What are NHS-recommended exercises for carpal tunnel syndrome?

NHS recommends gentle hand, wrist, and nerve-gliding exercises to help reduce the symptoms of carpal tunnel syndrome. These may include wrist flexor and extensor stretches, tendon-gliding movements, and median nerve gliding exercises. Always perform these exercises as instructed and avoid overexertion.

How often should I perform carpal tunnel exercises?

Most NHS guidelines suggest doing carpal tunnel exercises 1–3 times a day, depending on your symptoms and tolerance. It’s important to do the exercises gently and regularly, but you should stop if you experience increased pain or numbness.

Can exercises alone cure carpal tunnel syndrome?

Exercises can help manage and reduce symptoms, especially in mild to moderate cases. While they may not "cure" carpal tunnel syndrome on their own, they are an important part of the non-surgical management plan that may include wrist splints and lifestyle adjustments. If symptoms persist or worsen, consult your GP for further treatment options.

When should I stop doing the exercises and seek medical advice?

Stop doing the exercises if you notice increased pain, swelling, weakness, or numbness during or after exercising. You should contact a medical professional if your symptoms worsen, do not improve after a few weeks, or if you have difficulty performing daily activities.

Are there other non-surgical treatments I can use alongside exercises?

Yes, NHS advice often includes using a wrist splint, especially at night, modifying daily activities to reduce pressure on the wrist, managing underlying conditions (like diabetes), and taking pain relief like paracetamol or ibuprofen if needed. Combining these approaches with exercises can improve outcomes.

NHS Carpal Tunnel Syndrome Exercises: The Non-Surgical Plan

person Olivia Williams

NHS Carpal Tunnel Syndrome Exercises: The Non-Surgical Plan

Introduction

Carpal Tunnel Syndrome (CTS) is a common condition that affects the hand and wrist, causing symptoms like pain, tingling, and numbness. It is especially prevalent among adults in the UK, impacting everyday tasks and reducing quality of life. The NHS champions non-surgical plans, including specially designed exercises, as a first-line approach to managing CTS. Integrating these exercises is crucial for symptom relief, improved hand strength, and preventing the need for invasive interventions.

Understanding Carpal Tunnel Syndrome

Anatomy of the Carpal Tunnel

The carpal tunnel is a narrow passageway in the wrist, housing the median nerve and tendons that control finger movement. Compression of the median nerve within this tunnel leads to CTS symptoms.

Causes and Risk Factors

CTS develops from repetitive wrist movements, prolonged computer use, pregnancy, arthritis, diabetes, or wrist injuries. Individuals with jobs involving repetitive hand tasks, such as typing, are at higher risk.

Common Symptoms

Numbness or tingling in the thumb, index, and middle fingers
Hand weakness or difficulty gripping objects
Pain radiating towards the forearm
Symptoms often worse at night

When to Seek Medical Advice

Consult your GP if you have persistent symptoms, experience hand weakness, or if home treatments do not ease your condition. Early evaluation can help prevent long-term nerve damage.

The NHS Approach to Non-Surgical Management

The NHS emphasises thorough assessment and a stepwise approach to CTS management. Diagnosis involves physical examination and, sometimes, nerve tests. For mild to moderate cases, non-surgical interventions—including wrist splinting and specific hand exercises—are prioritised. These are often combined with lifestyle modifications and ergonomic advice to optimise results. Setting realistic expectations is vital: improvement occurs gradually, and consistent effort is key.

Benefits of Exercise for Carpal Tunnel Syndrome

Reducing Inflammation and Pressure: Exercise helps decrease swelling around the median nerve.
Improving Nerve Function: Regular movements facilitate nerve gliding and healing.
Enhancing Mobility and Flexibility: Gentle stretches preserve wrist and finger mobility.
Preventing Further Injury: Exercise strengthens supportive muscles and reduces recurrence risk.

Types of Exercises Recommended by the NHS

Nerve-Gliding Exercises

Purpose and Technique

Nerve-gliding exercises aim to help the median nerve move smoothly within the carpal tunnel, reducing tightness and relieving symptoms.

Step-by-Step Instructions

Hold your arm out in front, palm up.
Bend your wrist back, fingers extended, as if signalling "stop".
Slowly bend your wrist forward while keeping your fingers straight.
Repeat 5-10 times, up to three times daily.

Tendon-Gliding Exercises

Purpose and Technique

These exercises encourage smooth gliding of finger tendons through the carpal tunnel, preventing stiffness and scar tissue.

Step-by-Step Instructions

Start with your fingers straight.
Make a hook fist (bending the knuckles but keeping the middle joints straight).
Change to a full fist, curling fingers tightly into your palm.
Move to a straight fist (fingers bent at the base, straight at the end joints).
Return to the starting position and repeat each stage 5-10 times.

Wrist and Hand Stretches

Flexor Stretches

Extend one arm in front, palm up.
With the opposite hand, gently pull fingers back towards you to feel a stretch across your palm and inner forearm.
Hold for 10–20 seconds, repeat 3-5 times.

Extensor Stretches

Hold your arm out, palm down.
With your other hand, gently bend your wrist downwards and hold for 10–20 seconds.
Repeat 3-5 times for each wrist.

Strengthening Exercises

Safe Practice Guidelines

Only start strengthening once pain and inflammation are under control.
Move slowly and stop if pain worsens.

Simple Examples

Grip Squeeze: Gently squeeze a soft stress ball for five seconds, relax, and repeat 10 times.
Rubber Band Extensions: Place a rubber band around the fingers and slowly stretch them outward, repeating 10 times.

Creating a Home Exercise Routine

Frequency: Perform exercises 2–3 times daily, as recommended by your healthcare provider.
Adjust for Comfort: Modify movements if they cause sharp pain or excessive discomfort and prioritise slow, controlled actions.
Tracking Progress: Note reductions in symptoms, grip strength, and finger flexibility to assess improvement.
Reviewing Your Plan: If symptoms worsen or plateau after several weeks, consult your GP or physiotherapist to review your routine.

Additional NHS Self-Help Strategies

Wrist Splinting: Wear night-time wrist splints as recommended to keep the wrist in a neutral position and relieve symptoms.
Ergonomic Adjustments: Reorganise your workspace, avoid repetitive wrist bending, and use supportive equipment.
Pain Relief Options: Over-the-counter anti-inflammatory medication may help, as directed by your doctor.
Lifestyle Modifications: Manage health conditions like diabetes and maintain a healthy weight to reduce pressure on the median nerve.

When Non-Surgical Measures May Not Be Enough

Signs of Worsening: Persistent numbness, increasing pain, or significant hand weakness.
When to Escalate: If regular exercises and self-care don’t help after several weeks, seek specialist advice.
Other Interventions: Your GP may refer you for steroid injections, nerve conduction tests, or consider surgical options if necessary.

Resources and Support

NHS Information: Access detailed guides and leaflets on the NHS website.
Specialist Referrals: If required, your GP can refer you to a physiotherapist or hand specialist.
Community Support: Explore online forums and local groups for advice, emotional support, and shared recovery journeys.

Conclusion

Managing Carpal Tunnel Syndrome with NHS-recommended exercises and lifestyle adjustments can greatly improve your symptoms and overall hand function. Early intervention, consistency, and engagement with self-care strategies are key to avoiding surgery and maintaining your independence. Begin your non-surgical plan today to reclaim comfort and movement in your hands.

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