Treatments for Carpal Tunnel Syndrome







What Causes Carpal Tunnel Syndrome

Carpal Tunnel Syndrome Symptoms

Carpal Tunnel Syndrome Treatments

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Carpal Tunnel Syndrome In Musicians

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There are a number of treatments that are currently being used to treat Repetitive Strain Injuries like Carpal Tunnel Syndrome, but all of the techniques that are currently being used fall short of what the healthcare industry should consider as a "successful" treatment.

The best solutions to be considered should combine frequent breaks, job rotation when possible and a good stretching program followed by the use of FLEXTEND® exercises . Preventative stretching and the implementation of FLEXTEND® exercises to correct the muscle strength and length imbalance that often exist between the flexor and extensor muscles of the hand and forearm.

Studies have shown that productivity decreases, disability claims and lost time from work are reduced dramatically for individuals who implement an effective stretch and exercise program into their daily regimen of activities. The term "effective" is emphasized because most ergonomic programs and products are not specifically designed to address the actual causes of Carpal Tunnel Syndrome or other forms of Repetitive Strain Injuries. Many of these programs and products simply mask symptoms rather than eliminating them.

Here is a list of the current treatments, both conservative and radical in nature, which are being used for the prevention and rehabilitation of Carpal Tunnel Syndrome and Repetitive Strain injuries:


  1. Squeezing and Gripping Devices: These products tout themselves as the cure-all for Carpal Tunnel Syndrome and Repetitive Strain Injuries, but they exercise and strengthen the flexor muscle group that is already overdeveloped from performing repetitive activities that require "closing" of the hand. (i.e. Typing, texting, driving, writing, etc.)

    Using gripping and squeezing devices duplicate the exact same motion that caused the muscle imbalance, and will only continue to increase the strength and rigidity of the flexor muscles; exacerbating the injury even further. This is why so many people that go to therapy come out worse, therefore resorting to surgery.

    Therapy is only effective if the appropriate exercises and stretches are utilized. In most cases, patients report using squeeze balls, gripping devices, riding hand bicycles and performing finger-walking exericses....all which contribute to the existing muscle imbalance.

    Therapists should have their patients / clients perform stretches to the flexor group to lengthen them, which in turn will reduce the compression of the median nerve within the carpal tunnel and following up with extension and finger abduction exercises to shorten and tighten the extensor group which help hold the carpal tunnel open as well as help hold the length of the flexor muscles that was created by stretching them. When you lengthen one muscle group, the opposing (antagonist) muscle group must be shortened to help hold the length created during the stretch.)

  2. Wrist Braces and Splints: Wrist braces and splints are not effective in treating carpal tunnel syndrome and repetitive strain injuries, but can assist if worn during night-time only. These devices are meant to keep the wrist from dropping into flexion so that the wrist stays in the straight, neutral position in order to reduce impingement of the carpal tunnel. But instead, wrist braces often increase the symptoms of carpal tunnel syndrome and repetitive strain injuries, especially if worn during the daytime.

    • Daytime use:
      Wrist braces are NOT GOOD to wear while performing daily activities because they hold your own wrist up for you instead of the extensor muscles having to do it. Since the wrist brace is doing all the work in order to hold the wrist in the straight, neutral position, then the extensor muscles atrophy and become even weaker than they already were, and the muscle imbalance between the flexors and extensor becomes even greater. Another major problem is that even though the wrist is still held straight, you can still use your fingers to perform repetitive or static flexion, such as typing, writing, etc., which again, will contribute to the muscle imbalance even more.
    • Night-time use:
      Wrist braces and splints are MORE APPROPRIATE for night use in order to keep the wrist in the straight, neutral position. This is a key factor, because most people make a "fist" or "curl" their wrist into flexion while they sleep. Sleeping with the hands in this position causes the flexor muscle group to become even tighter and shorter; causing further impingement and damage to the carpal tunnel.
  3. Massage:
    It is good to have the flexor muscles massaged and stretched-out, but unless followed immediately with strengthening exercises for the extensor muscles that extend the fingers, elbow and wrist, and the abductor muscles of the fingers, it will have little effect on correcting the muscle imbalance that causes carpal tunnel syndrome and repetitive strain injuries. Massaging and stretching the stronger, shorter and tighter flexor muscles will only result in temporary relief because the longer and weaker extensor muscles have not been shortened and strengthened through extension exercises which will ultimately hold the stretching and lengthening of the flexor muscles in place.

