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What is it?

CTS is a condition caused by a nerve (median nerve) being compressed as it passes through a tunnel (carpal tunnel) in the wrist. The carpal tunnel is formed by the wrist bones and a thick ligament (see picture below).

CTS symptoms can vary but can include tingling/pins and needles, numbness, pain in forearm which can be worse at night disturbing sleep. In the day weakness of thumb), or clumsiness may also be noticed.

What causes it?

Anything that reduces the space within the carpal tunnel some common examples are inflammation, arthritis of wrist, swelling after wrist fracture, fluid retention (hormonal changes), pregnancy, diabetes or can be a combination of these factors.

1. Think about how you use your hands, activity modification

There is more room in the carpal tunnel when your wrist is straight and symptoms tend to be less when the wrist is straight.

• Try to avoid working with your wrists bent forward or backwards for long periods particularly pinching or gripping objects

• Try to avoid activities with repeated bending of wrist

• Try to avoid (decrease) gripping /pinching for a long period

  • Loosen grip and/or change position regularly e.g., reading, using your phone, sweeping, pushing a trolley etc.

  • Take regular breaks if unable to change the task.

2.Think about the environment you’re in, modifying your environment

• Use utensils/equipment/pens with larger grips as it takes less force to hold.

• Think about your desk set up/computer.

• Wear padded gloves or wider softer handles to reduce vibration if cutting grass or biking for example.

• Can someone or an aid help me e.g., jar opener, different gardening tools.

3. Exercises: some research suggests symptoms can be relieved/helped by gliding the median nerve through the tunnel

Median Nerve Glides

1. Start with your arm as shown below in picture A.

2. Straighten out the elbow and wrist to nearly straight as in picture B.

3. Alternate these positions

4. Repeat 5 times 3-4x a day

5. Bend your wrist down and up, keeping your fingers relaxed (elbow straight)

6. Repeat 10 times 3-4x a day

1. Start with your fingers and wrist straight every time

2. Follow the order as shown below

3. Do 10 repetitions 3-4X a day (hold each position for a second or two)

4. Good Posture: your median nerve starts off in your neck before traveling down your arm to your wrist/hand. Therefore, important to think about good posture in standing and sitting.

5. Splinting, wearing a splint at night may help reduce your symptoms

• Rests the wrist

• Keeps it straight at night (decreases pressure in the carpal tunnel)

• Normally made from neoprene (wet suit material) with bar inside

• Easily purchased online or in local pharmacy

• Wear firmly not too tight (should not worsen your symptoms)

• Check for marking/irritation or rubbing, if this occurs please remove splint 

NONE OF THESE STRATEGIES OR EXERCISES WILL WORK IMMEDIATELY IT MAY TAKE A FEW WEEKS.