PRAYER: Place your hands in a “prayer” position. Touch the palm-side finger pads together and slowly push the palms into one another while keeping the elbows up as much as possible as you feel a strong stretch in the hands, fingers, and palm-side of the forearms.
SHAKE: Shake your hands for 10-15 seconds as if you just washed them and you’re trying to air dry them off.
WRIST FLEXION STRETCH: Hold your arm out in front of you with the elbow straight, palm facing down. With the opposite hand, bend the wrist as far downward as possible so the fingers point to the ground. This will produce a strong stretch in the muscles located in the back or top of the forearm. Repeat five to ten times holding each stretch for 15–20 seconds (as tolerated).
These exercises can be repeated multiple times a day, as often as once per hour. It is often very helpful to set a timer on your cell phone to remind you to take a stretch break. A “good pain” (stretch) is considered safe while sharp or radiating pain may be potentially harmful. However, if you experience sharp, lancinating, or radiating pain, then stop or modify the exercise.
Frequently, CTS involves more than just the wrist, and exercises that target the neck, shoulder, and elbow can often hasten recovery. This is especially true when there is “double crush syndrome” where the median nerve is entrapped in more than one location such as the neck, shoulder, elbow, or forearm (as well as the wrist).
Chiropractic management of CTS can include manipulation and mobilization of the hand, wrist, forearm, elbow, shoulder, and neck. Muscle release techniques are often employed as well as the use of physical therapy modalities such as laser, electric stimulation, ultrasound, and others. The use of night splints to keep the wrist straight when sleeping is a “standard” used by most healthcare providers. Co-management with primary care may be appropriate if diabetes, inflammatory arthritis, or other complicating conditions are present.
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