    If your flexor muscles that close your hand are 6-inches long on one side and they are normally 8-inches,( but they've shortened in their relaxation state from overuse), and your extensor muscles on the back-side of the hand and forearm are10-inces long and they are normally 8-inches, but they have lengthened because of no direct stimulus through exercise and movement), than a muscle imbalance has been created. Now if you stretch the flexor muscles which were 6-inches to the point where they are now the normal 8-inches long that they should be, and the extensor muscle have not been strengthened so they remain 10-inches long, the flexor muscles will just tighten right back to their original position because there is nothing to hold them in their stretched position. Now, if the 6-inch flexor muscles were stretched to where they were 8-inches long, and the extensor muscles were strengthened and shortened to where they are 8-inches instead of the 10-inches they had been, than you now have equal pull on both sides of the joint. Both muscle groups are now 8-inches long, and the extensor muscles can now provide enough counteractive support to keep the stronger, tighter flexor muscles from narrowing the carpal tunnel and impinging the structures within.

  4. Physical Therapy: This can be a good choice of therapy if you choose someone that knows what they are doing. Too often therapists are caught assigning suffers of carpal tunnel to performing hand-bike exercises along with finger walking, and gripping exercises, thinking that if they strengthen the "apparently" weak flexor muscles the condition will go away. This is the same for massage therapists, chiropractors and occupational therapists. The weak grip is either due to pain inhibiting the grip or median nerve dysfunction. The exercises listed will only contribute and worsen the condition as the therapist is duplicating the exact same motions that caused the disorder to occur. Too many health professionals these days although supposedly schooled in biomechanics and muscle function have a poor grasp on basic body mechanics and function.

  5. Occupational Therapy: OT's are most known for assisting those with occupational disorders and illnesses, those who have been severely damaged physically and or mentally. Their basic function is to assist individuals in daily living procedures. For this reason, it is a huge mystery for many how or why OT's became known as hand therapists that treated musculoskeletal disorders. That is what physical therapists do and should fall under their scope of practice since PT's have a much greater working knowledge of muscles and bio mechanics.

  6. Chiropractic: This mode of therapy can be beneficial if kept in perspective. Chiropractors move bones back into their correct alignment, which is necessary for proper pain-free function. But, MUSCLES MOVE BONES, not the other way around. If the musculoskeletal imbalance is addressed, the bones maintain their alignment as there is equal contractile and tensile pressure surrounding the joint, therefore maintaining that joints alignment. It is fine to have an adjustment or series of corrections and then maintain the proper alignment through stretches and exercises.

  7. Ultrasound:
    Ultrasound is ok if used in conjunction with a treatment program that includes soft-tissue work, stretching of the flexor muscle group, and the strengthening of the extensor muscle group. Ultrasound can help reduce inflammation in an acute case of tendonitis, carpal tunnel syndrome, or other form of injury, but does no good when used alone.
  8. Extension Exercise Devices:
    EXTENSION EXERCISES ARE THE KEYSTONE TO RECOVERY. There are a number of extension exercise devices on the market that ALMOST provide the correct motion in order to treat the dysfunction of Carpal Tunnel Syndrome and Repetitive Strain Injuries. But they all fail in providing the correct bio-mechanical hand, wrist and elbow movements, and varied resistance levels, that will result in the successful treatment of these injuries.

    This is because the extension exercise devices on the market:

    1. Do not allow a complete range of motion of the fingers, wrist and elbow joints from flexion into full extension, and full abduction (splaying) of the fingers, which is absolutely critical in effectively rehabilitating carpal tunnel syndrome and repetitive strain injuries.

    2. Provide finger extension of only 1-5 of the digits, and with most of the emphasis on the Metaphalangeal joint (most proximal finger joint). This means that there is only one joint being exercised, while the others stay stiff and are only affected by isometric, (non-moving) exercises.

    3. Provide only wrist extension without finger extension and finger abduction!

    4. Do not include finger, wrist and elbow extension, along with full abduction (splaying) of the fingers, all in one exercise motion, without any type of gripping or squeezing action required.




  1. Wrist Splints and Anti-Inflammatory Medication:
    This approach to treating carpal tunnel syndrome and repetitive strain injuries has a very poor success rate. The FAILURE RATE for total alleviation of all symptoms is about 82.6%.

  2. Iontophoresis and Splinting:
    This procedure is also very ineffective and reveals that only 11 subjects out of 19 experienced relief.

  3. Steroid Injection:
    The FAILURE RATE for total alleviation after a one-year follow-up is about 75.6% of all patients.

  4. Surgery:
    The average failure rate, which is very conservative, is 57% after following the patient from 1-day to 6-years. At least one of the following symptoms re-occurred during this time; pain, numbness, and tingling sensations. After 6-years, the onset of at least one of these symptoms can reach higher than 90%. Most of these individuals will have surgery more than once, and patients have been known to have as many as 5-8 surgeries on just one hand!