Carpal tunnel syndrome is a painful condition, with symptoms ranging from numbness, tingling and paresthesia (pins and needles) in the thumb, index and middle fingers. Not all of the listed symptoms have to occur simultaneously and can vary from week to week. Severe cases of carpal tunnel are characterized by wrist inflammation and swelling and muscle wasting in the hand, especially the base of the thumb (Thenar eminence).

Carpal tunnel syndrome in most cases is caused by a muscle imbalance between the flexors, extensors, radial and ulnar deviators and supinator and pronator muscles in the hand and forearm that ultimately leads to median nerve entrapment at the wrist junction. The entrapment occurs as both weak and strong muscles pull at the bones in a tug-of-war fashion, causing the bones to shift towards the stronger muscle side and resulting in the shifting and misalignment of the bones, which in turn compress the median nerve and other surrounding soft tissues and blood vessels.

It is simply that the weaker stabilizing muscles can no longer do their job and lose the battle as the stronger muscles tighten down further and further and compress underlying structures. The condition can be exceedingly painful, and it is often associated with decreased strength and coordination in the hand. Although numerous treatments exist, such as cortisone injections and surgery, the most effective are those that address the underlying muscle imbalance that drives the condition.

During an initial doctor visit, patients may be prescribed non-steroidal anti-inflammatory drugs (NSAIDS) to reduce swelling and ease pain. They may also be advised to refrain from movements that place undue pressure on the affected area or wear a brace, which is fine but at nighttime only as daytime use increases the existing muscle imbalance by reducing stimulation and activity to the already weak and imbalanced extensor muscles. However, these are generally short-term treatments intended to provide relief of acute symptoms.

Effective relief and long-term treatment for carpal tunnel syndrome often comes in the form of hand and forearm exercises and stretches that promote muscle balance around the median nerve. These exercises are designed to promote greater equality in muscle strength and length in the wrist and to bolster trapped nerves and tendons. Many occupational and physical therapists used nerve and tendon "gliding" exercises in the early stages of the illness, but fail to take it the next step, which is to create overall balance between all of the agonist and antagonist muscle groups in the hand and forearm, the key to fast, effective relief.

Research supports the use of exercises that involve strengthening the extensor muscles and stretching the flexor muscles and tendons in the hand and forearm. The goal is to provide overall balance and stability to the muscles, which in turn provides increased joint integrity and the reduction of median nerve compression.

By eliminating the causative factors of median nerve compression through effective stretch and exercise therapy, the injury simply goes away!

Be sure to consult with your physician prior to beginning an exercise or therapy program.