Carpal tunnel syndrome can be a debilitating condition if not managed early. Fortunately, the earlier you address this condition the more likely you are to recover. Contrary to popular belief, not everyone who will suffer from carpal tunnel syndrome will need surgery. There are natural and non-invasive ways to help relieve the symptoms and prevent worsening of conditions. Detailed below is a comprehensive way of managing your carpal tunnel syndrome.
What is carpal tunnel syndrome?
Before describing carpal tunnel syndrome let’s have a look at the structure of a normal wrist. Figure 1 shows us a simplified visual representation of the inside of our wrist.
The carpal tunnel is a space surrounded by 2 main borders which are the carpal bones and flexor retinaculum. Under the tunnel is a layer of carpal bones composed of small and oddly-shaped bones. Above is the flexor retinaculum, which is a fibrous band and/or ligament which traverses the ceiling of the tunnel. Housed within the carpal tunnel are 9 tendons and the median nerve.
For most sufferers of carpal tunnel syndrome, the origin of this condition resides within the compression of the median nerve within this tunnel. The median nerve originates from the neck, spans along the arm and forearm before entering the hand through the carpal tunnel. This nerve helps with 2 major functions of the hand and wrist including:
- Ability to sense and feel through the hand and fingers
- Movement through the wrist, fingers (mainly the 2nd-3rd fingers) and thumb
When the median nerve is compressed within the carpal tunnel, additional pressure occurs within the wrist. Increased pressure will begin to impact on the structure of the median nerve and surrounding blood vessels. The consequences of these changes lead to carpal tunnel syndrome which leads to a collection of symptoms and signs such as:
- Numbness and pins & needles in the forearm, thumb and 2nd-3rd fingers
- Weakness especially when gripping
- Wrist and hand pain which disrupts sleep
- Swelling of the hand (especially in more severe cases)
How does carpal tunnel syndrome happen?
Under many circumstances, there are no obvious reasons for carpal tunnel syndrome. Factors such as gender, size of the carpal tunnel, anatomical differences and even certain conditions (e.g. diabetes, heart disease etc.) can make someone vulnerable to carpal tunnel syndrome.
Other known common reasons are repetitive wrist movements and work-related tasks, as they can create additional pressure strain within the carpal tunnel. Constant loading of the wrist can negatively impact the structures in the carpal tunnel such as the enlargement of the tendons and swelling. As these structures take up more space within the tunnel, they can compress the nerve even more.
Examples of these movements include:
- Poor workplace set-up (e.g. keyboard, mouse etc.)
- Using vibrational equipment (e.g. drills, construction tools etc.)
- Repetitive strain injuries (e.g. playing piano, hammering etc.)
Can carpal tunnel syndrome go away on its own?
Trying to get rid of carpal tunnel syndrome can be unpredictable and usually a drawn-out process. Whether the condition progresses or worsens will change depending on a case-by-case basis. Factors such as the severity of the disease, the length of the condition and pre-existing medical issues may contribute to the outcome.
Fortunately, albeit extremely slow, carpal tunnel syndrome can improve and disappear on its own. Especially for mild to moderate cases, surgery is not required. Although seeing a health professional such as a GP, physical and/or hand therapist will help speed up the process and prevent worsening. Unfortunately, more severe cases will often not improve without carpal tunnel surgery.
How can I manage carpal tunnel naturally?
There are different ways of managing carpal tunnel syndrome naturally without surgery and corticosteroid injections for milder cases. The first point of action would be to see a health professional so they treat you naturally and provide specific advice. Below will be a list of non-invasive physical and hand therapy treatments to help get rid of carpal tunnel syndrome.
Rest and activity modification
Aggravating movements such as repetitive wrist movements or poor postures at work can worsen symptoms. Discussing any potential occupational modifications between your physical therapist, workplace and yourself may be beneficial. Simple changes such as ergonomically arranging the workplace or even temporarily stopping certain duties could be advised. Prevention is always better than a cure.
Wearing a wrist brace
Wearing specifically designed wrist braces can provide relief in the short term. Although using it won’t get rid of carpal tunnel syndrome, symptoms such as pain and swelling may ease. The brace will usually fit over the wrist and have a straight metal bar to restrict movement.
