Because carpal tunnel syndrome (CTS) is a “cumulative trauma” condition where repetitive motion results in overuse and subsequent injury to multiple areas in the upper extremities, there are many exercise options for patients with CTS. Most exercises address the forearm, wrist, and hand as well as the neck, shoulder, and elbow, depending on the extent of the injury. As each case of CTS is unique and individually different from other cases, it is smart to start with basic exercises and add more exercises over time rather than to begin too many exercises at once.

Since CTS is caused most frequently from overuse of the hands at a repetitive job or in pursuit of a hobby, stretching the inflamed tendons (the string-like attachments of muscles to the bone) in an important objective. There are four basic movements of the wrist and the muscles that move the wrist and fingers are located in the forearm and hand. Hence, stretching will take place in these four different directions as overuse injuries (or tendonitis) is usually not limited only to the carpal tunnel tendons (located on the palm side of the wrist), but usually includes many of the other muscle/tendons on the thumb and/or back side of the wrist. The following are three exercises that stretch the wrist/hand on the thumb side, back side, and palm side.

Exercise 1 (for the thumb side of the wrist): START POSITION: Sit or stand with both arms held out straight (elbows, wrists, & fingers), thumbs pointing upwards and palms facing each other. MOVEMENT 1: Tuck the thumb into the each palm and grab it with the other four fingers making a fist with the thumb inside the fist. MOVEMENT. 2: Bend the wrist downwards towards the ground and feel the stretch on the top/thumb side in the wrist and thumb. Hold for 8-10 seconds and repeat several times a day (example: once an hour).

Exercise 2 (for the back side of the wrist): START POSITION: Same as above. MOVEMENT 1: Bend (flex) the fingers at the big knuckles (base of the fingers) followed by flexing the wrist. MOVEMENT 2: Using your other hand, pull the back of the hand and apply a gradually increasing stretch until a “good hurt” is achieved on the back side of the forearm, wrist, and hand. Hold for 8-10 seconds and repeat several times a day (example: once an hour).

Exercise 3 (for the palm side of the wrist): START POSITION: Same as above. MOVEMENT 1: With the fingers pointing downwards, place the palm of the hand on the wall or hook the fingers on the edge of a desk or table and apply a gradual increasing stretch by bending the hooked fingers backwards until the “good hurt” is felt in the forearm palm-side muscles. MOVEMENT 2: Reach over the top with your other hand and grasp your thumb and pull back adding an additional stretch to the tendons that travel through the carpal tunnel. Hold for 8-10 seconds and repeat several times a day (example: once an hour).

Done together, these three exercise, when performed multiple times a day (especially during work or at times of fast, repetitive arm/hand movements), can act as a “mini-break” from fast, repetitive work. Chiropractic treatment approaches for CTS include training of these and other exercises as well as manipulation/mobilization of the joints including the neck, shoulder, elbow, forearm, wrist, and hand, depending on what is needed for each case. Wrist splinting (especially at night), nutritional advice, and workstation assessments also play important roles in the non-surgical care of CTS.