Carpal Tunnel Syndrome: Causes, Relief, and Treatment

Imagine this: you're typing away at your desk, finishing up that last email, when suddenly your hand starts to tingle. A numb, burning sensation creeps into your fingers. You shake your hand. Nothing. It persists. You might brush it off at first - but what if it keeps happening?

That, in a nutshell, is often how Carpal Tunnel Syndrome (CTS) makes its first appearance. It's sneaky, it's annoying, and if left unchecked, it can seriously interfere with daily life - from working on your laptop to pouring your morning coffee.

In this article, we’ll take a deep dive into what Carpal Tunnel Syndrome is, why it happens, and most importantly, what you can do about it. From manual therapy to shockwave therapy, from simple changes to your routine to advanced medical interventions, we’ve got you covered with practical, science-backed strategies.

What Exactly Is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome occurs when the median nerve - which runs from your forearm into the palm of your hand - gets compressed at the wrist. This compression happens in a narrow passageway in your wrist called the carpal tunnel. When pressure builds up in this space, the nerve can’t function properly. The result? Tingling, numbness, pain, and even weakness in your hand.

It’s one of the most common nerve-related disorders, affecting around 3–6% of adults in the general population, particularly women and individuals who perform repetitive hand or wrist movements (office workers, musicians, and gamers!).

Common Symptoms of CTS include:

●     Numbness or tingling in the thumb, index, middle, or ring finger

●     Pain that radiates up the arm or worsens at night

●     Hand weakness or dropping objects

●     Relief when shaking the hand ("flick sign")

What Causes Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome usually doesn’t appear out of the blue. It tends to develop over time from a combination of everyday habits, health issues, and physical strain. Here are some of the most common culprits:

●     Repetitive hand movements: Tasks that involve doing the same wrist or finger motions over and over - like typing, texting, knitting, or assembly line work - can irritate the tissues in your wrist. Over time, this builds pressure around the median nerve.

●     Poor ergonomics: If your workstation setup forces your wrists into awkward positions - like bending them too far up or down while typing or using a mouse - that strain can slowly lead to nerve compression.

●     Wrist injuries: A fracture, sprain, or even lingering stiffness from an old injury can reduce space inside the carpal tunnel, making it easier for swelling or inflammation to trap the nerve.

●     Health conditions: Medical issues like diabetes, hypothyroidism, or rheumatoid arthritis can increase your risk. These conditions either cause nerve damage directly or lead to inflammation that tightens the space around the nerve.

●     Pregnancy: Hormonal changes and fluid retention during pregnancy can cause swelling in the wrist, which puts extra pressure on the median nerve - especially during the third trimester.

Think of your carpal tunnel like a highway. If there’s a traffic jam due to swelling or anatomical narrowness, the median nerve gets stuck in the bottleneck - leading to those all-too-familiar CTS symptoms.

Early Management Strategies: The First Line of Defense

1. Ergonomic Adjustments

If you're spending hours on a computer, a few tweaks can go a long way.

●     Keep wrists in a neutral position: Use a wrist rest or split keyboard.

●     Adjust chair and desk height: Your forearms should be parallel to the ground.

●     Take breaks: The "20-20-20" rule applies to your hands too—every 20 minutes, take 20 seconds to move or stretch.

2. Night Splints

It’s common to bend your wrists without realizing it while you sleep—especially if you curl up or rest your hand under your pillow. Unfortunately, this bent position can squeeze the median nerve even more. Night splints gently hold your wrist in a straight, neutral position throughout the night. This helps reduce pressure inside the carpal tunnel and can significantly ease tingling or numbness that tends to get worse while you're sleeping. For many people, using a splint consistently at night brings noticeable relief within a few weeks.

3. Activity Modification

Modify or rotate tasks to avoid repetitive strain. For example, switch hands when using tools or alternate between keyboard and voice dictation. You can also use standing desks or ergonomic keyboards to reduce the risk.

