Carpal Tunnel Syndrome Treatment

What's The Best Carpal Tunnel Syndrome Treatment?

Watch the video to learn what causes carpal tunnel syndrome, plus what exercises and other types of carpal tunnels syndrome treatment can help you avoid surgery.

Table Of Contents:

What Is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a common condition that causes pain, numbness, and tingling in the hand and arm. It can be incredibly painful and debilitating, especially if it's in your dominant hand.

Other Symptoms Of Carpal Tunnel Syndrome May Include:

  • Feeling clumsy or dropping things
  • Difficulty sleeping at night
  • Your hands feel especially numb in the morning
  • Trouble with tasks using your hands like typing or playing an insturment

Carpal Tunnel Syndrome Causes

The carpal tunnel is a narrow passageway in the wrist that protects the median nerve, which runs from the forearm to the hand.

Carpal Tunnel Syndrome

The tunnel is formed by your wrist bones (or carpal bones) as the floor and sides of the tunnel. The roof of the carpal tunnel is formed by a ligament over top called the transverse carpal ligament.

There are several structures that run through the carpal tunnel including:

  • The flexor tendons that bend your fingers.
  • The median nerve
  • Occasionally arteries, which can take up extra space in the tunnel

Of these structures, the median nerve is usually the primary structure involved in carpal tunnel syndrome.

The Median Nerve And Carpal Tunnel Syndrome

The median nerve controls the movement and sensation of the thumb and first two fingers.

Median-Nerve in Carpal Tunnel Syndrome

Carpal tunnel syndrome occurs when the median nerve is compressed as it passes through the carpal tunnel.

What Causes The Median Nerve To Get Compressed?

Carpal tunnel syndrome is essentailly an overuse injury.

Therefore, repetitive motion is the most common cause of carpal tunnel syndrome.   

Activities that involve repetitive motion of the wrist and fingers, such as typing or playing a musical instrument, can lead to carpal tunnel syndrome.

Other things that take up space in the carpal tunnel can also trigger carpal tunnel syndrome.

As mentioned previously, some people have blood vessels that run through their carpal tunnel such as a branch of their radial artery (where you take your pulse), or a persistent median artery, which usually goes away during embryonic development.

Carpal tunnel syndrome during pregnancy.

Pregnancy can cause swelling in the hands and feet which can also cause carpal tunnel syndrome.  Usually this type of carpal tunnel syndrome resolves after delivery.

Diabetes And Carpal Tunnel Syndrome

Diabetes are also common causes of carpal tunnel syndrome.

Diabetes is related to increased nerve problems (neuropathy) in general.

Diabetic neuropathy typically affects the smaller nerves in you hands and feet such as with carpal tunnel syndrome or tarsal tunnel syndrome.

This is often described as a "stocking and glove" distribution due to numbness in your toes and fingers.

Carpal Tunnel Syndrome Treatment

There are a variety of treatment options for carpal tunnel syndrome.

Treatment options include:

  1. Wrist splints: Wrist splints are devices that hold the wrist in a neutral position to help alleviate pressure on the median nerve. They can be worn during the day or at night while you sleep.
  2. Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs such as ibuprofen can help reduce inflammation and pain in the wrist.
  3. Corticosteroid injections: Corticosteroid injections can also help reduce inflammation and provide relief from pain.
  4. Physical therapy: Physical therapy can help improve flexibility and strength in the hand and wrist, which can help alleviate pressure on the median nerve.
  5. Surgery: In severe cases of carpal tunnel syndrome, surgery may be necessary to release the pressure on the median nerve. This procedure is called a carpal tunnel release.

Medications To Treat Carpal Tunnel Syndrome

The two classes of medications listed above are both anti-inflammatory medications.

If the carpal tunnel is narrowed it makes sense that the tendons, blood vessels, and nerve that run through it can get inflamed, and anti-inflammatories do a good job of treating that inflammation.

