Numbness and tingling sensation, and pain in the hands and forearm are symptoms that you may be suffering from a condition called Carpal Tunnel Syndrome. It is a common condition where the median nerve, one of the major nerves of the hands, is compressed. Early diagnosis is important, and doing carpal tunnel syndrome exercises to treat this condition because if left untreated for a long time, it can result in permanent loss of function, sensation, and weakness.
Anatomy
The median nerve is one of the major nerves in hand, which originates from a group of nerve roots in the neck and comes together to form a single nerve in the arm. The median nerve then travels down the upper arm, across the elbow, and into the forearm; then, it passes through a narrow passageway in the wrist called carpal tunnel to reach the hands and fingers. Carpal bones or wrist bones form the floor and sides of the carpal tunnel. In contrast, the roof of the carpal tunnels is made up of transverse carpal ligament, a strong band of connective tissue.
The median nerve separates into several smaller nerves once it reaches the palm. It allows sensation in the thumb, index finger, middle finger, and half of the ring finger (the thumb side) and controls the muscles around the base of the thumb. The flexor tendons also travel through the carpal tunnel with the median nerve. These are the nine tendons that bend or flex the fingers and thumb. These boundaries in the carpal tunnel make it difficult to stretch or increase in size because it is very rigid.
How does carpal tunnel syndrome occur?
There are several possible reasons carpal tunnel syndrome occurs, and a combination of factors usually causes it. It can occur when the carpal tunnel narrows and the synovium, or the tissue surrounding the flexor tendons, becomes inflamed. These can put pressure on the median nerve that passes through the carpal tunnel and decrease its blood supply, resulting in numbness, tingling sensation, pain, and weakness of the hand and fingers. Women and older people are most likely to develop this condition.
Some risk factors also increase the likelihood of developing carpal tunnel syndrome. This includes:
- Heredity: In some people, their carpal tunnel is smaller, or there are anatomic differences that can change the amount of space the median nerve passes through, and it can be hereditary.
- Repetitive motion: Repetitive motion of the hand and wrists over a prolonged period may irritate the tendons in the wrist and cause swelling. This can put pressure on the median nerve and result in carpal tunnel syndrome.
- Hand and wrist position: Activities involving excessive flexion and extension of the hands and wrist over a prolonged period can increase the pressure on the median nerve.
- Pregnancy: Hormonal changes can cause swelling, which can also put pressure on the median nerve.
- Other medical conditions: Several conditions are associated with carpal tunnel syndromes, such as diabetes, rheumatoid arthritis, and thyroid gland imbalance.
What are the symptoms of Carpal Tunnel Syndrome?
Weakness in the hands, wrist, and fingers, such as the thumb, because the median nerve supplies the muscles here. Symptoms of carpal tunnel syndrome usually start gradually. This includes numbness or tingling in the hands or fingers, especially in the thumb and index, middle, or ring fingers. You may also feel an electric shock sensation in these fingers traveling from the wrist to the arm.
How to diagnose Carpal Tunnel Syndrome?
Different tests are done to diagnose carpal tunnel syndrome. Tinel sign is the most common test done for this condition. In this test, the doctor will tap the palm side of your wrist or ask you to flex your wrist with your arms extended fully. Imaging tests such as X-rays, ultrasounds, and MRI or magnetic resonance imaging can also be done to look at the bones and tissues of your hand. Electromyograms can also be recommended to check for the muscle’s electrical activity, and nerve conduction studies to check for the signals of the nerves of your hand and arm.
What are the treatments for Carpal Tunnel Syndrome?
Treatment for Carpal Tunnel Syndrome depends on your symptoms and their severity. The treatment for carpal tunnel syndrome can be non-surgical or with surgery. Non-surgical are for less severe cases and allow you to continue daily activities without interruption. But for severe cases, surgical options with high positive outcomes are recommended. Generally, treatment includes lifestyle changes, carpal exercises, immobilization, medication, and surgery.
1. Lifestyle changes
Modifying the activities that cause your symptoms can be done. For example, if repetitive motion or hand and wrist position causes your symptoms, taking frequent breaks and straightening your hands and wrist may prevent this from aggravating it.
