What are the best carpal tunnel exercises?
One morning you woke up with terrible pain in the wrist, out of no clue you started shaking the hand in order to get some relief. If you are experiencing the exact same problem, then you could be suffering from a wrist pain condition known as carpal tunnel syndrome.
It is commonly seen in professionals required to work long hours on a computer keyboard. Fortunately, if detected early it can easily be managed by simple home tips, exercises, and physiotherapy. In this article, we will learn the best exercises to cure carpal tunnel at home
How do I know if I have carpal tunnel syndrome?
In my usual physiotherapy practice, I have found that the person whose professions involve long hours of working on the computer keyboard are more susceptible to this kind of wrist pain.
I have also found that physiotherapy and exercises for carpal tunnel syndrome are very beneficial. Carpal tunnel syndrome sufferers usually come to me in my clinic with complaints like:
- Tingling and numbness on the palm.
- Weak grip strength of the hand.
- Difficulty in holding a glass of water with a painful hand.
These were some common signs you could look for, as you will proceed further with this article you will learn more of its sign and symptoms. Now, let’s try to understand what is carpal tunnel syndrome and why does it cause our wrist pain.
What is carpal tunnel syndrome?
Carpal tunnel syndrome is a painful wrist joint condition manifested by tingling and numbness in the palm and weakness of the hand. But to better understand the symptoms of the carpal tunnel we must first have a clear picture of its causes.
In carpal tunnel syndrome, the median nerve is compressed at the wrist joint when it passes through the carpal tunnel. Compression could occur either due to decrease circumference of the tunnel itself or due to increased pressure inside the tunnel due to fluid retention.
In either of the condition, all the vital structure passing through gets compressed. The nerve being the most sensitive of all is responsible for all the symptoms.
Now that you know there is a tunnel on the wrist joint. But, you might be wondering, what this carpal tunnel is made up of? Where it is actually present at the wrist? And, how does it causes wrist pain?
To, answer all these questions, we need to learn little about its related anatomy.
Anatomy of carpal tunnel
A Carpal tunnel is present at the wrist joint. It is actually a tunnel-like structure through which different structures like blood vessels tendons and nerve passes through. As you can see in the image below.
We can compare this to a railway tunnel through which the railway track passes. Every tunnel has a roof and floor. The roof of this tunnel is formed by the soft flap-like structure called flexor retinaculum and the floor is formed by the carpal bones.
All the vital structures like nerves, tendons, arteries, and veins pass through this tunnel. But, the most important and delicate of all is the median nerve. The median nerve is a nerve that originates from our neck cervical region and travels down the hand to supply to the thumb index finger and middle finger.
What causes carpal tunnel pain
Any pathology around the carpal tunnel (wrist) can lead to the narrowing of the canal. This could be an actual narrowing of the tunnel or when the tunnel is filled with fluid. In both condition it exerts pressure inside the tunnel leading to compression of the median nerve.
There are many factors that lead to an increase in the pressure inside the tunnel. We have listed a few of them below.
The following factors can contribute to carpal tunnel syndrome:
- Trauma or injury to the wrist that causes swelling. Like scaphoid fracture or Colle’s fracture
- Hypothyroidism.
- Rheumatoid arthritis.
- Work stress common in the long hour working
in the computer keyboard. This the most common reason why wrist pain complains visit to us. - During pregnancy or Menopause.
- Development of a cyst or
tumor in the canal. - And in some cases, no cause can be identified.
Symptoms of carpal tunnel syndrome
The symptoms are usually found on the outer side of the palm and finger (on the side of thumb) along the nerve path because of compression of the median nerve. You will numbness on the palmar aspect of the thumb, index finger, and a few portions of the middle finger.
You can see the figure in which the shaded region is the symptoms area. Note that it is along the path of the median nerve. Morning pain and tingling sensation are the most irritating symptoms, you may even wake up out of sleep due to pain.
Your hand may “fall asleep” frequently and difficulty in holding a pen, a glass of water, bottle and you may even drop the objects.
Other symptoms include:
- numbness, tingling, and pain in your thumb and the first three fingers of your hand
- pain and burning that travels up your arm
- wrist pain at night that interferes with sleep
- weakness in the muscles of the hand
How to prevent carpal tunnel
One of the most basic things to prevent carpal tunnel is to follow the ergonomic way of sitting at your desk. Adopting an improper way of sitting on a computer may not only lead to wrist pain, but it can also result in neck and back pain. You learn more about computer ergonomics here: “What is the Best Way to Sit at Your Desk?“.
Another way is, to take a break every half hour and perform this elbow exercise for 5 minutes.
Easy carpal tunnel exercises
All the carpal tunnel exercises are aimed at stretching the muscle and soft tissue around the wrist and carpal tunnel. This way we can release the compression inside the tunnel and create sufficient room for the nerve and other structures that pass by.
The exercises essentially are wrist range of motion exercises, wrist stretching exercises and strengthening exercises.
1) Wrist ROM exercise
So, the first exercise in the list of carpal tunnel exercises is the wrist range of motion exercises. Moving the wrist in a different direction will ease the pressure inside the carpal tunnel. As you can see in the figure you have to move the wrist in an up and down direction. Flex and extend the wrist joint a minimum of 20 to 30 times in a session.
