Everything You Need to Know About Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome happens when the median nerve gets compressed or pinched as it passes through the carpal tunnel in the wrist. This tunnel is a narrow space surrounded by bones and ligaments, and when it becomes too tight (from swelling or pressure), the nerve gets irritated, causing numbness, tingling, weakness, and pain in the thumb, index, middle, and part of the ring finger.

An analogy…

Think of the carpal tunnel like a busy tunnel under a bridge, with cars (tendons) and a motorbike (the median nerve) all trying to squeeze through. If there’s traffic or the tunnel gets narrower, the motorbike gets squashed — that’s what happens to the nerve in carpal tunnel syndrome.

What causes carpal tunnel syndrome?

The carpal tunnel is a tight passageway on the palm side of the wrist that houses the median nerve and several flexor tendons. When this tunnel becomes inflamed, swollen, or narrowed, it compresses the median nerve. This can result from repetitive hand or wrist use, fluid retention, or even wrist fractures that alter the tunnel’s shape.

What are the signs and symptoms of carpal tunnel syndrome?

Numbness or tingling in the thumb, index, middle, and half of the ring finger
Symptoms often worse at night or after repetitive use
Pain or aching in the hand, wrist, or forearm
Weakness in grip or dropping objects
Clumsiness or trouble with fine motor tasks
In severe cases, muscle wasting in the base of the thumb

What tests are used to diagnose carpal tunnel syndrome?

Tinel’s Sign: The practitioner gently taps over the median nerve at the wrist (just above the carpal tunnel). A positive test occurs if this produces tingling, zapping, or pins and needles in the thumb, index, middle, or half of the ring finger.

Phalen’s Test: The patient presses the backs of their hands together with wrists fully flexed and holds the position for 30–60 seconds. A positive result is when this position causes numbness, tingling, or pain in the median nerve distribution.

Nerve Conduction Studies (NCS): This test measures how quickly electrical signals travel along the median nerve. Slower signal speeds across the wrist compared to other areas can confirm compression of the nerve and help determine the severity of carpal tunnel syndrome.

How long does carpal tunnel syndrome take to heal?

Mild to moderate cases often improve with activity modification and splinting over 4 to 8 weeks. More severe or chronic cases may take 2 to 3 months or longer to resolve, especially if there’s nerve damage. If surgery is required, recovery usually takes 6 to 12 weeks, with full return to normal function over several months depending on severity and rehab.

How does carpal tunnel syndrome happen?

Repetitive hand or wrist movements
Prolonged wrist flexion or compression
Wrist fractures or arthritis altering the tunnel shape
Poor posture or shoulder/neck tightness contributing to nerve irritation
Medical conditions like diabetes, thyroid issues, or autoimmune disorders

What treatment can help carpal tunnel syndrome?

Night splinting to keep the wrist in a neutral position during sleep
Activity modification (avoiding repetitive or prolonged wrist use)
Ice and anti-inflammatories to reduce swelling
Manual therapy (e.g. nerve glides, wrist mobilisation, soft tissue release)
Nerve gliding exercises to help the nerve move freely
Postural correction for the neck and shoulders

What exercises or stretches can I do for carpal tunnel syndrome?

Median nerve glides
Wrist mobility exercises
Grip and finger strength training
Shoulder and neck stretches to reduce nerve tension

What products can help with carpal tunnel syndrome?

Finger PIP/DIP joint flexion

Sit upright in a chair. Place your affected arm on a table, holding the forearm up and your hand and fingers straight. Bend the end and middle joints of your fingers, keeping your knuckles straight. Try to touch your palm with the tips of your fingers before straightening your fingers again. Remember to keep your wrist straight throughout the exercise, using your opposite hand to support it if needed.

AROM wrist flexion/extension

Start in a seated position with your forearm resting on a table and your thumb facing upright to the ceiling. Bend your wrist forwards, and then extend your wrist backwards, keeping your fingers relaxed throughout the whole movement.

Isometric wrist extension

Start in a seated position with your forearm resting on a table and your palm facing down. Place your other hand on the back of your affected hand. Attempt to lift your affected wrist up, whilst resisting the movement with your good hand. Ensure you keep your forearm in contact with the table. Hold this position

Seated wrist extension – with weight

Start in a seated position. Grasp a weight in your hand with the palm facing down and rest that elbow on a table or your knee. Start in a neutral position then lift the wrist up. Control the movement as you lower the hand back down to the neutral position. It is important to keep your forearm in contact with the supportive surface at all times

PROM wrist extensors stretch

Extend your affected arm straight out in front of you with your palm face down, and drop your hand towards the floor. With your other hand, apply a gentle pressure to the back of your wrist and hold. You should feel this stretch down the back of your forearm.