Treating Carpal Tunnel Syndrome

Carpal tunnel syndrome occurs when the medial nerve in your wrist gets pinched, causing pain, tingling, or numbness in your hand and fingers.

For most people, carpal tunnel syndrome will worsen gradually over time without treatment. (1) Luckily, there are a number of carpal tunnel treatments to help relieve your symptoms.

Your doctor will probably start off by recommending nonsurgical treatment for carpal tunnel syndrome, especially if your symptoms are mild and there’s no sign that your median nerve has been damaged.

Nonsurgical treatments for carpal tunnel syndrome include these options:

• Carpal Tunnel Brace Wearing a splint or brace around your wrist can help reduce pressure on the median nerve by keeping your wrist in a neutral or straight position. Your doctor may recommend wearing the brace at night to keep your wrist from bending while you sleep. It may also help to wear the brace during daytime activities that aggravate your symptoms, according to the American Academy of Orthopaedic Surgeons. (1) Wrist splinting is often the first line of treatment for carpal tunnel syndrome.
• Over-the-Counter Medicine Over-the-counter pain medicines, including ibuprofen (Advil, Motrin) and naproxen (Aleve), can  temporarily relieve pain and inflammation in some people with carpal tunnel syndrome, but these medicines won’t treat the underlying cause of the pain. (2)
• Steroid Injections Like over-the-counter pain medicines, corticosteroid injections to the wrist and hand may provide some temporary relief from the symptoms of carpal tunnel syndrome. (1)
• Physical or Occupational Therapy Some people with carpal tunnel syndrome choose to see a physical or occupational therapist. A therapist can use special techniques to move around the hand and wrist in a way that helps the nerves and tendons pass more smoothly through the carpal tunnel. However, there’s not much evidence that these manipulations help, says the physician-run website UpToDate. (3)
• Complementary and Alternative Medicine Treatments  Yoga has been shown to reduce pain and improve grip strength among those with carpal tunnel syndrome, according to the National Institute of Neurological Disorders and Stroke (NINDS). Some people report relief with acupuncture or chiropractic treatments, according to a Cochrane review, though more studies are needed to evaluate the effectiveness of these therapies for carpal tunnel syndrome. (2)
• Carpal Tunnel Exercises There are some at-home exercises you can try for carpal tunnel syndrome, but studies are mixed on how much these exercises really help. Carpal tunnel exercises may be most effective when paired with another carpal tunnel treatment, such as a wrist splint or steroid injections. (4)

Trying Simple Carpal Tunnel Exercises

Basic carpal tunnel exercises to potentially try, after discussing with your doctor, include these movements: (5,6)

• Gently shake your hands or wrists until the pain or numbness goes away.
• Make a fist. One at a time, release each finger until all your fingers are pointing at the ceiling and it looks like you are telling someone to stop with your hand. Repeat 5 to 10 times.
• Make a fist, then open your hand by fanning your fingers out one at a time. Repeat 5 to 10 times.
• Place your arm straight in front of you with your fingers facing the floor. Use your other hand to push down slightly on the downward-facing hand, stretching your hand and fingers as far as they will go. Hold that position for about 20 seconds.

If nonsurgical treatments aren’t giving you relief or if your medial nerve has been damaged, your doctor may recommend a type of surgery called carpal tunnel release.

What Is Carpal Tunnel Release Surgery?

Carpal tunnel release is usually an outpatient procedure. It’s one of the most commonly performed surgeries in the United States. (2)

Carpal tunnel surgery involves cutting a ligament around the wrist to relieve pressure on the medial nerve. After surgery, the ligament grows back together, leaving more room in the carpal tunnel for nerves and tendons to pass through. (1)

The surgery can be done under general anesthesia, which makes you fall asleep, or with a local anesthetic, numbing just the hand and arm. (1)

There are two ways to perform carpal tunnel release surgery: (1)

• Open Carpal Tunnel Release Your doctor will make an approximately 2-inch incision to open your wrist and cut the carpal tunnel ligament.
• Endoscopic Carpal Tunnel Release Your surgeon will make two small incisions (each about a half-inch). One incision will go on the palm of your hand and one on the wrist. A tiny camera goes into one incision. The camera provides a picture of the inside of your wrist on a monitor while the doctor inserts a small knife into the other incision to cut the ligament.

The benefits and risks of each surgery are pretty similar, according to the American Academy of Orthopaedic Surgeons. (1) As with any surgery, there are some risks involved.

These complications of carpal tunnel release surgery are the most common: (1)

• Bleeding
• Infection
• Damage or injury to the medial nerve

Recovery From Carpal Tunnel Release Surgery

Some of the symptoms of carpal tunnel syndrome may go away immediately after surgery, but full recovery may take up to a year. You’ll initially lose some of your grip strength and the ability to move your hand and wrist in certain ways, but these will come back gradually as the ligament heals.

Your doctor may refer you to a hand therapist to help with recovery if you’re experiencing a lot of hand pain or weakness that lasts more than a couple of months. (2)

Even with surgery, your hand may never feel completely normal. Many people report a little residual numbness or tingling after carpal tunnel surgery. (2)

Hormonal changes during pregnancy can cause swelling of the tissues around the carpal tunnel, leading to hand and wrist pain.

Carpal tunnel syndrome typically goes away on its own after pregnancy. Nonsurgical therapies — for instance, wearing a carpal tunnel brace at night — may help ease symptoms in the meantime. Pregnancy-related carpal tunnel syndrome does not usually require surgery. (3)