Exercises and Non-Surgical Treatment for Carpal Tunnel Syndrome
Some simple measures can be taken to quickly relieve symptoms. It is important to know that these tips
are particularly effective in the early stages of the disease.
It is important to know that numbness or loss of sensation in the fingers always reveals the existence
of a pathology, or disease, in one or more nerves of the arm or forearm. If the numbness is limited to
the thumb, index and middle fingers, it is very likely that it is, indeed, carpal tunnel syndrome. If
numbness and wrist pain cause nocturnal awakening, the diagnosis becomes almost certain. It is not
uncommon for the nerve to be pinched further up, in the forearm or elbow, in addition to the carpal
tunnel.
Perform stretching and nerve-sliding exercises with the arm and wrist:
FIGURE 1/ Stretch your elbow and place your wrist in a fully extended position, also
extending your fingers. Then keep your elbow straight and raise your hand and fingers to the
sky.
FIGURE 2/ Then place the wrist in flexion, keeping the elbow extended. Keep your elbow straight
and lower your hand to the ground. Then alternate wrist positions from full extension to a fully
bent position. Repeat these movements alternately when symptoms occur. The movements must be
done slowly, counting about 3 seconds to move from an extreme bending position to an extreme
extension position, and vice versa. Perform 5 to 10 repetitions of each movement.
FIGURE 3/ Then do the same manoeuvres by holding the elbow in a bending position. The elbow is
then bent at a right angle of 90° and the wrist is bent backwards and held in this position.
FIGURE 4/ The elbow is then held in the same bending position and the wrist is brought forward
as if mimicking the image of a duck’s head. These stretching and nerve sliding exercises aim to
stretch and lengthen the nerve and thus to help reduce pressure on the nerve.
FIGURE 5, 6, 7, 8/ Stretching poses, such as those practiced in yoga, consist of
relaxing and
lengthening the transverse ligament of the carpus that forms the roof of the carpal tunnel, and
the ligaments that connect the bones that form the floor of the tunnel. The aim is to make the
channel less rigid and therefore reduce the pressure locally. These exercises are effective for
less developed forms of compression from the median nerve to the wrist.
Identify
the activities that trigger symptoms and avoid them for a few days. An occupational therapist can
help you change your posture or workstation and encourage you to take regular breaks. It is also
important to alternate tasks to save your wrist. Modifying your keyboard for an ergonomic keyboard
and using forearm supports to avoid wrist extension when using the mouse are some of the suggestions
that might be made. If a wrist support is added to the keyboard, make sure it does not increase the
pressure in the carpal tunnel.
Some
Get a wrist rest orthosis. This brace needs to put the wrist in a neutral position. These orthoses
are available in pharmacies, orthotists or specialized occupational therapists, and let the nerve
rest in the canal and thus avoid the increase in canal pressure during bending and wrist extension
movements. The neutral position is preferable for the extension. These orthoses can be made to
measure (moulded thermoplastic orthoses) or in prefabricated models. The orthosis should be worn at
night for a maximum of four to six weeks. Then discontinue wearing the brace and see if the symptoms
reappear or increase in intensity. If this is the case, continuing to wear the orthosis is not
recommended without consulting a doctor, because it means that the compression is severe and
progressive and it is important to consult a hand surgeon.
Modify the tools or work equipment you use that are associated with the onset of symptoms. Keep the
wrists in a neutral position rather than in flexion or extension. Use modified tools that reduce the
amount of gripping force required for the task at hand. Avoid any external pressure on the carpal
tunnel area, which is called the “heel of the hand.” Increase the diameter (size) of frequently used
tool handles and grips. Avoid using vibrating tools or choose tools that cause less vibration.
Wearing anti-vibration gloves may be beneficial.
- Modify your diet: You can reduce the amount of salt in your diet because salt
promotes water retention and therefore edema or swelling in the tendons.
- Vitamin B6 may be useful in cases where there is a deficiency of this vitamin.
Vitamin B6 supplements will therefore not benefit everyone. A blood test can detect this one.
Apply ice
locally to the wrists if you find it helps. Ice can be applied in 10-minute increments, waiting a
minimum of 2 hours before reapplying. The use of a towel soaked in cold water, or a bottle of cold
or iced water, applied directly to the carpal tunnel area, can provide some comfort.
Drugs available without a prescription: If there are no contraindications, you can take
non-steroidal
anti-inflammatory drugs (NSAIDs), such as ibuprofen, for a few days.
Perform “contrast” baths: In order to reduce the feeling of swelling you can feel in
your hand, or the visible swelling if there is any, you can try doing “contrast” baths. These
baths will create an induced “pumping” in your hand.
Procedure to follow:
1. Take 2 containers that will let you immerse your hand completely in water. If your
kitchen sink
has 2 sides, it can easily be used.
2. Fill 1 container with warm water, water warm enough to be easily tolerable to touch
with
the
unaffected hand, without being too hot, to avoid burning yourself.
3. Fill the other container with cold tap water.
4. Place the hand, including the wrist, in 1 container and stay there for 1 full minute,
keeping
track with a timer.
5. Alternate from one container to the other, every minute, for a total of 10 minutes.
You
may feel
relief after doing these baths. They can then be done twice a day, once at the beginning
of the
day and once at the end of the day. If you do not feel any better, or a positive effect
on the
swelling of your hand, after using these baths for 1 week, you can stop doing them.
Cortisone injections into the carpal tunnel, when properly performed by a
specialist, are
not painful and can temporarily improve symptoms. On the other hand, it is not advisable to
repeat them
several times, because they can mask the symptoms of lasting nerve compression and therefore
worsen
silently. At that point, there is a danger of irreversible damage.
