Physiotherapy Management Of Carpal Tunnel Syndrome

Carpal Tunnel Syndrome happens when a nerve in your wrist (called the median nerve) gets squeezed. This can cause pain, numbness, tingling, and weakness in your hand and fingers. physiotherapy management play a key role for recovering from carpal tunnel syndrome

Aims of physiotherapy management for carpal tunnel syndrome

 The main goals of physiotherapy for Carpal Tunnel Syndrome are to reduce symptoms, restore hand and wrist function, and prevent the condition from getting worse. Here are the specific aims:

Relieve Pain and Discomfort

• Reduce pain, tingling, and numbness in the wrist and hand using physical therapy techniques and modalities (e.g., TENS, cold/heat therapy).

Reduce Swelling and Inflammation

• Use treatments such as ultrasound, ice therapy, and manual therapy to decrease inflammation around the median nerve.

Improve Nerve Mobility

• Perform nerve gliding exercises to help the median nerve move freely through the carpal tunnel without getting trapped or irritated.

physiotherapy for carpal tunnel syndrome for restore Hand and Wrist Function

• Improve grip strength, fine motor control, and overall function of the wrist and fingers through targeted strengthening exercises.

Increase Flexibility and Range of Motion

• Reduce stiffness in the wrist and fingers with stretching and tendon gliding exercises, allowing smoother hand movements.

Correct Posture and Ergonomics

• Educate on proper hand and wrist positioning during work and daily activities to avoid further nerve compression.

Prevent Recurrence and Long-Term Damage

• Teach patients how to modify activities, avoid harmful wrist positions, and follow a home exercise program to prevent symptoms from returning.

Delay or Avoid Surgical Intervention

• In many cases, physiotherapy can effectively manage symptoms and reduce the need for surgery by addressing the root causes early.

Physiotherapy management for carpal tunnel syndrome

Physiotherapy plays a key role in reducing pain, improving wrist and hand function, and preventing the condition from getting worse. A combination of exercises, manual therapy, pain-relieving treatments, and changes in daily activities can help manage and recover from CTS effectively.

Wrist and Hand Exercises

These exercises are designed to improve flexibility, relieve pressure on the median nerve, and restore normal movement of the tendons and nerves in the wrist and hand.

Nerve Gliding Exercises

These exercises help the median nerve move smoothly through the carpal tunnel without being pinched or stuck.

Examples:

• Stretch your fingers and thumb out fully, then slowly curl them into a fist.
• Open your hand and gently bend your wrist backward and then forward.
• Repeat 5–10 times, 2–3 times a day.

Tendon Gliding Exercises

These exercises help tendons slide smoothly and prevent stiffness.
Movements include:

• Straight Hand: Fingers fully extended
• Hook Fist: Bend only the top and middle joints of fingers
• Full Fist: Curl all joints to make a full fist
• Tabletop Position: Fingers bent at 90 degrees at the large knuckles
• Perform 5–10 repetitions of each position daily.

Wrist Stretches

Improves flexibility and reduces tightness in the wrist muscles.
How to do it:

• Hold your palm with the other hand and gently pull the wrist back and hold for 15–30 seconds.
• Repeat the same motion by pulling the wrist downward.
• Do this 2–3 times per stretch, twice daily.

Manual Therapy for carpal tunnel syndrome

Hands-on techniques used by physiotherapists to relieve muscle and joint stiffness, improve mobility, and reduce nerve compression.

Soft Tissue Mobilization

• Massage techniques used on the forearm, wrist, and hand to reduce muscle tension and swelling around the carpal tunnel.

 Joint Mobilizations

• Gentle movements applied to the wrist and carpal bones to improve flexibility and reduce stiffness that may compress the median nerve.

Modalities for Pain Relief

Various therapeutic devices can be used to ease symptoms, promote healing, and reduce inflammation.

Ultrasound Therapy

• Uses sound waves to heat tissues deeply, helping reduce inflammation and improve healing in the wrist.

TENS (Transcutaneous Electrical Nerve Stimulation)

• Delivers mild electrical pulses to reduce pain signals from the median nerve.

Cold and Heat Therapy

• Cold packs reduce swelling and numb pain.
• Heat packs improve blood flow and help loosen tight muscles.

Apply for 10–15 minutes as needed.

Strengthening Exercises

These exercises help improve the strength of your wrist, hand, and finger muscles. Strong muscles support your wrist better and reduce the pressure on the nerve.

A. Grip Strengthening

• Squeeze a soft ball, therapy putty, or hand gripper for 5 seconds, then relax.
• Repeat 10 times, 1–2 sets daily.

B. Wrist Resistance Exercises

• Use light weights (0.5 to 1 kg) or resistance bands.
• Exercises include wrist curls (upward and downward) and wrist rotations.
• Do 10–15 repetitions, 2–3 sets per day.

Ergonomic and Postural Corrections

Making small changes in how you use your hands and position your wrist during activities can help avoid extra stress on the median nerve.

Wrist Splints

• Wearing a wrist splint keeps your wrist in a neutral (straight) position.
• Especially helpful to wear at night to prevent wrist bending during sleep.

Workplace Adjustments

• Position keyboards and mouse at the correct height.
• Use a wrist rest or ergonomic keyboard.
• Avoid keeping your wrist bent or twisted while working.
• Take breaks every 30–60 minutes to stretch your hands and wrists.

Activity Modification and Education for carpal tunnel syndrome

Physiotherapists also educate patients on how to avoid movements or habits that worsen symptoms.

Tips:

• Avoid repetitive or forceful gripping.
• Use larger joints (like shoulder and elbow) to reduce wrist strain.
• Use assistive devices to open jars or lift objects.
• Break up long tasks with frequent rests.
• Don’t rest your wrists on hard surfaces for too long.

Patient Education and Home Program for carpal tunnel syndrome

A physiotherapist will guide you on:

• How to perform exercises at home correctly
• Monitoring symptoms and avoiding flare-ups
• Long-term strategies to prevent recurrence