Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome occurs when the median nerve is compressed as it passes through the carpal tunnel in the wrist. This condition often results from repetitive hand use, sustained wrist positions, or swelling within the tunnel.

Common Symptoms

• Numbness or tingling in the thumb, index, and middle fingers

• Night pain or waking with hand numbness

• Weak grip strength or dropping objects

• Hand clumsiness with fine motor tasks

Physical Therapist Diagnosis

A PT evaluates symptom history, sensation, grip strength, and nerve tension tests (Phalen’s, Tinel’s). Differential diagnosis helps distinguish it from other causes of hand numbness.

Why it Happens

Repetitive hand use, poor wrist ergonomics, or swelling from inflammation can irritate the median nerve. Risk increases with jobs requiring prolonged typing, tool use, or vibration exposure.

Why it Doesn’t Always Heal on Its Own

Mild cases may improve with rest, but without intervention, ongoing compression can cause permanent nerve damage and persistent weakness.

Ideal Physical Therapy Treatment

Therapy aims to reduce nerve compression, restore function, and improve ergonomics.

Key components include:

• Nerve gliding and mobility exercises

• Manual therapy to improve wrist and forearm mobility

• Dry needling for secondary muscle tightness in the forearm

• Strengthening and postural retraining for wrist and hand stability

• Ergonomic education to reduce repetitive stress

Expected Outcomes

Many cases improve significantly with therapy, especially if caught early. Severe or long-standing compression may require surgical release, but PT remains essential for recovery.

Key Takeaway

Carpal tunnel is highly manageable with early intervention. Addressing mechanics, mobility, and ergonomics can prevent progression and restore full hand function.