The carpal tunnel is formed from the wrist bones and a ligament that crosses over the top of them. These form a tunnel where the tendons to the fingers and a branch of the median nerve will travel. Carpal tunnel syndrome refers to when the median nerve is compressed in this tunnel.
Symptoms of carpal tunnel include:
- Sensory changes (tingling or numbness) in the first, second, third, and half of the fourth finger.
- Potentially pain in the palm side of the wrist.
- Symptoms are initially intermittent and worse at night. As the condition progresses symptoms become constant.
- Shaking of the hand can relieve symptoms.
- Weakness and decrease in coordination in the hand.
- Aggravated by repetitive hand movements (ie. keyboard and mouse work) or vibration.
Current clinical practice guidelines recommend several self-management and exercise-based strategies:
- Activity modification (keyboard and mousing, repetitive tasks, vibration),
- Using splinting/bracing to keep the wrist in neutral,
- Soft tissue release around sites of median nerve entrapment and the neck,
- Stretching, and,
- Heat for short-term pain reduction.
Clinical treatment also includes exercises to work on the gliding of the other tendons/nerve in the carpal tunnel and wrist strengthening.
Please see the Physio Fixes protocols for a complete program to help in your recovery!
DISCLAIMER: This information is not intended as medical advice or a substitute for medical counseling. By choosing to follow the information that follows, you recognize that despite all precautions taken by Physio Fixes Inc. there is a potential risk of injury and you expressly acknowledge such risks and waive, relinquish, and release any claim that you may have against Physio Fixes Inc. You should always get evaluated for exercise by a physician or medical professionals, especially if symptoms occur from a trauma or are worsening. The user agrees by purchasing this program that Physio Fixes will not be held responsible in the event that an injury occurs.
References
American Academy of Orthopaedic Surgeons. Management of Carpal Tunnel Syndrome Evidence-Based Clinical Practice Guideline. Published February 29, 2016.
Burke FD, Bradley MJ, Sinha S, Wilgis EF, Dubin NH. Primary care management of patients with carpal tunnel syndrome referred to surgeons: are non-operative interventions effectively utilised? Postgrad Med J. 2007 Jul;83(981):498-501. doi: 10.1136/pgmj.2007.058206. PMID: 17621622; PMCID: PMC2600099.
Carpal Tunnel Syndrome: A Summary of Clinical Practice Guideline Recommendations-Using the Evidence to Guide Physical Therapist Practice. J Orthop Sports Phys Ther. 2019 May;49(5):359-360. doi: 10.2519/jospt.2019.0501. PMID: 31039688.
Carpal Tunnel Syndrome: Physical Therapy or Surgery? J Orthop Sports Phys Ther. 2017 Mar;47(3):162. doi: 10.2519/jospt.2017.0503. PMID: 28245744.
Oskouei AE, Talebi GA, Shakouri SK, Ghabili K. Effects of neuromobilization maneuver on clinical and electrophysiological measures of patients with carpal tunnel syndrome. J Phys Ther Sci. 2014 Jul;26(7):1017-22. doi: 10.1589/jpts.26.1017. Epub 2014 Jul 30. PMID: 25140086; PMCID: PMC4135187.
Page MJ, O’Connor D, Pitt V, Massy-Westropp N. Exercise and mobilisation interventions for carpal tunnel syndrome. Cochrane Database Syst Rev. 2012 Jun 13;(6):CD009899. doi: 10.1002/14651858.CD009899. PMID: 22696387.
Viera AJ. Management of carpal tunnel syndrome. Am Fam Physician. 2003 Jul 15;68(2):265-72. PMID: 12892346.
