Carpal Tunnel and central sensitisation

Carpal Tunnel – Physiotherapy is better

Carpal Tunnel is a diagnosis that is becoming more and more common. But what is the best solution?


  • a vague aching in your wrist that can extend to your hand or forearm.
  • Tingling or numbness in your fingers or hand, often worse on waking.
  • Pain from your wrist up your arm to your shoulder or down into your palm or fingers, especially after forceful or repetitive use.
  • Weakness in your hands and a tendency to drop objects.
  • A loss of feeling in some fingers.

What to do

A recent study in Madrid compared physiotherapy with surgery for women with Carpal Tunnel syndrome.

Unsurprisingly, in my completely unbiased opinion, physiotherapy got better results in terms of pain reduction and, most critically, return to function and movement. This was especially noticeable at the 1, 3 and 6 month marks as they didn’t have to recover from surgery.

But one of the most critical factors is that the physiotherapy included techniques to “desensitise the central nervous system”.

Central Sensitisation

If you’ve read my blog before you will have seen many articles that I have written on Chronic Pain and how to manage it (tip – not painkillers!) and one of the key factors is central sensitisation.

This occurs when the ongoing pain starts to make your entire nervous system super sensitive. So any small thing, which you wouldn’t normally notice, trips you over the edge into BIG pain.

And painkillers can’t treat it.

And operations can make it worse.

And it’s often ignored – or dismissed as you being a “hypochondriac”.

What does this have to do with Carpal Tunnel?

Well carpal tunnel syndrome occurs when there is trauma to the nerve that runs from the neck, through the shoulder, elbow and wrist to the fingers. Nerve issues can quickly lead to central sensitisation. And once this happens they often don’t respond well to treatment or surgery.

So including techniques for desensitisation is critical for getting a good response.

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