Treatment for carpal tunnel syndrome usually involves using a wrist splint, applying cold compresses, taking anti-inflammatory medication to reduce pain, doing physical therapy, getting corticosteroid injections, or in some cases, undergoing surgery.
These treatments aim to relieve symptoms like tingling or a pins-and-needles sensation in the thumb, index, middle, or ring fingers.
Treatment should be guided by an orthopedic specialist and tailored to the severity of symptoms. Starting treatment as early as possible helps to prevent worsening of the condition.
Treatment options
The main carpal tunnel syndrome treatments include:
1. Lifestyle changes
Doctors may recommend changing certain habits to avoid movements that worsen symptoms. This includes avoiding activities that strain the hands, especially those that involve repetitive motions.
For people who work on a computer, it’s recommended to place the keyboard at a comfortable height to reduce wrist strain, and to keep the elbows supported on the desk.
2. Cold compresses
Applying a cold compress to the wrist helps reduce pain and swelling, and may also ease tingling or prickling sensations in the hands.
To prepare a cold compress, place ice in a thermal bag or chill a gel pack in the freezer. Wrap it in a clean, dry towel and apply it to the affected wrist for 10 to 15 minutes, one to two times per day.
3. Immobilization
Wearing a rigid wrist splint, also known as a brace or orthotic, may be recommended by a doctor for mild to moderate symptoms.
The splint limits wrist movements that can make symptoms worse. It is typically worn for at least 3 weeks.
Rigid splints are usually recommended for nighttime use, helping to keep the wrist in a neutral position and reduce pressure on the median nerve, which runs through the wrist and into the palm.
While wrist splints can help relieve symptoms, they do not prevent the condition from progressing.
4. Pain-relieving medications
The main medications used to relieve pain from carpal tunnel syndrome are non-steroidal anti-inflammatory drugs (NSAIDs) or over-the-counter pain relievers, such as:
These medications help reduce inflammation of the median nerve, easing pain in the wrist and other symptoms of the condition.
5. Corticosteroid injections
Corticosteroid injections into the carpal tunnel may be administered by a doctor to relieve symptoms. They are commonly used for mild cases to provide long-term relief, or in moderate to severe cases to offer immediate pain relief.
Cortisone is typically used for these injections due to its strong anti-inflammatory effect.
6. Physical therapy
Physical therapy may be recommended by a doctor and should be done under the guidance of a licensed physical therapist. The treatment plan often includes wrist and hand mobilization exercises, stretching, and muscle-strengthening techniques.
Physical therapists may also use pain-relieving and anti-inflammatory devices, such as therapeutic ultrasound, to support treatment.
In addition, home exercises may be recommended to help relieve symptoms.
7. Surgery
In more severe cases where other treatments are not effective, surgery may be necessary. This procedure involves cutting the transverse carpal ligament to reduce pressure on the affected nerve.
After surgery, physical therapy sessions are typically needed to support recovery.
Exercises for carpal tunnel syndrome
While these exercises can be done at home, they should always be guided by a physical therapist to ensure they are suitable for the symptoms.
Exercise 1
Start with the hand open and extended. Then close the fingers into the palm. Next, bend the fingers into a claw shape before returning to the open hand position.
Repeat 10 times, 2 to 3 times a day.
Exercise 2
Bend the wrist forward with fingers extended, then bend the wrist backward while closing the hand into a fist.
Repeat 10 times, 2 to 3 times a day.
Exercise 3
Extend the arm and bend the hand backward, using the other hand to gently pull the fingers back.
Repeat 10 times, 2 to 3 times a day.
Signs of improvement
Signs of improvement from carpal tunnel syndrome usually appear about two weeks after starting treatment. They include fewer episodes of tingling in the hands and less difficulty gripping objects.
Signs of worsening
Signs that the condition is getting worse include trouble holding small objects like pens or keys and difficulty moving the hand.
Symptoms may also interfere with sleep, as they tend to worsen at night.