Carpal Tunnel Syndrome Exercises With Progression (Video)

By: November 15, 2012

The Carpal Tunnel is a narrow rigid pathway formed by the carpal bones of the wrist and the inelastic transverse carpal ligament. Traveling through the tunnel are nine finger flexor tendons and the median nerve. CTS is the condition used to describe the pain, numbness, and weakness associated with compression of the median nerve against the transverse carpal ligament. This is often caused by pressure from swollen synovium (or the outer sheaths) of the flexor tendons. If left untreated, CTS can lead to considerable discomfort, impaired function of the hands, and permanent disability. It is the most common disorder of the hand affecting up to 5% of the population.

There are many risk factors that may lead to CTS: Conditions that lead to increased joint swelling like RA, obesity, and preganacy can increase pressure on the median nerve at the wrist. But most commonly, we are treating CTS in those who perform highly repetitive tasks with their hands.

The symptoms of CTS include paresthesias (which describes numbness or tingling), night pain, daytime pain aggravated by increased repetitive activity (can sometimes radiate up arm as CTS progresses)
and decreased strength of the hand, especially of the thumb that results in poor grasping and pinching.

CTS is most manageable when it is diagnosed early, as its effects can lead to irreversible nerve damage over time. The goal in managing CTS is to decrease pressure on the median nerve.
Many conservative treaments for mild to moderate forms of CTS that include rest, a wrist splint to help keep neutral wrist alignment, anti-inflammatory medication, modify work environment, and therapeutic exercise.

2 exercises that I find very effective in the management of CTS are median nerve gliding technique and the 3 fist tendon flexor tendon gliding exercise.

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