Carpal tunnel syndrome is a common condition of the wrist, mostly affecting women. The thumb, index (1st), middle, and ring fingers are mainly affected by Carpal Tunnel syndrome. For mild to moderate cases of Carpal Tunnel Syndrome, studies have shown that a combination of night splinting and exercises can have good outcomes. In this article, we will discuss the various easy-to-do and proven home-based exercises and splinting techniques to relieve the symptoms.
What is Carpal Tunnel Syndrome?
One of the major nerves of the hand is the median nerve. It passes through a very narrow space in the hand, called a carpal tunnel. Carpal means “related to hand”, and tunnel means “a small opening”. When passing through this small space, if the median nerve gets continuously compressed due to various reasons like injury, arthritis, or wrong posture, etc , it will cause persistent pain, tingling, numbness of the fingers and thumb. This is called the carpal tunnel syndrome.1
Symptoms of Carpal Tunnel Syndrome
Symptoms of CTS include:
- Pain in the wrist and hand, which can sometimes extend to the arm
- Tingling or numbness in the thumb, first, middle and half of the ring finger
- Thumb Muscle weakness
However, many other diseases can show similar symptoms. These include overuse injury, cervical spondylosis, tendonitis, diabetic neuropathy etc. Hence, it is best to get a diagnosis from the physician. The physicians may conduct various physical examinations like Tinel test, Phalen test and various Electroconduction Studies to confirm the diagnosis.2
Non surgical/ Home based Therapies
Before beginning the Home based treatment
Consult your doctor
- Home treatment can be beneficial only after proper diagnosis of the condition and when performed properly under guidance of physician
- Some exercises and splinting may increase your pain and numbness if done incorrectly. Hence, your treating doctor plays an important role in deciding the type of exercises that could give the best outcomes, and for how long you should continue them
- Once the exercise regime is approved by the doctor, you can continue them at home.3
Exercises
Many studies have shown positive effects of exercise combined with splinting. Exercises gently glide the median nerve and tendons through the carpal tunnel. They also decrease the swelling around the nerve fibres, hence decreasing pain
| Exercise | Repetitions per day | Care to be taken | |
| Wrist Extension and Flexion Stretch |  | 5 repetition4 times a day, 5-7 times a week | Do not lock your elbow, but keep the elbow stable and fingers relaxed |
| Medial Nerve Glides |  | 10 to 15 repetitions in a day, 6-7 days a week | Avoid excess pressure on the thumb in position 6.Hold each position for 3 seconds. |
| Tendon Glides |  | 5 – 10 repetitions, 2 to 3 times a day, as tolerated. | A gentle pulling sensation may occur with these exercises, but they should not cause increased pain |
Splinting
Splint is a device that supports an injured tissue. Hand and wrist splints are designed to protect and support painful or swollen joints and surrounding structures by making sure that hand and wrist are in correct position. Some splints are flexible and some are rigid which are advised by the doctor as per the requirement.3
Generally, doctors advise you to wear splints at night, while sleeping.
Straps of the splint should be firm enough to stabilize your hand, but take care to not make them too tight. Your doctor can help you in adjusting the sprint as per your comfort. You can also wear liners under splint for comfort.
Splints keep the hand stable. This decreases pressure on the carpal tunnel, allowing muscles to rest.
Sometimes, wearing splints in the wrong manner or position can cause increased pain, skin irritation, increased swelling, pins and needles, and color changes to your skin. You must immediately consult your physician for change of the splints.
Modify your Day-to-Day Activities
While they may go unnoticed, some routine activities can worsen your symptoms. After identifying the aggravating tasks various simple modifications can provide a great relief from symptoms, like
- Decrease the duration of activity
- Take frequent breaks during repetitive actions
- Find ways that provide as little stress on hands as possible
- Change hand positions frequently when doing prolonged tasks like using keyboard or mouse for computers
- Use day-to-day items like spatulas etc for cooking with thicker handles, as they require lesser force to hold.3
- Use soft gloves to decrease vibrations, e. g while riding a two wheeler.
Maintain a Good Posture
A good posture of shoulder and neck helps relieve symptoms as the median nerve starts in your neck and travels along the length of your arm.
- While sitting, see that your bottom and spine are well supported by a firm chair or backsupport. Keep shoulders relaxed.
- Keep elbows by your side, feet firmly on the floor.
- Ensure that your hands and wrist relaxed and supported
- Shoulder roll exercises help to maintain correct posture. Do these exercises slowly, 10 times per session, 5 sessions per day.
- For people using computers for long, keep the screen at eye level so you do not have to bend.
- When standing, keep feet flat and shoulder-width apart. Ensure equal weight on each leg.
- When standing, keep the knees relaxed and slightly bent.3
What to Avoid in Carpal Tunnel Syndrome?
- Do not pinch or grip firmly for longer. Loosen your grip when reading a book, or holding things for a longer time like phone etc.
- Avoid extreme movement of wrist, forwards and backwards. As there is less space in the carpal tunnel when your wrist is bent, it increases the amount of pressure within the carpal tunnel.
- Avoid repetitive tasks or tasks that increase your symptoms
- Some exercises may cause slight pulling sensation, but if more pain and numbness occurs, do not ignore it.
- Do not hesitate to ask about any confusion about the duration and length of the exercises when in doubt.3
Conclusion
Clinically approved exercises nerve/tendon glides, wrist stretches, and gentle strength moves can significantly relieve mild-to-moderate Carpal Tunnel Syndrome. Done carefully and consistently, they help to increase mobility, decrease pain, and may delay or decrease surgical need. But they should always be paired with proper posture and ideally supervised by a qualified therapist.
References:
- OrthoInfo Available from: https://orthoinfo.aaos.org/globalassets/pdfs/a00789_therapeutic-exercise-program-for-carpal-tunnel_final
- Sevy JO, Sina RE, Varacallo MA. Carpal Tunnel Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2025 Jun 11]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK448179/
- Lewis KJ, Coppieters MW, Ross L, Hughes I, Vicenzino B, Schmid AB. Group education, night splinting and home exercises reduce conversion to surgery for carpal tunnel syndrome: a multicentre randomised trial. Journal of Physiotherapy [Internet]. 2020 Apr 1 [cited 2025 Jun 11];66(2):97–104. https://www.sciencedirect.com/science/article/pii/S1836955320300242
- Page MJ, O’Connor D, Pitt V, Massy‐Westropp N. Exercise and mobilisation interventions for carpal tunnel syndrome. Cochrane Database Syst Rev [Internet]. 2012 Jun 13 [cited 2025 Jun 11];2012(6):CD009899. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536321/
Written By: Dr Priyanka H. Bhanushali
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