Physical Therapy for Carpal Tunnel Syndrome
4-10 million Americans suffer from Carpal tunnel syndrome (CTS) every year. This is especially so for those who perform repetitive hand movements.
Living with this condition can be hard. It makes everyday tasks like typing, holding objects, or even using your phone difficult.
Nonetheless, physical therapy exercises for carpal tunnel can help relieve the pain and improve the function of your hand.
Let's discuss how in detail!
What Is Carpal Tunnel Syndrome?
A common misconception among patients is that carpal tunnel is in the wrist. However, it is an opening at the base of the wrist and is an "entrance" to the palm.
Carpal Tunnel Syndrome (CTS) is a condition caused by pressure on the median nerve. This nerve runs through a narrow passageway in your wrist called the carpal tunnel. It controls sensations in your thumb and most of your fingers.
When the tunnel becomes compressed or narrowed, it pinches the nerve and causes symptoms like tingling, numbness, and pain.
CTS is linked to activities that involve repetitive hand and wrist motions, like typing, assembly line work, or using tools. Health conditions like arthritis, diabetes, or pregnancy can also trigger it. Without treatment, CTS can worsen over time and may cause permanent nerve damage if left unchecked.
Physical therapy is one way to manage and reduce the symptoms of carpal tunnel syndrome.
Credits: By Dr. Harry Gouvas, MD, PhD - I Dr. Harry Gouvas, MD, PhD created this work entirely by myself.
What are the Symptoms of Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome (CTS) develops gradually. It starts with mild symptoms that get worse over time. Here are the common symptoms of CTS and what each one can mean for you.
The feeling of tingling or numbness in your fingers
The first sign of CTS is a tingling or numb feeling in your thumb, index, and middle fingers. It can feel like your hand has “fallen asleep.” This sensation may come and go at first, but over time, it will become more frequent and noticeable, especially at night or after using your hands a lot.
Pain in your hand, wrist, or forearm
Pain is another common symptom. You may feel discomfort in your wrist that can travel up your arm or down into your hand. This pain gets worse after doing repetitive tasks like typing or gripping objects.
Weakness in your hand
You may notice your hand feeling weaker than usual. It can become harder to grip objects, and you may start dropping things more frequently. Weakness happens because the muscles that control your thumb can be affected by the nerve compression.
Intense feeling at night
CTS symptoms tend to get worse at night. You might wake up with numbness or pain in your hand or fingers. This is because of the way your wrist naturally bends while you sleep, which puts pressure on the nerve.
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What Causes Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome (CTS) happens when pressure builds up on the median nerve in your wrist. This nerve controls movement and feeling in parts of your hand. Here are some of the causes of CTS.
Repetitive hand movements
One of the most common causes of CTS is repetitive hand motions. Activities like typing, using a computer mouse, or assembly line work can put strain on your wrist. When you move your hand the same way for long periods, it can cause swelling in the carpal tunnel, squeezing the median nerve.
Injuries in your wrist
If you have had a wrist injury, like a fracture or sprain, it could also cause CTS. When the wrist heals, it might not align perfectly again, and this creates pressure in the carpal tunnel.
Pregnancy
Pregnancy can cause fluid retention, which sometimes leads to swelling in the carpal tunnel. This is usually temporary and improves after delivery, but it can still cause CTS symptoms during pregnancy.
Genetic
Some people are simply more likely to develop CTS because of their genetics. If your carpal tunnel is naturally smaller, there’s less space for the median nerve, and this makes you more prone to nerve compression.
Photo by Anete Lusina
Diagnosis of Carpal Tunnel Syndrome
If you're feeling some of the symptoms above, the best way to determine whether you're suffering from carpal tunnel syndrome is to get a diagnosis from a professional.
Your PT will ask about your daily activities, work habits, and how long you’ve had symptoms. They will want to understand how CTS affects your ability to do things like typing, gripping objects, or using your hands by doing the following:
Physical examination
During a physical exam, your therapist will check for tenderness, swelling, or weakness in your wrist and fingers. They will also look for signs of numbness or tingling in your hand. A common test is to ask you to press the backs of your hands together to see if this causes tingling. They will also tap on the inside of your wrist (a test called Tinel’s Sign) to check for a tingling sensation in your fingers.
Nerve tests
If needed, your doctor may order nerve tests like electromyography (EMG) or nerve conduction studies. These tests measure how well your nerves are working and if there’s any damage to the median nerve.
Imaging tests
In some cases, X-rays or ultrasound may be used to check for other issues, like arthritis or a wrist fracture, that could be contributing to the problem. These imaging tests help your therapist or doctor get a clearer view of your wrist and rule out any other causes of your symptoms.