This brace should not be worn constantly during the day as the muscles around the hand and wrist can deteriorate. Instead, it should be worn at night time when carpal tunnel syndrome tends to flare up during this period. By stabilising the wrist, the aim is to reduce the compression of the median nerve.
Manual therapy encompasses specific hands-on techniques such as soft tissue massage, myofascial release and joint mobilisations. These target specific areas that are directly and indirectly affected to relieve carpal tunnel symptoms. The goal of manual therapy is to help take the pressure off the median nerve by loosening tight muscles and stiff joints. Similar to electrophysiological options, these should only be considered for short-term management.
Prolonged periods of poor posture such as in incorrect keyboard and mouse placement can create additional strain through the carpal tunnel. Consulting a professional ergonomist may help with your workplace set-up.
Some common ergonomic changes that these ergonomists will recommend include:
- Adjusting your posture
- Using ergonomic equipment (e.g. standing desks, ergonomic mouse pads, etc.)
- Specific exercises and stretches
- Providing advice about modifying or changing the aggravating activities
Some physical therapists will use electrophysiological machines to help ease the symptoms of carpal tunnel syndrome. These machines applied on the outside surface of the skin without the use of strong chemicals.
Using mediums such as lasers and ultrasound, these machines will affect the inside structures without penetrating the skin. Although the research is not conclusive, they have been designed to beneficially impact the area being treated by increasing blood flow and improving nerve function.
Although these treatments can help with reducing symptoms, the research about its efficiency is still non-conclusive. Treatment such as electrophysiological modalities should only be used as an adjunct and not as the main treatment.
Exercise and rehabilitation
Exercises such as grip strengthening, wrist stretches and hand stretches should all be considered to help reduce the symptoms of carpal tunnel syndrome. These exercises aim to take the compression forces off the median nerve and prevent further functional decline (e.g. muscle wastage, wrist flexibility, etc.) Seeing your physical therapist is recommended so they can direct you with a tailored exercise program.
What exercises help carpal tunnel?
There are no exercises that can guarantee a cure to carpal tunnel syndrome. However, based on my clinical experience and limited evidence, here are 5 simple exercises that can help improve symptoms.
1. Median nerve gliding exercises
Median nerve glide exercises are awkward movements but are performed to directly stretch out the affected nerve. Almost like flossing your teeth, this movement aims to gently stretch and move the nerve along the path of the neck, arm, and wrist. Perform as much as tolerable. Nerve gliding exercises can be irritable if pushed too hard.
2. Wrist flexor stretch
Stretching out the muscles and tendons in the forearm may help open up the room in the carpal tunnel. Creating more space in the tunnel may take less pressure off the nerve. When performing these exercises do not push too hard, pull just enough for a gentle stretch.
3. Grip strengthening
Due to lack of usage, the muscles around the forearm and hand can deteriorate. Maintaining grip strength is important to maintain the functionality of the hand.
4. Pectoral minor stretch
The pectoral minor is a chest muscle which starts from the upper ribs and attaches to the shoulder blade. It runs across a major network of nerves called the brachial plexus (which actually supplies the median nerve). When this muscle is tight (especially when in poor sitting postures), it can begin to impact the brachial nerve. A tight pectoral minor can either contribute to or mask as carpal tunnel syndrome. Perform as tolerable.
5. Shoulder blade squeezes
As described above, poor sitting postures can often lead to poor elbow/wrist position and stooped over shoulders. These positions place a greater risk for median nerve compression and therefore the likelihood of carpal tunnel syndrome. Performing these exercises engages the correct postural muscles and acts as a reminder to sit correctly.
Hopefully this guide will assist in helping you naturally manage your condition. Although there are no guarantees to get rid of your carpal tunnel syndrome, these are some useful tips to help relieve your symptoms. However, it’s important that you seek the expert opinion of a relevant health professional to make an accurate diagnosis and suitable management plan.
Disclaimer: The content written on this page was created for educational purposes. Information on this page should not be used as medical advice or a substitution for seeking the services of a health professional. Anyone suffering from carpal tunnel syndrome symptoms should book in a consultation with their primary healthcare practitioner (e.g. physical therapist, family doctor etc.).
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