Modification of activities and workplace:
Modification of activities and workplace is done which can be beneficial in controlling milder symptoms of CTS. For example, proper placement of the hand on the keyboard at a proper height and minimizing flexion, extension, abduction, and adduction of the hand when typing.
Ice therapy can be used by applying ice to the wrist for 10- 15 minutes once or twice an hour.
Heat therapy can be applied by immersing the affected hand in warm water moving the hand and wrist in the water.
Ultrasound therapy is used to break the adhesions, increase circulation and improve range of motion by using its fibrinolytic, anti-inflammatory, and anti-irritant action of the ultrasound.
Transcutaneous electrical stimulation (TENS):
Transcutaneous electrical stimulation (TENS) is highly effective to reduce pain and swelling.
Laser therapy is used to decrease pain and paresthesia. Laser therapy is also approved by the FDA for the treatment of carpal tunnel syndrome (CTS).
Iontophoresis is also found to be effective as a treatment of carpal tunnel syndrome.
Splinting and hand brace
The physiotherapist advises the patient to take sufficient rest. Immobilization helps to eliminate active movements in the affected hand. The wrist is fixed in a neutral position so the tension in the carpal canal will be minimal and the carpometacarpal and the interphalangeal joints are fixed in slight flexion to achieve the same.
Manual therapy includes mobilization of soft tissue, carpal bone, and median nerve. It is a hands-on technique that helps to increase the mobility of the nerve. It also helps to improve the range of motion of joints that are affected by the carpal tunnel.
Massage therapy includes compression, cross-fiber function, deep tissue work, stretching, and trigger point. This therapy reduces pain, improves grip strength, and makes muscles more flexible.
Stretching exercises include "Stretch Armstrong." In this exercise, the arms are placed in front (one at a time), spreading the fingers, and then "stretching the wrist and fingers as far as possible and then holding that position for 20 seconds. Basic wrist stretches include bending the hand towards the body so that the fingers point up toward the ceiling.
Strengthening exercises help to strengthen the hands and the grip. Hand exercises like hand squeeze exercises like squeezing a soft rubber ball and then holding the squeeze position for 5 seconds. The physiotherapist recommends 10 repetitions and 3 times a day. For the wrist, wrist curls are done by bending the wrist 30 times daily while the arm is bent like the letter L, and a wrist resistance exercise can also be done by raising one hand while the other hand is kept down.
Movement exercises consist of tendon gliding and nerve gliding. The tendon exercise consists of moving fingers through different positions like curling them inward till they're bent at the middle knuckles and straightened so that the hand is shaped like an L. Nerve exercise such as moving parts of the hand and wrist into different positions. Straightening the fingers out so that they point up, other exercises consist of bending the wrist so that the fingertips are pointed away from the body of the patient.