Manual Therapy for Carpal Tunnel Syndrome

Manual therapy involves hands-on techniques used by physical therapists or chiropractors to relieve pressure and improve mobility.

Techniques May Include:

●     Soft tissue mobilization: Targets the muscles and fascia around the forearm and wrist.

●     Nerve gliding exercises: Help the median nerve move freely within the carpal tunnel.

●     Joint mobilization: Restores mobility to restricted wrist or elbow joints.

●     Stretching: Focused on forearm flexors and extensors to reduce tension.

A 2017 study published in the Journal of Manipulative and Physiological Therapeutics found that manual therapy combined with nerve-gliding techniques showed significant improvement in symptoms and function after just a few weeks. (1)

●     Think of manual therapy as "clearing the traffic" around your nerve highway. By reducing muscle tension and improving flexibility, you're giving the median nerve more room to breathe.

Medical Interventions: When Symptoms Persist

Sometimes conservative methods aren’t enough. If CTS symptoms linger or worsen, your healthcare provider may suggest one of the following:

1. Corticosteroid Injections

Steroid injections are a common option for calming down inflammation inside the carpal tunnel. By delivering the medication directly to the problem area, they can provide quick, targeted relief - often within just a few days. These injections are especially helpful for moderate symptoms or flare-ups that aren’t responding to rest and splinting.

●     How long does it last? Relief can range from a few weeks to several months.

●     Pros: Quick-acting, minimally invasive, done in the clinic

●     Cons: Temporary solution; repeated use may cause tissue weakening over time

2. Shockwave Therapy

This non-invasive technique uses sound waves to stimulate healing and reduce pain in the wrist. Shockwave therapy is gaining popularity as an alternative for people who want to avoid injections or surgery. It’s believed to increase blood flow, break up scar tissue, and trigger the body’s natural repair process. Studies have shown promising results for reducing CTS pain and improving function, particularly in mild to moderate cases.

●     Typically done once a week for 3–6 sessions

●     Low risk of side effects, with no downtime

●     Best suited for: Early-stage CTS or those looking for drug-free treatment options.

3. Surgical Options

When symptoms become severe, long-lasting, or start affecting hand strength and daily activities, surgery might be the best option. Carpal tunnel release surgery involves cutting the tight ligament pressing on the median nerve, giving it more space to function.

●     Success rate: About 75-90% of patients report major symptom relief

●     Recovery time: Around 4-6 weeks for desk jobs, longer for hands-on work

While surgery is typically a last resort, it’s a highly effective and often permanent fix for those who’ve exhausted other treatment avenues.

Preventing Carpal Tunnel Syndrome

Even if you’ve never experienced CTS, taking steps to protect your wrists is a smart move. Prevention strategies include:

●     Maintaining good posture and wrist alignment

●     Regular breaks during repetitive tasks

●     Strengthening hand and wrist muscles

●     Using tools with ergonomic grips

Remember: the earlier you address symptoms, the better your outcomes. Don’t wait for hand numbness to become your daily wake-up call.

Take Away

Carpal Tunnel Syndrome can sneak into your life and disrupt everything from your job to your sleep - but it doesn't have to stay that way. With early intervention, thoughtful management strategies, and a mix of conservative and advanced treatment options - from manual therapy to injections and even shockwave therapy - there’s a way forward that doesn’t always involve surgery.

If you’re starting to notice symptoms or struggling with persistent hand pain, listen to your body. Seek professional help, and don’t underestimate the power of small changes in your daily routine. Your hands do a lot for you. It’s time to return the favor.

References

1. Wolny T, Saulicz E, Linek P, Shacklock M, Myśliwiec A. Efficacy of Manual Therapy Including Neurodynamic Techniques for the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Trial. J Manipulative Physiol Ther. 2017 May;40(4):263-272. doi: 10.1016/j.jmpt.2017.02.004. Epub 2017 Apr 8. PMID: 28395984.