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Peter C. Amadio, M.D.
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Question
Carpal tunnel exercises: Can they relieve symptoms?
I've been diagnosed with carpal tunnel syndrome. Would regular hand and wrist exercises help me avoid surgery?
Answer
from Peter C. Amadio, M.D.
Probably not. When used alone, carpal tunnel exercises aren't likely to relieve symptoms such as pain and numbness. And they don't replace other carpal tunnel treatments, such as surgery, behavior modification or wrist splints.
Carpal tunnel syndrome is caused by compression of the median nerve as it passes through the carpal tunnel and under the transverse carpal ligament at the wrist. Pressure on the nerve can stem from anything that reduces the space within this area, including swelling, overuse of the forearm or hand muscles, injury to the surrounding area, or nerve entrapment in scar tissue.
Nerve gliding exercises — one type of carpal tunnel exercise — are meant to help the median nerve move normally within the carpal tunnel space. Though they're often prescribed early in a treatment program, nerve gliding exercises can sometimes worsen symptoms. If a median nerve remains trapped, nerve gliding exercises can stretch, irritate or injure the nerve.
Despite their limits, carpal tunnel exercises may be helpful in some situations:
- To complement another treatment option. Carpal tunnel exercises may be helpful for mild to moderate symptoms when combined with other treatments, such as activity modification, wrist splinting or injections of corticosteroids into the carpal tunnel.
- After surgery to prevent the nerve from becoming scarred in the incision area. Nerve gliding exercises may be helpful when there is significant trauma to the area, such as a fracture that requires wrist surgery or repair near the carpal tunnel. After traditional surgery, general range-of-motion exercises are sometimes recommended to keep the fingers and wrist from becoming stiff, but specific nerve gliding exercises aren't usually needed.
If your doctor recommends carpal tunnel exercises, start them gradually to ensure they don't cause more harm than good.
- Bardak AN, et al. Evaluation of the clinical efficacy of conservative treatment in the management of carpal tunnel syndrome. Advances in Therapy. 2009;26:107.
- Scott KR. Treatment of carpal tunnel syndrome. http://www.uptodate.com/home/index.html. Accessed March 23, 2009.
- Piazzini DB, et al. A systematic review of conservative treatment of carpal tunnel syndrome. Clinical Rehabilitation. 2007;21:299.
- Lund AT (expert opinion). Mayo Clinic, Rochester, Minn. April 1, 2009.
