Carpal Tunnel Syndrome

The carpal tunnel is a narrow passageway on the palm side of your wrist, which is formed by the wrist bones, or carpals, and the Transverse Ligament. This tunnel provides protection to the median nerve and the tendons of your fingers that help bend them.

The carpal tunnel is a very small space to house the nerve and the tendon. The median nerve often gets compressed, causing pain and numbness in the wrist and hand.


  • Tingling or numbness – most often in the thumb, index and middle fingers, and less often on the inner aspect of the ring finger. Often occurs while gripping or holding something like a writing utensil or a coffee mug. Usually worst when first awakening. The need to "shake it out" is often something people try to alleviate these symptoms.
  • Pain can radiate from the wrist up the arm to your shoulder or down to the palm and fingers.
  • Weakness in hands and loss of grip strength, tendency to drop objects.

Risk Factors

  • Repetitive use or injury– Prolonged periods of repetitive flexing and extending of the tendons. Injury to the wrist can cause swelling that adds pressure to the median nerve.
  • Physical Characteristics – the tunnel may be more narrow in some people's wrists
  • Other Health conditions– Rheumatoid arthritis, diabetes, thyroid disorders, menopause and pregnancy
  • Gender – Women are three times more likely to develop symptoms than men
  • Posture– rounded shoulders and flexed wrists can cause increase pressure on the nerves that can affect your wrist and hand.
  • Muscular imbalances can lead to postural deviations and compensations that increase strain on the arms and wrists
  • Occupation – job tasks that combine repetitive, forceful, awkward or stressed motions. Using power tools, heavy assembly line work, and extensive computer use.


  • Take frequent breaks
  • Watch your form – avoid bending your wrist all the way up and down.
  • Improve your posture – strengthening muscles in the back and stretching the arms and chest can allow for improved alignment
  • Reduce your force and relax your grip
  • Ergonomically align your work station or area. Preventing unnecessary reaching will decrease strain on the arms and wrists.

Physical therapy can speed recovery through specific exercise programs to stretch tightened muscles and strengthen weakened postural muscles. Therapists can perform manual treatments and utilize modalities and bracing to reduce muscular and neural tension. Therapists also educate about ergonomics, posture, and prevention.