pregnancy can also be a cause. We see farmers, cleaners, weightlifters and people with clerical duties present with CTS.
There may be associated lower neck problems which contribute to the likelihood of developing CTS .
Clinical history is usually obvious, but these days, nerve conduction studies can be performed to ascertain the level at which the damage exists, and the extent of the nerve damage.
CTS is a common problem affecting about 5% of the population.
Decompression of the nerve, restoration of blood supply to the nerve and regeneration of the nerve are issues that need to be addressed in treating CTS.
PRP makes a very useful and effective treatment for CTS. It delivers a multitude of growth factors to the injured nerve which have the ability to;
- Reduce inflammation and thus swelling
- Promote new blood vessel formation
- Protect nerves against degeneration and
- Stimulate nerve repair
PRP is injected around the median nerve at the wrist to decompress the strangulating influence of a tight nerve sheath, thus offering a hydro-dissecting function, whilst also delivering its load of growth factors to the nerve and blood vessels.
Research on PRP for CTS
Numerous clinical studies have been performed on PRP injection for carpal tunnel syndrome with very encouraging results. Most of the studies have studied the effect of a single injection. See Research page for more information.