What causes Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome occurs when one of the nerves in the arm becomes compressed at the wrist, resulting in pain, numbness, and tingling in the wrist and hand. It’s common in people who spend lots of time using their hands at work, like dental staff, office workers, and hairdressers.
If you think you might have Carpal Tunnel Syndrome, Phalen’s test can help to confirm it. Just place the backs of your hands together in front of your chest, with your fingers pointing downward. Hold this upside-down prayer position for thirty seconds. If you experience pain, numbness, or tingling in the thumb, index, or middle finger, you may be experiencing nerve compression in the carpal tunnel. Retry this test after you’ve done some of the exercises in this post, to see if the compression has eased.
The whole body matters, not just the wrist
Although the pain and loss of sensation associated with Carpal Tunnel Syndrome are caused by the compression of the nerve at the wrist, there are many other factors that contribute to the disorder. Upper-body mobility and strength, posture, and workplace ergonomics can play a large role in the condition and are often overlooked in routine treatment. Many interventions, such as splinting and surgical release of the median nerve, target the wrist exclusively and may fail to address these contributing factors.
This post will highlight some of the biomechanical factors that contribute to Carpal Tunnel Syndrome and explain how to improve them. The same biomechanical factors also contribute to other conditions of the upper limb, such as Tennis Elbow, Golfer’s Elbow, wrist pain, De Quervain’s tenosynovitis, and ulnar nerve entrapment. If you’re experiencing any of these, you may find the following tips helpful.
Tight muscles in the arms and neck can affect the nerve
The median nerve is partially responsible for the movement and sensation in the forearm and hand. Originating from a plexus of nerves in the neck and shoulder, it travels across the front of the shoulder and down into the arm, where it eventually ends in the hand.
On its journey from the neck to the hand, it passes between and through many different muscle groups. If these are tight, it can restrict the nerve’s ability to move freely as we use the arm. If the median nerve can’t move with the wrist, bending the wrist may compress the nerve and cause pain and numbness.
So, how do we make sure the muscles of the neck and arm are loose enough for the median nerve to slide through and avoid compression?
Stretches for Carpal Tunnel Syndrome
To ensure that the median nerve can move freely throughout the upper limb, we want to improve mobility along the entire course of the nerve. It starts at the neck, travels in front of the shoulder and down the arm into the hand. This means that stretching the neck, upper arm, and forearms can all be useful in improving symptoms. The Phyx app contains a comprehensive list of all the stretches you’ll need.
One of the most useful exercises for Carpal Tunnel Syndrome and other upper limb issues involves using a foam roller and a ball to help stretch the muscles of the arm.
Stretching and massage can reduce pain temporarily, but for lasting relief, we should address the reason the muscles are getting tight in the first place.
Strengthen the mid-back to offload the arms and neck
Tension in the arms is often a result of weakness or stiffness in the mid-back. When the muscles of the mid-back are underactive or too stiff to move effectively, the muscles int he arms perform more of the work and can become overloaded. The Phyx app has a range of exercises to strengthen the upper back, one of which is shown below.
This exercise can help to strengthen and mobilize the mid-back, reducing the load on the arms and preventing compression of the median nerve at the wrist. But we also need to address the reason the upper back became stiff and weak in the first place.
Optimizing your posture and workstation
Mid-back dysfunction is often a result of suboptimal posture and workplace ergonomics. If you sit with the shoulders hunched and the head forward for long periods each day, the upper back becomes weak and stiff from prolonged rounding.
It is more difficult to maintain an upright posture if your workstation is not arranged ergonomically. The easiest things to change at your workstation are the:
- Screen height. Make sure the top third of your screen is at eye level, so you are not looking down at it.
- Desk and chair height. Make sure your chair is high enough, and your desk is low enough so that your shoulder is relaxed down away from your ear when your forearms rest on the desk. If it is too high, the prolonged shrug of the shoulder will tighten the neck muscles and contribute to the immobility of the median nerve.
For more information and step-by-step guides on how to improve your posture and workspace, check out the Modifications section of the Phyx app.
Achieving long-term relief involves changing habits
Now that you have started to improve the tension and weakness in your upper body, your posture, and your workstation set up, you can start to change the way you use your upper body in the long term.
Exercising regularly and being mindful of how you use your upper body will help to maintain mobility and strength. Engaging the mid-back in your sitting posture and when performing daily activities can help to keep the load off of the arms. It can also help to prevent neck and shoulder pain.
Engaging in a regular stretching and strengthening routine can help to reduce symptoms and prevent other injuries in the long term. Think of it like brushing your teeth. You wouldn’t start brushing your teeth only after you’ve developed a cavity; you do it regularly to prevent disease. You should exercise regularly for the same reason.
One of the best ways to stay motivated about regular exercise is to track your improvement. When you first open the Phyx app, you will identify your pain, strength, and mobility level, and record your functional level. The app will send you regular reminders to use your exercises and update your progress. When you stick with it, you will see your strength and mobility improve while your pain decreases.
Carpal Tunnel Syndrome and other upper limb disorders are often contributed to by tension in the neck and arms, and by weakness in the upper back. To improve symptoms, we should stretch the neck and arms, and strengthen the upper back. Factors like posture and workstation ergonomics can cause these imbalances and should be addressed for long term results. It’s easier to make stretching, strengthening, and good posture habitual when you can see your progress. Start logging your progress today with a free trial of Phyx Premium.
Don’t have an iOS device? Have a chat with one of our physios and get the exercises and advice sent to you directly.