Carpal Tunnel Syndrome: Symptoms, Exercises and Treatment

%14People in the general population who have numbness, tingling or pain in the hand

%3,8People diagnosed with carpal tunnel syndrome on examination

%2,7People whose diagnosis is also confirmed by a nerve conduction test

6 weeksRecommended trial period for a night splint

What is it?

On the palm side of the wrist, there is a narrow channel formed by bones and a thick ligament. The tendons that bend the fingers and the median nerve pass through this channel. When the pressure inside the channel rises, the nerve is squeezed and symptoms start in the fingers that the nerve supplies.

It is usually diagnosed from the symptoms and an examination. Not every patient needs a nerve conduction test (EMG) or imaging; these may be requested when the diagnosis is uncertain or when surgery is being planned.

Symptoms and risk factors

Numbness and tingling in the thumb, index finger, middle finger and half of the ring finger
Symptoms that get worse at night, wake you from sleep and ease when you shake your hand
Numbness that gets worse when you hold a phone, drive or read a book
Weakness in the thumb, difficulty gripping, dropping things
Risk factors: excess weight, pregnancy, jobs that involve repetitive gripping, joint inflammation (arthritis), diabetes, a family history, a previous wrist injury

Does computer use lead to carpal tunnel syndrome?

Contrary to popular belief, according to the American Academy of Orthopaedic Surgeons' 2024 guideline, there is no evidence to support a strong link between heavy keyboard use and carpal tunnel syndrome.

Even so, keeping your wrist bent for long periods can make symptoms worse. Keeping your wrist straight and taking frequent breaks when you use a keyboard and mouse helps ease any symptoms you already have.

Treatment

In mild and moderate cases, treatment starts with non-surgical methods. If there is persistent numbness or muscle wasting, a surgical assessment takes priority.

Night splintA night splint that keeps the wrist straight (in a neutral position) is the first-line treatment recommended by the physiotherapy guideline. The UK's health service (NHS) recommends trying one for up to 6 weeks.
Adjusting your daily loadCutting down on tasks that involve bending the wrist over and over again and gripping hard takes the strain off the nerve.
Manual therapyDepending on the examination findings, manual therapy for the hand, wrist and upper limb may be used; the guideline's recommendation is based on weak evidence.
ExerciseTendon and nerve gliding exercises are widely used, but the evidence for their effectiveness is limited and of low quality. They should be done as a supporting treatment, without making the symptoms worse.
Cortisone injectionIt can reduce symptoms in the short term; however, according to the 2024 guideline, no long-term benefit has been shown.
SurgeryReleasing the ligament on the palm side of the wrist takes the pressure off the nerve. In suitable patients, surgery gives more benefit than non-surgical treatment at 6 and 12 months. Open and closed (endoscopic) techniques have similar long-term results, and the operation can also be done under local anaesthetic alone.
During pregnancyCarpal tunnel syndrome linked to pregnancy often goes away on its own in the months after the birth; during this time, a night splint is a good option.

Exercises at home

Four exercises for carpal tunnel syndrome

These movements should be gentle. If numbness and tingling increase during or after exercise, make the movement smaller or stop that exercise. Do them as a support to the night splint and to adjusting your daily load.

Tendon gliding

Hold your hand upright with your fingers straight. Move through the following positions in turn, holding each one for 3 seconds: curl your fingertips down into a hook; make a full fist; keep your fingers straight and bend them to 90 degrees only at the knuckles where they join the hand (tabletop position); make a fist while keeping your fingertips straight; then open your hand. This helps the finger tendons glide smoothly inside the tunnel.

5–10 rounds, 3–5 times a day

Median nerve glide

Stand up straight and raise your arm out to the side at shoulder height, with your elbow straight and your palm facing up. Slowly bend your wrist back while tilting your head to the opposite side, then bring both back to the start together. The aim is to let the nerve glide without stretching it; if the tingling increases, make the movement smaller.

10 reps, 2–3 times a day

Wrist flexor stretch

Stretch your arm out in front of you with the elbow straight and palm facing up. With your other hand, gently pull your fingers down and back until you feel a mild stretch on the inside of your forearm. Do not push so far that the numbness increases.

