Carpal Tunnel

Carpal tunnel syndrome is when a nerve in your wrist gets squashed.

There’s a small tunnel in your wrist (called the carpal tunnel) that your nerves and tendons pass through. One important nerve — the median nerve — gives feeling to your thumb and fingers. If this tunnel gets tight or swollen, it puts pressure on the nerve.

What it feels like:

  • Tingling or “pins and needles” in your thumb and fingers

  • Numbness (like your hand has fallen asleep)

  • Pain in your wrist or hand, sometimes going up your arm

  • Weakness or dropping things

When it’s worse:

  • At night (can wake you up)

  • When using your hands a lot (typing, gripping, phone use)

Why it happens:

  • Repetitive hand/wrist use (eg tennis, office work)

  • Poor wrist position (bent for long periods; eg typing, painting)

  • Swelling (e.g. pregnancy, injury)

How can our Physios help?

Physiotherapists help by reducing pressure on the nerve and improving how your hand and wrist move.

  • Education & activity changes: Show you how to avoid positions and tasks that irritate the nerve (e.g. prolonged wrist bending, poor desk setup)

  • Splinting advice: Recommend a wrist splint (especially at night) to keep the wrist in a neutral position

  • Exercises:

    • Nerve gliding (to help the nerve move freely)

    • Tendon gliding (reduce stiffness in the tunnel)

    • Strengthening (hand, wrist, and forearm)

  • Manual therapy: Techniques to improve wrist and soft tissue mobility

  • Pain management: Advice on load management and symptom control

Goal:
👉 Reduce symptoms, improve function, and avoid the need for injections or surgery where possible.



References:

Ballestero-Pérez., R et al. (2017). Effectiveness of nerve gliding exercises on carpal tunnel syndrome: A systematic review. Journal of Manipulative and Physiological Therapeutics, 40(1), 50–59. https://doi.org/10.1016/j.jmpt.2016.10.004

Kim, S. D. (2015). Efficacy of tendon and nerve gliding exercises for carpal tunnel syndrome: A systematic review of randomized controlled trials. Journal of Physical Therapy Science, 27(8), 2645–2648. https://doi.org/10.1589/jpts.27.2645

Gräf, M., et al. (2022). Physiotherapy and sports therapeutic interventions for treating carpal tunnel syndrome: A systematic review. Journal of Clinical Medicine, 11(13), 3709. https://doi.org/10.3390/jcm11133709

O’Connor, D., Marshall, S., & Massy-Westropp, N. (2003). Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome. Cochrane Database of Systematic Reviews, 2003(1), CD003219. https://doi.org/10.1002/14651858.CD003219