How Physical Therapy Helps with Carpal Tunnel Syndrome
Physical therapy is a key treatment for managing Carpal Tunnel Syndrome (CTS). It focuses on reducing pain, improving movement, and preventing further damage. Physical therapy targets the root of the problem by addressing nerve compression, inflammation, and poor wrist posture.
A physical therapist can use techniques to help reduce pain and swelling in your wrist and hand. These may include ice therapy or ultrasound to calm inflammation. Gentle movements and stretches will also help improve blood flow and ease discomfort.
Physical therapy is a safe, non-invasive way to treat CTS. With regular sessions, it can improve your condition, making it easier to perform daily tasks without pain.
Photo by Matthias Zomer
Common Physical Therapy Techniques for Carpal Tunnel Syndrome
Physical therapists use several techniques to help relieve the symptoms of Carpal Tunnel Syndrome (CTS). These methods focus on improving movement, reducing pressure on the nerve, and strengthening the muscles around the wrist and hand. Below are some common physical therapy techniques that are effective for CTS.
Stretching exercises
Stretching exercises improve flexibility and reduce tension in the wrist and forearm. They target the muscles and tendons to relieve pressure on the median nerve.
Nerve gliding exercises
These exercises are designed to help the median nerve move smoothly through the carpal tunnel. These exercises can reduce irritation and help prevent the nerve from getting stuck in a compressed position.
Strengthening exercises
As your pain improves, your therapist will introduce strengthening exercises. These exercises focus on improving the strength of the muscles in your wrist, hand, and forearm. Stronger muscles support better wrist posture and reduce the chances of the median nerve getting compressed again.
Manual therapy (Soft Tissue Mobilization)
Physical therapists also use manual therapy to reduce tightness in the soft tissues around your wrist. This involves gentle massage or other hands-on techniques to improve circulation and reduce stiffness in the muscles and tendons. Soft tissue mobilization can help relieve pain and improve your overall wrist function.
Postural correction and ergonomics
Poor posture and repetitive wrist strain often contribute to CTS. A physical therapist will educate you on postural correction and ergonomic adjustments to reduce wrist stress during daily activities.
When combined, these techniques provide a well-rounded approach to reducing the symptoms of CTS. Each method targets a specific ASP wrist strain that often contributes to CTS. A physical therapist will educate you on postural correction and ergonomic adjustments to reduce wrist stress.
Photo by Ryutaro Tsukata
Effective Physical Therapy Exercises for Carpal Tunnel Syndrome
Here are some effective exercises that your physical therapist may recommend for you.
Wrist flexor stretch
It is a simple exercise that helps relieve tension in the wrist and forearm. To do this stretch:
Extend your arm out in front of you with your palm facing up.
Use your other hand to gently pull your fingers back toward your body.
Hold the stretch for 15 to 30 seconds and repeat 10 times.
Wrist extensor stretch
The exercise focuses on the muscles on the back of your forearm. It helps loosen tight muscles that can contribute to CTS. To perform this stretch:
Hold your arm straight out in front of you with your palm facing down.
Use your opposite hand to gently pull your fingers down and back toward your body.
Hold for 15 to 30 seconds and repeat the stretch 10 times.
Nerve gliding exercises
This helps the median nerve move freely through the carpal tunnel. These exercises reduce nerve compression and improve mobility. One example involves making a fist, then slowly opening your hand, stretching your fingers, and extending your wrist. Perform this motion several times. This will allow the nerve to "glide" through the wrist without irritation.
Tendon gliding exercises
These exercises are designed to improve the movement of the tendons in your wrist and hand. To do this exercise:
Start by holding your hand straight.
Slowly bend your fingers to touch the top of your palm, then straighten them again.
Repeat the exercise in different hand positions, like forming a fist or curling just the tips of your fingers.
Grip strengthening
Strengthening the muscles in your hand and wrist can prevent the median nerve from being compressed. To do this:
Get a softball.
Squeeze the softball or grip strengthener for a few seconds at a time.
Repeat the exercise 10 to 15 times.
These exercises can improve your wrist function and reduce pain over time. However, it’s important to perform them under the guidance of a physical therapist to ensure you're doing them correctly and safely.
When to Start Physical Therapy for Carpal Tunnel Syndrome?
Starting physical therapy as early as possible is key to preventing the symptoms of Carpal Tunnel Syndrome (CTS) from getting worse.
If your symptoms are mild or just starting, beginning physical therapy quickly can stop the condition from progressing. Early intervention through stretching, strengthening, and posture correction can reduce the need for more invasive treatments, like surgery.
