Self help for treating Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) can usually be treated with manual therapy and self-managed care.

The carpal tunnel is located on the palm side of your wrist. Its main role is to protect the most important nerve to your hand and the nine tendons that help bend your fingers. When this nerve is compressed, it causes numbness, tingling and eventually hand weakness. Various factors can contribute to the development of Carpal Tunnel Syndrome including the anatomy of your wrist, underlying health problems, and patterns of repetitive hand use.

Signs and symptoms

Burning, numbness or itching in the palm of the hand and fingers. Sensation of finger and wrist swelling. Weakness of grip. Pain that may wake the individual during the night.

Complications if left unattended

Left untreated, CTS can cause loss of sensation in some fingers and permanent weakness of the thumb as the muscles of the thumb atrophy.

Heat and cold perception may also be affected in untreated CTS cases.

Immediate treatment

Cease repetitive stress activity causing the condition. Immobilization of the wrist with bandage or splint to prevent further irritation.

Rehabilitation and Prevention

Halting the repetitive sport or activity and allowing for rest and rehabilitation time following diagnosis of carpal tunnel syndrome is essential.

A bandage or splint may be used to stabilize the injured hand. Releasing the tension in the wrist and hand during sports and periodic exercises to retain mobility and retard stiffness in the hands may help prevent the onset of CTS.

Trigger points

Most cases of CTS are associated with trigger points. These trigger points may be causal or may become active as part of the body's natural protect and defend mechanism - as the body attempt's to "shut down" specific muscles to aid recovery.

CTS typically includes treating trigger points in the scalenes, trapezius, triceps, and the wrist flexor and extensor muscles. 

Self help

Stretching is an important part of the rehabilitation process and should begin as soon as pain allows and be continued throughout the rehabilitation program and beyond - good maintenance prevents re-injury.

The following program comprises muscle stretching (muscles of the forearm) as well as neural stretches and is typical of the type of program that your therapist may recommend.

Use common sense when stretching or performing any exercises at home. Start slowly and stop if you feel more pain than you feel comfortable with.

Even simple stretching exercises can be dangerous if performed incorrectly. It's always best to seek suitable professional advice, especially if you haven't exercised for a while.

Neural stretch

This stretch addresses the ulnar nerve, which runs very close to the medial epicondyle (bony bit on the inside of the elbow), and may become trapped by scar tissue.

• Adopt the position shown above

• The stretch can be increased by placing something under the elbow to raise it up, which increases the amount the upper arm is lifted relative to the shoulder

• Hold stretch for 5 seconds, repeat 5 times and aim to stretch at least 3 times a day

Neck stretch

• Place arms behind you

• With one hand, gently take the opposite hand

• Pull slightly to the opposite side

• At the same time, gently bend neck to the side - with forehead pointing down

• The neck should be bent to the side that the arm is pulling toward

• Hold stretch for 30-50 seconds and repeat on opposite side. Repeat 3 times on each side, twice daily.

Chin tucks

• Sit up straight in a chair. Sit to the front, not against the back of the chair. Sitting up will help you to strengthen the muscles you need for good posture

• Think of lifting the crown of your head to the ceiling. Be careful not to tip the head back. Your chin should be parallel to the floor

• Without tipping the head in any direction, pull your chin and head straight back. You will feel a stretch in the back of your neck

Repeat for three sets of 8 to 12 repetitions twice daily.

Prayer position

• Start with your palms together in front of your chest, just below your chin

• Slowly lower your hands towards your waistline

• Keep your hands close to your stomach and your palms together, until you feel a mild to moderate stretch under your forearms

Hold for at least 30-50 seconds and repeat 2 to 4 times, twice daily

Extensor stretch

• Hold the arm straight out before you with the palm facing outwards

• Flex the hand so that your fingers point upright

• With the opposite arm, pull fingers towards you for maximal stretch

Hold stretch for 20-30 seconds and repeat 3 times, twice daily

Flexor stretch

• Extend arm in front of you with your palm facing upwards

• Bend your fingers so that they are facing downwards

• With your opposite hand gently pull the fingers back towards your torso.

Hold for 20-30 seconds and repeat 3 times, twice daily

Extensor strength

• Hold small weight or can in hand with palm facing down • Extend the wrist upwards so that it is pulled back

• Hold position for two seconds, then lower

Repeat 30 times, twice daily