15–20 seconds, 3 reps

Thumb stretch

Place your hand on a table with your palm facing up. With your other hand, gently pull your thumb out and back; feel a mild stretch at the base of your thumb.

15–20 seconds, 3 reps

Looking after your wrist in everyday life

The aim is not to stop using your hand, but to cut down on positions that increase the pressure on the nerve.

Try not to sleep with your wrist bent; a splint helps with this.
Do not hold your phone in the same hand with your wrist bent for long periods; take frequent breaks.
When you use a keyboard and mouse, keep your wrist straight and support your forearms.
Break up tasks that need strong, repetitive gripping and, if possible, take turns using each hand.
When symptoms start, shaking your hand and changing position brings relief.

Video

Videos for carpal tunnel syndrome

From the YouTube channel of US physical therapists Bob Schrupp and Brad Heineck.

A stretch and five tips for carpal tunnel syndrome

A wrist stretch and things to watch out for in everyday life.

Two exercises and two self-tests

Exercises and simple tests used for carpal tunnel syndrome.

Videos belong to the Bob & Brad channel.

Frequently asked questions

Does carpal tunnel syndrome go away on its own?

In mild cases, and especially during pregnancy, symptoms may ease on their own within a few months. However, if numbness and loss of strength last a long time or keep getting worse, treatment should not be delayed, so that the nerve is not permanently damaged.

How long should I wear a night splint?

A splint that keeps the wrist straight is worn mainly at night. The UK's health service (NHS) recommends trying it for up to 6 weeks. If your symptoms also get worse during the day, work out with your physiotherapist how best to use it.

Does using a computer cause carpal tunnel syndrome?

According to the American Academy of Orthopaedic Surgeons' 2024 guideline, there is no evidence to support a strong link between heavy keyboard use and carpal tunnel syndrome. Jobs that involve repetitive gripping, excess weight and pregnancy, on the other hand, are among the risk factors.

Do cortisone injections work?

A cortisone injection can reduce symptoms in the short term. However, according to the 2024 guideline, no long-term benefit has been shown, and symptoms may come back over time.

When is surgery needed?

If the muscles at the base of your thumb are getting thinner, or you have constant numbness, loss of strength, or symptoms that do not go away despite a splint and other treatments, you need an assessment by a hand surgeon. In suitable patients, surgery gives more benefit than non-surgical treatment at 6 and 12 months.

Do exercises help?

Tendon and nerve gliding exercises are widely used, but according to a Cochrane review, the evidence that they work is limited and of low quality. They should be done without making the pain and numbness worse, as a support to the splint and to adjusting your load.

When to seek help right away

The following may show that the nerve is seriously affected, or that the numbness has another cause. See a doctor without delay:

Constant numbness, or thinning or wasting of the muscles at the base of the thumb
Marked loss of strength in the hand, often dropping things, difficulty doing up buttons
Numbness spreading to the neck and the whole arm, or numbness in both hands along with numbness in the legs (it may be coming from the neck or spinal cord)
Sudden weakness in the arm or face, or difficulty speaking (it may be a stroke; call 112)
Severe pain, swelling and numbness that start after a wrist injury
Redness and warmth in the wrist, with a fever

Sources

American Academy of Orthopaedic Surgeons. Management of Carpal Tunnel Syndrome: Evidence-Based Clinical Practice Guideline. Rosemont (IL): AAOS; 2024.
American Academy of Orthopaedic Surgeons. Management of Carpal Tunnel Syndrome: Evidence-Based Clinical Practice Guideline. Rosemont (IL): AAOS; 2016.
Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I. Prevalence of carpal tunnel syndrome in a general population. JAMA. 1999;282(2):153-158.
Erickson M, Lawrence M, Jansen CWS, et al. Hand pain and sensory deficits: carpal tunnel syndrome. Clinical practice guidelines linked to the International Classification of Functioning, Disability and Health. J Orthop Sports Phys Ther. 2019;49(5):CPG1-CPG85.
NHS. Carpal tunnel syndrome.
Page MJ, O'Connor D, Pitt V, Massy-Westropp N. Exercise and mobilisation interventions for carpal tunnel syndrome. Cochrane Database Syst Rev. 2012;6:CD009899.
Physiopedia. Carpal Tunnel Syndrome.