But like all medications, they do have side effects associated with them, so you have to balance the risks with the benefits.

At More 4 Life, we focus on treating the ROOT CAUSE of carpal tunnel syndrome so that you DON'T need to rely on NSAID, steroid injections, or carpal tunnel surgery.

So the rest of this post will focus on carpal tunnel syndrome treatments that DON'T require medications, injections, or surgery.

Carpal Tunnel Syndrome Splints

Carpal tunnel syndrome splints are devices that are worn on the wrist to help alleviate the symptoms of carpal tunnel syndrome.

They keep the wrist in a neutral position, which can help to reduce pressure on the median nerve.

If your wrist is too flexed (palm toward forearm) that kinks the median nerve as it runs through the carpal tunnel.

Conversely, if your wrist is too exteneded (back of hand toward forearm as if doing a pushup), your median nerve gets overstretched across the carpal bones of the wrist.

Either of these problems can make carpal tunnel syndrome worse.

Keeping your wrist in a neutral position can help reduce pain, numbness, and tingling from carpal tunnel syndrome.

Night Splints For Carpal Tunnel Syndrome

Some splints are designed to be worn at night to keep the wrist in a neutral position while sleeping.

Since you can't control what you do while your sleeping, it's good to have some external support to keep your from flexing your wrists.  This is especially important for people who sleep tightly curled up in a fetal position.

Daytime Use Of Carpal Tunnel Splints

You can also wear wrist splints during the day to provide support while performing activities activities that require repetitive us of your hands such as typing or lifting.

It's a good idea to wear wrist splints during any activity that causes you pain if you have carpal tunnel syndrome.

Best Carpal Tunnel Syndrome Splint

To say that there's a best wrist splint for carpal tunnel syndrome would be incorrect.

They're pretty basic.

There are a few features that you should look for, but overall, there are TONS of bands available on the market. As long as they meet a few basic requirements (listed below), one's probably not substantially better than another.

This carpal tunnel syndrome brace was "Amazon's choice" and I would agree with that.

It has all the key features that a carpal tunnel syndrome brace should have.

  1. It holds the wrist in neutral
  2. It's sturdy and has reinforcement along the palm side to keep you from flexing your wrist.
  3. It has Velcro straps for easy application
  4. It's reasonably priced.

I'm a fan of paying for quality, but in this case there's no need to spend an arm and a leg to keep your arm and hand feeling good.

Carpal Tunnel Syndrome Exercises

There are several exercises that can help if you have carpal tunnel syndrome.

The goal of carpal tunnel syndrome exercises is to either:

  1. maximize the amount of space inside the carpal tunnel, or
  2. to help with the function of the structures that run through the carpal tunnel

If you Google it you're probably going to find very general exercises like the ones below.

Here are a few general exercises for carpal tunnel syndrome:

  1. Wrist extensor stretches: Hold your arm out in front of you with your palm facing down. Use your other hand to gently bend your wrist down towards the ground. Hold for 30-60 seconds and then release.
  2. Wrist flexor stretches: Hold your arm out in front of you with your palm facing up. Use your other hand to gently bend your wrist down towards the ground. Hold for 30-60 seconds and then release.
  3. Hand squeezes: Gently squeeze a stress ball or a hand gripper to strengthen the gripping muscles in your hand and forearm.
  4. Spreading the hand: Splay your fingers out wide to stretch your hand.

Most of these are okay... not stellar, but OK.

Skip the Wrist Extensor Stretch

The one exercise that you probably want to avoid is the wrist extensor stretch (where you're flexing your wrist).  When you do this, you bringing your hand toward the forearm, which narrows the space inside that carpal tunnel.

It can put pressure on the median nerve and kind of "kink" the nerve inside the carpal tunnel.

The one exception might be if you have a lot of stiffness in the top of the forearm and you can't get your palm very far toward your forearm.

