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Hand Physical Therapy for Carpal Tunnel Syndrome

Carpal tunnel syndrome is a disorder that usually affects both hands, causing pain and numbness in the wrists, fingers, and hands. It is caused by the compression of the median nerve, which passes through a small canal (a “tunnel”) in the wrists. This nerve is located on the palm side of your hands, and provides sensation to all fingers except the pinky finger. The median nerve may become compressed by swelling inside the wrists. Mild to moderate carpal tunnel syndrome may be manageable with behavior changes, wrist splints, and physical therapy, but severe carpal tunnel syndrome usually requires surgery for recovery.

Some of the exercises you may try to relieve carpal tunnel syndrome include:

  • Shake it out: This exercise is particularly useful at nighttime, when symptoms are often worse. Shaking your hands out can provide you necessary relief.
  • Fist to stop sign: To do this exercise, make a fist, slide your finger to point up toward the ceiling (the “stop” hand signal) and repeat 5-10 times.
  • Fist to fan: Making a fist, fan your fingers out and stretch them as far as you can, repeating 5-10 times.
  • Thumb touches: Touch the fingertips to the tip of your thumb to make an “O” shape, and repeat a few times.
  • Wrist flex and extend: Holding your arm straight in front of you with your wrists and hands straight and the palm of your hands facing down, bend the wrists down so your fingers point towards the floor. Use the other hand to increase this stretch, and pull the fingers gently towards you body, holding this pose for up to 30 seconds.
  • Nerve gliding: This exercise involves bending your elbow and making a fist that faces you. Straighten your finger so they point up with the thumb tucked in, pointing up. Bend the wrist to point your fingertips away from you, and hold the thumb in close against your fingers. Extend your thumb out to the side, but turn your forearm away from you. Use your other hand to pull the thumb down a little more for just a few seconds. Repeat up to 5 times, and do the exercise 2-3 times a day. A physical therapist can help you do this properly.

Regular hand and wrist exercises coupled with behavior changes may help relieve pain and restore function, but for some, they are ineffective to provide sufficient relief. Despite the limitations of carpal tunnel exercises, they can be more effective when combined with corticosteroid injections into the affected wrist(s) to reduce inflammation. However, steroid injections can only be used a limited number of times before they become ineffective. Mild pain medication and over-the-counter painkillers may be useful for longer-term use. Treating any underlying condition causing carpal tunnel syndrome, such as diabetes or arthritis, is also necessary to adequately relieve carpal tunnel symptoms.

Hand Physical Therapy After Carpal Tunnel Surgery

Once you are in the recovery stage after carpal tunnel surgery, your orthopedic surgeon will likely recommend range-of-motion exercises, such as nerve-gliding, to prevent nerve scarring. This is especially useful if your carpal tunnel syndrome was caused by significant trauma to the wrist, like a wrist fracture requiring surgery to repair the structure of the carpal tunnel.

If you have carpal tunnel syndrome and need physical therapy, contact QualCare Rehabilitation to learn more about how we can help you. Simply call (713) 588-0042 or fill out our online contact form.

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