Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy affecting approximately 3% of the general adult population. Individuals with jobs or hobbies that involve fast, repetitive movements and forceful gripping with little-to-no rest may be at increased risk for CTS, as are those with metabolic/hormonal conditions that can lead to increased swelling/pressure/inflammation in the wrist. In most instances, treatment guidelines recommend utilizing conservative treatment approaches, like chiropractic care, before consulting with a surgeon. In addition to workstation modifications, manual therapies, nutritional recommendations to reduce inflammation, nocturnal splinting, and co-management with other healthcare professionals, doctors of chiropractic will also advise patients to perform exercises at home to speed recovery and prevent recurrence.
Below is a description of four CTS-specific exercises recommended by the American Academy of Orthopedic Surgeons (AAOS).
Exercise 1: Wrist Extension Stretch. With the elbow straight (but not “locked”), bend the wrist back (as if saying “STOP”) and use the other hand to apply “over-pressure” to assist to a maximum tolerated stretch. Hold for fifteen seconds. Repeat five times for each wrist.
Exercise 2: Wrist Flexion Stretch. With a straight elbow (but not “locked”) and the palm facing down, bend the wrist downward until the fingers point toward the floor and use the other hand for to achieve the maximum tolerated stretch. Hold for fifteen seconds, repeat five times for each wrist.
Exercise 3: Median Nerve Glides. Make a fist (with the top of the hand facing upward) and then open the hand, but not the thumb, and bend the hand backward toward the forearm and extend the thumb backward. Rotate the palm up toward the ceiling, keeping the wrist/fingers/thumb extended. Grasp the thumb with the other hand and extend back (assist) to tolerance (but not too hard). Hold for three to seven seconds and repeat on the other hand.
Exercise 4: Tendon Glides Type One: Start with the hand pointed outward with the fingers straight out, palm facing down. Bend the fingers upward and then curl them downward into a fist. Tendon Glides Type Two: Start with the hand pointed outward with fingers straight out, palm facing down. Bend the fingers downward touching the end of the fingers to the base of the palm.
The AAOS recommends warming up the hands and wrists with heat for about 15 minutes before performing these exercises and using ice for 20 minutes to cool down afterward. If your symptoms to worsen, cease these exercises and consult with your doctor of chiropractic about modifications.