In case you’ve had surgery to treat CTS, starting physical therapy afterward is very important for your recovery. Physical therapy helps prevent scar tissue from forming, restores movement to your wrist and improves your overall hand function.
Your therapist will guide you through exercises to strengthen your wrist and hand muscles while helping you avoid movements that could slow down healing.
Can Physical Therapy Prevent Surgery for Carpal Tunnel Syndrome?
Yes, physical therapy can prevent the need for surgery in cases of Carpal Tunnel Syndrome (CTS), especially when started early.
When caught in the early stages, physical therapy can reduce or even eliminate CTS symptoms. Techniques like nerve gliding exercises and stretching help release pressure on the median nerve.
Physical therapy is a non-invasive approach to treating CTS. It avoids the risks and recovery time associated with surgery. Many people find relief from pain, numbness, and weakness by following a personalized therapy plan that includes exercises and lifestyle changes. For some, this can be enough to manage CTS long-term without the need for surgery.
In cases where physical therapy does not fully resolve the symptoms or if the condition is severe, surgery may still be required. But, by trying physical therapy first, many people can avoid surgery altogether or delay it for as long as possible.
Duration and Frequency of Physical Therapy for Carpal Tunnel Syndrome
The duration and frequency of physical therapy for Carpal Tunnel Syndrome (CTS) will depend on how severe your symptoms are and how well you respond to treatment. Your physical therapist will create a customized plan based on your needs, but here’s a general idea of what to expect.
For most people, physical therapy for CTS lasts anywhere from 4 to 6 weeks. Some individuals may require longer if their symptoms are more severe or if the condition has been present for a long time. Sessions are held once or twice a week, but this can vary based on your progress.
Along with your therapy sessions, your therapist will give you exercises to do at home. You’ll need to perform these exercises daily to get the best results.
Your therapist will monitor your progress over time. If your symptoms improve, the frequency of therapy sessions may decrease. If your symptoms persist or worsen, your therapist may adjust the treatment plan or recommend further evaluation.
Tips for Managing Carpal Tunnel Syndrome at Home
While carpal tunnel physical therapy is important, you can also make small changes to your routine to reduce symptoms and prevent the condition from worsening. Here are some practical tips to help you manage CTS at home.
Take frequent breaks
If your work or hobbies involve repetitive hand movements, try to take regular breaks. Even a few minutes of rest can relieve the pressure on your median nerve. Stretch your fingers and wrists during these breaks to keep them flexible.
Maintain good wrist position
Keep your wrists in a neutral position whenever possible. Avoid bending your wrists too far up or down, as this can strain the carpal tunnel. Wear a wrist brace at night to keep your wrists straight while you sleep.
Adjust your workspace
If you work at a desk, make sure your workspace is ergonomically friendly. Position your keyboard so that your wrists stay straight. Also, use an ergonomic mouse and keyboard to reduce strain on your hands.
Do gentle stretches
Incorporate gentle wrist and hand stretches into your daily routine. Stretching can help relieve tension in the muscles and tendons around your wrist. Your physical therapist can guide you on the best stretches to do.
Apply cold packs
If you experience swelling or discomfort, applying a cold pack to your wrist can help reduce inflammation. Hold the cold pack on your wrist for 10-15 minutes, a few times a day, to ease pain.
Frequently Asked Questions
How long does it take to see results from physical therapy for carpal tunnel?
Results from physical therapy for Carpal Tunnel Syndrome vary from person to person. Most people start noticing improvements within 4 to 6 weeks of consistent therapy. Early-stage symptoms may improve faster, while more severe cases can take longer. The key is to follow the exercises and recommendations provided by your therapist.
Can physical therapy completely cure carpal tunnel syndrome?
Physical therapy can effectively manage and reduce the symptoms of Carpal Tunnel Syndrome, but whether it offers a complete "cure" depends on the severity of your condition.
For mild to moderate cases, physical therapy can greatly improve wrist function and reduce pain without surgery. However, for more advanced cases, where nerve damage is more severe, physical therapy might not fully cure the condition, but it can still delay or prevent the need for surgery.
Final Thoughts
Carpal Tunnel Syndrome can make everyday tasks challenging, but physical therapy can help manage your symptoms and improve your quality of life. Starting therapy early can reduce pain, increase wrist movement, and possibly help you avoid surgery. With the right exercises and lifestyle changes, you can keep your symptoms under control.
Our PTs at Miracle Rehab Clinic understand how frustrating Carpal Tunnel Syndrome can be. Simple tasks like typing or holding a cup shouldn’t cause pain, and we’re here to help. We listen to what you’re going through and create a plan that works for your needs. You don’t have to deal with this alone.
Book an appointment with Miracle Rehab Clinic today and make sure you get the treatment you deserve.
