Carpal tunnel release surgery is one of the most common surgical procedures. Carpal tunnel surgery is usually best for people with severe symptoms, but nonsurgical treatments by a physician, physical therapist and/or occupational therapist can effectively treat mild cases of carpal tunnel syndrome, CTS, in some people.
Splinting
Early treatment of carpal tunnel syndrome includes corticosteroid injections from your doctor and a wrist splint a physical therapist can custom fit for you. Splinting, or wearing a brace, is effective for people with mild CTS; up to 80 percent of patients notice decreased symptoms within a few days of wearing a splint. Your therapist may have you wear a splint for weeks or even months depending on how bad your CTS symptoms are. Splints are typically worn during physical activities like sports and at night.
Strengthening and Stretching Exercises
Physical therapists sometimes recommend strengthening and stretching exercises for the hands and fingers to treat carpal tunnel syndrome. The therapist chooses exercises based on the individual and monitors their application. An example of a basic stretch is finger abduction and adduction. Simply hold your hand vertical to the floor with your thumb on top and fingers together, then spread your fingers wide and bring them back together.
It is important to avoid activities that aggravate your symptoms, so do not perform any exercises that are similar to what caused your CTS. Generally, limiting activity for two to six weeks helps relieve CTS for people with mild symptoms. Your physical therapist may suggest a period of inactivity instead of exercise.
Nerve and Tendon Gliding Exercises
Nerve and tendon gliding exercises are also part of a supervised exercise program with your physical therapist. These exercises target the nine tendons that pass through the carpal tunnel and the three nerves that bring sensation to the hand. These exercises glide the tendons through the carpal tunnel to lubricate them and reduce microscopic adhesions. Microscopic adhesions may cause the nerves to bind, which leads to sensations such as pain and tingling in the fingers when you move. An example of a tendon gliding exercise is the full fist. Simply make a fist by bending your finger joints and curling the fingers into a fist to touch the middle of your palm. Your therapist will advise you whether to hold the positions for a sustained time or to move in and out of them.
Swelling Reduction Techniques
Corticosteroid injections from your doctor reduce pain and swelling, as do nonsteroidal anti-inflammatory drugs such as ibuprofen. Reduced pressure on the median nerve from a reduction in swelling is what causes the CTS pain to lessen. Your physical therapist can reduce swelling by elevating the affected arm, applying cold packs, using compression wraps or applying retrograde massage. Therapists often use these treatment techniques after CTS surgery.
References
- National Institute of Neurological Disorders and Stroke; Carpal Tunnel Syndrome Fact Sheet; November 2002
- University of Maryland Medical Center: Carpal Tunnel Syndrome - Treatment
- Mayo Clinic; Carpal Tunnel Syndrome: Treatments and Drugs; February 2011
- Hand Health Resources: Carpal Tunnel Syndrome
- Hand Health Resources: General Information - Exercise