Modified Wrist Flexor Stretch

Stretching your wrist flexors is a good exercise for carpal tunnel syndrome.

However, when you pull your fingers up, like that you tension the median nerve and finger flexors, which can make your symptoms worse if your carpal tunnel syndrome is really severe.

Instead of pulling your fingers backward, try pulling from your hand instead. (See video for demonstration)

Alternatively, try stretching with your hand on the table as shown below.

modified wrist flexor stretch for carpal tunnel syndrome

How to stretch your wrist flexors:

  1. Take your hand and you put it on a table or a flat surface as shown above.
  2. Lean over top of it and then put your other hand over top as shoe.
  3. Use the top hand as a fulcrum as you rock your body back and forth.

This helps mobilize the carpal bones in your wrist and also helps put less strain on the finger flexors and median nerve.

Spreading Your Fingers And Hand

Opening your palm up one and spreading your fingers helps open up the space of your carpal tunnel.

Splay your fingers as wide as you can, and you can even use the other hand for a little overpressure to stretch the transverse carpal ligament that forms the roof of the carpal tunnel.

Median Nerve Glides

Then median nerve that runs from your neck down your arm into your hand and into these first three fingers .

The median nerve is the primary structure that's affected incarpal tunnel syndrome, so it's important to get that nerve movig and functioning right.

Here's how to do median nerve glides to accomplish that task:

start with your palm fingers touching your shoulder.

Then extend your elbow so that your palm is out to the side, face up.

Staying in that position, pull your wrist back into extension (fingers toward floor).

Return to the starting position and repeat.

If you need to add more tension, bend your head away from the arm you're stretching.

Doing this gets the median nerve moving better and gives it the movement and blood flow that nerves need to be health.

*Note: these exercises shouldn't hurt.  If you have increased pain from doing these exercises, consult with a physical therapist.

Can Your Neck Affect Carpal Tunnel Syndrome

Your neck can absolutely affect carpal tunnel syndrome, especially if you have carpal tunnel syndrome in BOTH hands.

The C6 and C7 nerve roots from your neck can also cause pain in your hand and fingers.

Your C6 nerve root supplies feeing to your thumb and index finger while the C7 nerve root supplies sensation to your middle finger.

Interestingly though, the strength in your hand is suppled mostly by the C8 and T1 nerve roots.

Furthermore, many people who have carpal tunnel syndrome also have referred pain from their neck (cervical radiculopathy).

So it's important to rule out a pinched nerve at C6, C7, C8, or T1 before having invasive treatment for carpal tunnel syndrome such as surgery.

If the pain is coming from you neck, neither wrist exercises nor surgery will completely stop the pain.

Click here to learn exercises for a pinched nerve in your neck

Other Carpal Tunnel Syndrome Treatments

Bracing and exercises are a good first start, but to find a long term solution to carpal tunnel syndrome, you need to fix the root cause.

If your carpal tunnel syndrome is coming from overuse, you need to modify the provoking activities.  A few examples are listed below.

Take breaks from repetitive hand movements

Get up from your desk and move around or stretch at least once per hour.

Use ergonomic equipment

Split keyboards allow your wrist to stay in a neutral position inline with your forearms.

ergonomic keyboard for carpal tunnel syndrome

Additionally, ergonomic keyboard require less pressure to make a keystroke so your hands don't get fatigued as fast.

Use Proper Posture

And if you have problems with your neck, it's also important to use proper posture when working at a desk.

Make sure you have proper arm support on your chair and that you're floating your hands over the keyboard, not resting your wrists on the desk.

Physical Therapy For Carpal Tunnel Syndrome

Carpal tunnel syndrome isn't something that you should try to treat on your own.

You use your hands everyday, and gambling on the health you your hands by trying to do-it-yourself isn't a good idea.

If you've tried some of the strategies in this post and your carpal tunnel syndrome hasn't gotten better yet, contact a physical therapist who has experience treating carpal tunnel syndrome.

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