A majority of people with carpal tunnel syndrome can trace their problem to their occupation or hobby. In other words, how you use your hands is a major contributor to getting this disorder. So if you already have symptoms, you can change your behavior (change how you use your hands) which can alleviate or eliminate symptoms.

If you use your hands vigorously all day long, you may have to re-think about your profession or hobby. That’s because what you do with your hands is making your hands sick. Try to avoid constant stress on your hands. See if there are ways to do the same thing, but with less stress. Never over-bend your wrist, or keep it bent for long periods of time. Can you alternate hands and do the same thing? Can you use tools to take up some of the stress? Will gloves help? Avoid tight and prolonged gripping (especially repeated grip-and-release).

Whichever activity modification you make, be sure to incorporate rest and stretches into your routine (see below for more). A short rest break every 15 minutes that incorporates quick stretches is a great carpal tunnel fighter. 

Tips to Change How You Use Your Hands

• Take short but frequent rest breaks from activities that cause pain and numbness. 
• Minimize wrist flexion and repetitive hand movements by changing HOW you work. 
• Identify the harmful activities you do which worsen symptoms. 
• Maintain good sitting posture.
• Use ergonomic tools like a mouse or keyboard.

Medicines like Advil, Motrin, Tylenol, and Aleve are called nonsteroidal anti-inflammatory drugs or NSAIDs. They are wonderful for relieving occasional pain because they reduce swelling (which causes pain). 

However, these medicines are only intended to be used on a temporary basis. In other words, do not use them daily for more than 3-4 weeks. That’s because of their potentially serious side effects such as liver and kidney failure.

Using a topical ointment or cream can give you instant relief from symptoms - particularly pain. But unfortunately, the relief is only temporary.

Ointments like Biofreeze, Icy Hot, and Tiger Balm contain menthol and are especially cooling. The cooling effect lasts for about 15 minutes whereupon you’ll need another application. And you’ll have to repeat applying it all day.

Diclofenac sodium medicated gels like Voltaren also offer pain relief by reducing swelling. Intended as an arthritis medicine, it also works for carpal tunnel syndrome. Daily application requires about a week to see good results. And you need to apply it every day to maintain the pain relief. Some people report side effects like skin reactions and gastrointestinal problems.

Cooling your hand and/or applying heat both work to relieve carpal tunnel pain. But the reason they work is different: ice is a temporary pain reliever; heat is a permanent healer.

Ice Therapy

Ice or cold therapy for damaged or painful tissues helps to numb the area and reduce swelling. Doing so takes pressure off the median nerve. But the problem is that as soon as you remove your hand from the ice (as in an ice bath), the swelling returns. That means you have to do this several times a day to get meaningful results.

Instead of ice baths, ice packs can be used over and over again with less mess. Be sure to avoid direct skin contact with the ice pack. Instead, insulate the ice pack using a damp towel around your wrist. You may need about 20 minutes to fully cool your wrist.

Heat Therapy

Nearly every disorder of the body is made better with heat. Heat is nature’s healer (that’s why inflammation causes warmth). Heat can help with soreness and stiffness that comes with carpal tunnel syndrome. And common heating pads wrapped around your wrist are easy to apply. 

The problem with heat is that using it alone probably will not make symptoms disappear. Think of heat as an “assistive therapy”, where another more aggressive therapy (e.g., stretching, massage and/or night bracing) is also needed.

Contrast Therapy

Many people claim good pain resolution using contrast therapy. This requires two bowls; one for ice water and one for warm water. First immerse your hand in the cold water for 2-3 minutes. Then immerse it into the warm water for about 1 minute. Keep switching from bowl to bowl for about 10-15 minutes.

Stretching the flexor tendons help loosen them so that inflammation and swelling around the median nerve does not occur. Like massage (see below) this remedy is effective because it interrupts adhesions and lubricates flexor tendons. When the adhesions responsible for inflammation and swelling are eliminated, the median nerve is no longer irritated. That’s how carpal tunnel symptoms resolve.

There are 4 “core” carpal tunnel stretching exercises that should become part of your daily life. For best results, start these stretches slowly. Over a period of 2-3 days, work up to performing these 4 stretching exercises every 2-3 hours. And do them especially immediately after you stress you hand (like after an hour of typing). In time, you will be able to do the entire set of 4 exercises in just 1-2 minutes. Also, none of these stretching exercises should hurt. If that happens, try warming your hands with a heating pad just before stretching.

1) Prayer Stretch

Press the palms of your hands together in front of you, fingers pointing upward. It should look like you are praying. Then slowly raise your elbows while keeping your palms at the same level. Stop when you feel stretching in your wrists and forearms. Hold the stretch for 30 seconds. Drop your hands to your sides and shake them out. Repeat this once more.

2) Stop Stretch

Stretch one arm out in front of you, with fingers pointed up, as if saying, “Stop!” Next, use your other hand to pull your fingers backwards, toward your body. Hold this position for 5 seconds. You can feel the tendons stretch from your fingers and into your forearm. Drop your hand to your side and shake it out. Repeat. Then do the same on your other hand.

3) Finger Interlace Stretch

Interlace the fingers of both hands in front of your chest. Next, rotate both wrists so that your palms face away from you. Straighten out your arms until you feel a stretch from your fingers to your forearms. Hold this position for 5 seconds. Drop your hands to your sides and shake them out. Repeat this once more.