2. Exercises
Stretching and strengthening carpal tunnel syndrome exercises can relieve symptoms.
3. Immobilization
A splint may be recommended to secure your wrist, prevent it from moving, and lessen the pressure on the nerves.
4. Medications
Anti-inflammatory drugs may be recommended to decrease pain, swelling, and inflammation.
5. Surgery
If conservative treatments don’t work, a surgical procedure called carpal tunnel release may be recommended. It increases the tunnel size to decrease pressure on your median nerve.
What carpal exercises can be done?
For minor to moderate cases of carpal tunnel syndrome, another non-surgical option that can help ease or improve their symptoms and avoid carpal tunnel surgery is exercise. These carpal tunnel syndrome exercises have the strongest effect when you also get other non-surgical treatment options, like changing the action that led to the syndrome or wearing wrist splints. These carpal exercises may not be easy at first, but they shouldn’t be painful. If they hurt, back off or stop completely and inform your health care provider. Ask your doctor if you’re unsure whether to do these carpal exercises.
Fist-to-Stop Sign Carpal Exercise
- Make a fist.
- Slide your fingers until they point toward the ceiling like you’re telling someone to stop.
- Repeat 5-10 times.
Fist-to-Stop Sign Exercise
Fist to Fan Sign Carpal Exercise
- Make a fist.
- Fan your fingers and outstretch them as far as you can.
- Repeat 5-10 times.
Fist to Fan Sign Exercise
Thumb Touches
- One at a time, touch the tip of each finger to the tip of your thumb so they make an O-shape.
- Repeat a few times.
Thumb Touches Exercise
Prayer Stretch
- Stand or sit comfortably in a chair.
- Begin by putting your palms together and your chest as if praying.
- Slowly lower your hands while keeping your palms together until you feel a stretch on your forearms.
- Hold for 15-30 seconds, then return to the starting position.
- As one of the carpal exercises, complete 3-5 repetitions, 1 set.
Prayer Stretch Exercise
Wrist Flexor Stretch
- Stand or sit comfortably in a chair.
- Extend your arm on the affected side with your palm up and down.
- Now, slowly bend your wrist, pointing your hand towards the floor.
- Using your other hand, bend your wrist farther until you feel a gentle stretch in your forearm.
- Hold for 15-30 seconds, then return to the starting position.
- Complete 3-5 repetitions, 1 set.
- Repeat on the opposite hand.
Wrist Flexor Stretch Exercise
Tendon Gliding
In this carpal tunnel syndrome exercise, you’ll move your fingers and hand through various positions. Take your time and move smoothly from one position to the next:
- Start with your elbow bent, your wrist straight, your fingers together and pointing toward the ceiling, and your thumb relaxed.
- Curl your fingers inward so they’re all bent at the middle knuckles, and your fingertips touch the top of your palm — it looks like you’re hitchhiking with curled fingers.
- Straighten your fingers to make an L-shape with your hand — your thumb’s still relaxed.
- Fold your fingers straight down so your fingertips touch your palm — you’re making a straight-fingered fist with your thumb now tucked in and touching your index finger.
- Curl your fingers into a regular fist.
- Repeat 10 times.
- Do this two to three times a day.
Nerve Gliding
Like the last carpal tunnel syndrome exercises, you’ll move through a series of positions with this one. Go slow and move smoothly:
- Bend your elbow and make a fist that faces you — your wrist is neutral.
- Straighten your fingers so they all point up, wrist neutral, thumb tucked in, and pointing up.
- Bend your wrist to point your fingers away from you, thumb still close to your fingers.
- Extend your thumb out to the side.
- Hold that position, but turn your forearm away from you.
- Use your other hand to gently pull your thumb down for a little more stretch. Do this for just a few seconds.
- Repeat three to five times.
- Do this two to three times a day.
Nerve Gliding Exercise
Surgery
A surgical option is recommended when carpal tunnel syndrome is severe and does not respond to non-surgical treatments. Surgery will help increase the tunnel’s size to lessen the pressure on the nerves and tendons that pass through the space.
Takeaway
Untreated carpal tunnel syndrome can cause permanent damage to the nerves and muscles. Consulting a healthcare provider is highly recommended if the symptoms already interfere with your normal activities and sleep patterns.