Similarly, you can move wrist to right and left, which we also call ulnar and radial deviation. We can also circumduction our wrist in clockwise and anticlockwise directions.
2) Wrist flexor stretching
Stretching of the carpal tunnel is very important for treating such pain. Stretching causes to relax of the flexor retinaculum thereby releasing pressure on the carpal tunnel. There are a
A very simple yet very effective exercise. Do this, just keep your sound hand over the finger of the painful hand and shown in the figure and press it. Press it so as to bend the wrist and apply force till the point you feel stretches over the wrist.
Hold this position for one minute and then slowly release it. Repeat it 3 to 5 times in a single session. Twice to thrice daily would be enough, you can also do it when you are at your office.
3) Joining hands
This is also a stretching exercise and as you can see in the figure it is very easy to do. For this just join your hands and press both hands together so that the wrist joint comes together. This will give you a gentle stretching over the wrist joint.
Maintain this position for 30 sec and repeat it 3 to 4 times in a single session.
4) Grip strengthening exercises for carpal tunnel syndrome
As the name suggests it’s a strengthening exercise for grip. Grip exercise increases blood flow around the elbow and increases the flexibility of the flexor retinaculum. You can use a soft sponge ball or gel ball for this exercise. It can be done as many times as possible.
5) Tennis ball self-massage
Our final exercise in the list of carpal tunnel exercises is actually a self-massage technique. This is a very effective self-massage technique that I usually recommend to my patient. For this, you simply need a tennis ball. Place the tennis ball on the table and keep your wrist over it. Now, simply move your hand to and for as displayed in the figure.
This will give a gentle massage over the wrist to help ease the pressure inside the carpal tunnel. Do it for 3 to 5 minutes in a single session.
Physiotherapy for carpal tunnel syndrome
Physiotherapy is beneficial for most carpal tunnel sufferers especially in mild to moderate cases. When you are referred to a physiotherapist they will thoroughly take your history of pain and take a careful assessment to determine which factors have contributed to the development of the condition. Accordingly, the treatment plan is devised.
Phase-I (Acute Phase)
During the acute phase which is characterised by the presence of inflammatory signs (i.e. morning pain or pain with rest), R.I.C.E Regime is beneficial. Where:
- R is for rest- This involves resting from aggravating activities often with the use of a splint. To start with the splint has to be used continuously. As the pain subsides use it during the night. The splint mentioned below can be used for it.
- I for icing. Ice packs, also known as cryotherapy are beneficial for pain relief. You can either use ice cubes or the most convenient is the use of a cold gel pack you can use.
- C for compression-Compression helps to prevent swelling and inflammation around the wrist joint thereby reducing pain. You can use a wrist support brace for this.
- E for elevation keeping the arm elevated.
Ultrasonic therapy: The application of UST or ultrasound therapy over the wrist has to be found to give tremendous relief to the sufferer. One needs to go to a qualified physio for ultrasonic therapy.
Phase-II
As the acute pain subsides your physiotherapist will address:
- Carpal bone mobilization
- Stretching of flexor retinaculum to open the carpal tunnel.
- Gliding exercises of nerve and tendon to ensure full unrestricted nerve motion is available.
- Muscle and soft tissue extensibility.
- Ultra Sonic Therapy.
- Interferential Therapy.
Prevent carpal tunnel by following these precautions
One of the most basic things to prevent carpal tunnel is to follow the ergonomic way of working on a computer and keyboard. Adopting an improper way of sitting on a computer may not only lead to wrist pain, but it can also result in neck and back pain. You learn more about computer ergonomics here: “Proper sitting posture at a desk for neck, back & hip pain“. Another way is, to take a break every half hour and perform this elbow exercise for 5 minutes. But what if you actually developed CTS wrist pain?
Other home remedies
Activities that place large amounts of stress through the forearm flexors should be minimized, these include: racquet sports, gripping activities, opening jars, cans or doors, carrying or lifting. Resting from aggravating activities ensures that the body can begin the healing process in the absence of further tissue damage. Once the patient can perform these activities pain-free, a gradual return to these activities is indicated provided there is no increase in symptoms.
Exercises are very important, however, you may sometimes develop pain after the exercise session. This is quite normal and you need not have to worry about it. Let me share some important tips and products that can help you with this.
If you have pain, simply apply a pain ointment over the painful area and let the body absorb it for 10 minutes. After a gap of ten minutes apply a cold pack over the area and you would feel almost instant relief.
JOINT FLEX OINTMENT
This highly effective pain balm I would like to recommend to you. I often prescribe this to my patient at my clinic. Get this for yourself now.
The treatment of carpal tunnel is possible. If detected early and in a less severe form it can easily be managed by simple exercises and some effective yet simple home tips. In the coming article, we will discuss its treatment, exercises, and home tips.
Often the numbness of the finger with a tingling sensation on the arm and forearm could be a result of cervical radiculopathy. For which you need to do completely different sets of exercises. If you actually diagnosed with carpal tunnel syndrome and these exercises are not helping you then you must immediately consult your doctor.
Keep Reading: 7 Easy Neck Exercises For Pinched Nerve To Cure Cervical Radiculopathy Permanently
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