4) Thumb Stretch

The thumb is the most commonly afflicted finger in carpal tunnel syndrome. Therefore, pay special attention to it with a dedicated thumb stretch. Grab your thumb and pull it backward as far as you can without causing too much pain. Hold that stretch for five seconds, then release. Next, rotate it like a helicopter blade in one direction several times. Then switch rotation direction. Repeat this on your other hand.

One of the simplest and most effective remedy for carpal tunnel syndrome is bracing (splinting) your hand while you sleep. The reason is simple; all humans bend their hands while unconscious. Some bend their wrists more intensely than others. When this happens, the carpal tunnel space is even more crowded than when the hand is straight. The extra crowding exerts more pressure on the median nerve. That’s why the symptoms in most carpal tunnel patients are worse in the morning.

The easy solution is to wear a night brace. It keeps your hand in a neutral (straight) position. But there are 4 major precautions to keep in mind.

1) Brace Only at Night

Wear a brace only at night, not during the daytime. That’s because your hand is working and moving during the day. So if your hand has to perform its regular task, and also has to fight the restrictive brace. That’s doubling your hand’s work! Instead, allow your hand move freely. Besides, joint movement is the only way the body can drain fluid from that joint. If you have carpal tunnel, you need to keep your wrist free of fluid pressure.

2) Never Wear Pharmacy Braces

Wrist braces sold in pharmacies are not certified to use with carpal tunnel syndrome. In other words, only a “certified carpal tunnel brace” is appropriate. Why? Pharmacy braces contain a “palmar spine”, which is a flat metal stiffener on the palm side of the brace. If you extend your wrist (i.e., bend your hand backward) while wearing a brace containing a palmar spine, the spine will push into your wrist. This will greatly increase the pressure inside you wrist joint, and ultimately compress the median nerve. The nerve will react with symptoms like pain and numbness. This is why people who wear a pharmacy brace while sleeping often wake with worse symptoms.

3) Brace When Hyper-Bending

Finally, some jobs require lifting or pushing heavy loads, where the wrist is bent under high force. If you know this will occur, then you WILL need to brace your hand during the daytime. The reason is because a brace will prevent hyper-extension of your wrist.

4) Choose the "Correct" Carpal Tunnel Brace

There are approximately 6 manufacturers of “certified carpal tunnel braces”. All of the braces are equally good. Of these, you should choose the brace that feels best. After all, you won’t be able to sleep with an uncomfortable night brace. Only the CarpalRx Night Brace has “side splints” which enhance comfort yet provide superior support.

Perhaps the most beneficial therapy for carpal tunnel syndrome is a technique called myofascial massage (also called myofascial release massage). A number of clinical studies have shown this technique is especially beneficial in patients with moderate or severe symptoms. 

Myofascial massage is effective because it breaks up adhesions around tendons. These adhesions are responsible for inflammation and swelling (and therefore, pressure) around the median nerve. When the adhesions are broken, the pressure is eliminated and symptoms resolve.

Myofascial release must be applied at least once daily (twice daily is best). And it must be applied daily for at least 30 days to see good symptoms remission. You can train a helper to do the massage for you. However, the CarpalRx performs myofascial release automatically, at home, and has a 97% effectiveness rate.

For decades and multiple clinical trials, yoga has been studied for use in carpal tunnel syndrome. The results? It almost universally helps reduce symptoms. But only if symptoms are mild or moderate.

The reason for its success is probably because yoga restores balance in the body. Carpal tunnel syndrome is a problem of both flexor tendons and the median nerve. Good balance within tissues minimizes poor tissue interactions, which lessens inflammation. 

The yoga exercises/poses most effective for carpal tunnel syndrome are:

1) Cat and Cow

2) Lotus Pose

3) Upward Facing Dog

4) Bharadvaja's Twist

5) Prayer Position

When doing these exercises/poses, remember to NOT over-extend your wrists. Nor should you put too much weight on your wrists. Also remember that yoga should never hurt, so stop it if you feel pain.

We know that the culprit in carpal tunnel syndrome is inflammation and swelling inside your wrist joint. This puts pressure on your median nerve which, in turn, causes pain and numbness. But inflammation can result from a number of medical conditions. These include:

• Pregnancy
• Diabetes
• Arthritis
• Hypothyroidism
• ATTR-CM
• Obesity

Half of women who get carpal tunnel during pregnancy see symptoms spontaneously resolve after childbirth. But other medical conditions must be managed for carpal tunnel symptoms to resolve. 

Therefore, you may be able to reduce carpal tunnel symptoms simply by managing the underlying condition. For example, losing weight often causes symptoms to disappear. And treating rheumatoid arthritis will often lessen the pain of carpal tunnel syndrome. Talk with your primary care doctor to discuss your other medical conditions.

Dr. Maik Zannakis (Dr. Z) 

Medical Director at the CarpalRx

Dr. Z is an acclaimed medical scientist renowned for his expertise in carpal tunnel syndrome and soft tissue disorders. With over 40 years of experience, he is credited with hundreds of medical journal publications and hundreds more web articles about carpal tunnel syndrome. After inventing the CarpalRx, Dr. Z became the go-to expert for carpal tunnel syndrome and wrist tendonitis. His opinions, inventions, and personalized care have distinguished Dr. Z as a trusted leader in this growing field. Read full Bio

Email: dr.z@carplarx.com

Phone: 800-450-6118