The Top 7 Carpal Tunnel Exercises and Stretches

We use our hands and wrists for nearly every task we accomplish throughout the day, but what if doing so becomes increasingly more difficult? Carpal tunnel does just that. Whether you’re a desk worker, mechanic, or chef, carpal tunnel syndrome derails even the most basic tasks. In this article, we’ll go over the absolute best carpal tunnel exercises and stretches to help you fight off nagging wrist pain.

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a painful condition caused by compression of the median nerve (the main nerve in the hand) as it travels through the carpal tunnel in the wrist. It commonly occurs in occupations that require repetitive hand movements (such as construction or typing).

Symptoms include pain, pins and needles, numbness, and loss of function. As a result, carpal tunnel syndrome can affect productivity and quality of life.

If left untreated, carpal tunnel syndrome can progressively worsen over time. Early diagnosis and treatment can help lead to a better prognosis. Treatment may include carpal tunnel exercises, physiotherapy, carpal tunnel splints, or carpal tunnel surgery.

Carpal Tunnel Anatomy

The carpal tunnel is a narrow passageway located in the inner wrist, through which important structures such as nerves and tendons pass in order to supply the hand with sensation and movement.

It is formed by the carpal bones in the wrist and a large ligamentous structure, called the flexor retinaculum. Any change to the boundaries of the carpal tunnel can compress the large median nerve as it travels from the forearm into the hand and affect its blood supply. This can include swelling or increased pressure from an injury, pregnancy, or arthritis.

The median nerve innervates the first three fingers, and half of the fourth. Therefore, when the median nerve is affected, it can cause sensory and motor changes in these fingers. The little finger and half of the ring finger are usually unaffected as they are innervated by a different nerve.

Signs And Symptoms

Carpal tunnel syndrome can affect one or both hands. Signs and symptoms may include:

Pain
Tingling
Numbness
Pins and needles
Paraesthesia (a sensation of burning or prickling)
Decreased fine motor control
Difficulty gripping objects
Radiating or referred pain
Hand weakness
Muscular atrophy
Loss of function

Diagnosis

Carpal tunnel syndrome does not usually resolve on its own. It may only begin with mild symptoms, but it can progress and cause permanent damage if left untreated.

An accurate diagnosis from a doctor is an important step before beginning any treatment. Diagnosis involves testing for sensory and motor deficits using a physical examination, specialized tests (such as Phalen’s Test or nerve conduction studies), and imaging (such as ultrasound or MRI).

Treatment Options: Conservative treatment for Carpal Tunnel Syndrome

Early or mild cases of carpal tunnel syndrome often respond well to conservative (non-surgical) treatments, including:

Rest

Movements or activities that provoke symptoms should be modified or avoided. This includes decreasing repetitive hand and wrist movements and using proper hand ergonomics during tasks such as typing or working.

Medications

A doctor may prescribe medications, such as pain relievers or anti-inflammatories, to help alleviate pain. Oral steroids or corticosteroid injections may be prescribed for more severe cases (however, steroids can have long-term side effects).

Carpal Tunnel Brace

A carpal tunnel brace may be prescribed by a doctor or physiotherapist to wear at night. This can help prevent excessive movement at the wrist when sleeping as the brace keeps the wrist in a neutral position, thereby reducing pressure on the median nerve.

Physiotherapy

Physiotherapists use treatments such as carpal tunnel exercises, carpal tunnel stretches, and mobilizations to restore normal movement in the hands and wrists. Physiotherapists can also offer advice on movements to avoid and other strategies to improve function and quality of life.

The Top 7 Carpal Tunnel Exercises

Exercise is a useful way to ease symptoms and restore strength and movement. Here are the top seven carpal tunnel exercises a physiotherapist may recommend for carpal tunnel syndrome:

Carpal Tunnel Exercises

1. Neural Glides

Nerve gliding is a neurodynamic technique that gently mobilizes the median nerve and the tendons in the wrist to help maintain normal movement in the hand.

The patient starts in a relaxed, seated position
The exercise is completed at different joints, including the fingers, thumb, and wrist
As this is a complicated exercise, the physiotherapist will guide the movement

2. Wrist Circles

Wrist circles are a gentle exercise to maintain movement in the wrists.

The patient starts in a relaxed, seated position
The hands are rotated in one direction then rotated in the opposite direction

3. Wrist Flexion Exercise

Wrist flexion (bending the wrist forwards) often become stiff with carpal tunnel syndrome. This exercise can help promote normal movement.

The patient starts in a relaxed, seated position
The hand is flexed forwards
A physiotherapist may incorporate a weight to progress this exercise

4. Wrist Extension Exercise

Wrist extension (bending the wrist backwards) often becomes stiff with carpal tunnel syndrome. This exercise can help promote normal movement.

The patient starts in a relaxed, seated position
The hand is extended back
A physiotherapist may incorporate a weight to progress this exercise

5. Ball Squeezes

Ball squeezes help to maintain the strength of the hand muscles.

The patient starts in a relaxes, seated position
The ball is gently squeezed
It is important to relax between each repetition

Carpal Tunnel Stretches

6. Finger and Thumb Stretch

As the fingers and thumb can become stiff, this stretch can help elongate the muscles, tendons, and other soft tissue structures in the hand.

The patient starts in a relaxed, seated position
The fingers are gently stretched by extending them backwards
This is then repeated for the thumb

7. Prayer Stretch

Prayer stretch helps to improve flexibility in both the fingers and palm, providing symptomatic relief.

The patient starts in a relaxed, seated position
The hands make contact in a prayer position
The elbows are then lifted slightly until a moderate stretch is felt

All exercises should be pain-free. A physiotherapist will outline the length of the program and appropriate number of repetitions for each exercise, depending on the severity and cause of the symptoms.

Advanced Treatment Options: Surgical treatment for Carpal Tunnel Syndrome

Surgery for carpal tunnel syndrome is called carpal tunnel release surgery. It is usually only recommended when conservative treatment has failed, or when symptoms are severe, unrelenting, or there is risk of irreversible damage.

The goal is to release the pressure on the median nerve by cutting the boundary of the carpal tunnel, usually the flexor retinaculum. Surgery helps to restore blood flow to the median nerve and resolve the sensory and motor deficits. The surgeon may prescribe a carpal tunnel splint after the surgery to protect the wrist for a short period of time.

Carpal Tunnel Surgery Recovery

In some cases, symptoms ease immediately after surgery, whilst other cases may recover more slowly. However, some patients with severe symptoms may never fully recover.

Recovery after surgery includes:

Short-term analgesia (pain-relieving medication)
Plenty of rest
Ice packs at regular intervals to alleviate swelling, pain, and other post-operative symptoms
Regular follow-ups with the medical team
Discussions with the surgeon about permitted activities and returning to work

If there are any concerning or unexplained symptoms, such as excessive swelling or pain, a doctor should be consulted immediately.

Next Steps

Carpal tunnel syndrome can cause irreversible damage to the hand if left untreated. Conservative treatment is recommended for the early stages of carpal tunnel, however if symptoms are persistent or severe, surgery may need to be considered. Visit a physiotherapy for a successful recovery.

Always seek professional medical guidance before starting any new exercises or treatment programs.