From manual to surgical therapy, there are several options when it comes to treating carpal tunnel syndrome. A combination of different approaches may be needed in order to get the relief you need, and as usual it is best to discuss the options with your local doctor or healthcare practitioner.
Hot and Cold therapy. To help reduce the symptoms of carpal tunnel syndrome, you can use ice on your wrist. Apply a cold compress or for 10-15 minutes over the wrist. Repeat 3-4 times a day. You can also try using heat to relieve muscle and tendon tension around your wrist.
Rest. You can put at rest your wrist avoiding all the movements which trigger the symptoms.
Some movements relieve and discharge your carpal tunnel from pressure such as gently shaking your wrist.
Pain Relief Medication. Some pain relief may be achieved with over-the-counter medications such as aspirin, ibuprofen, or naproxen. Remember that these medications will help you ease the pain, but won’t address or cure the cause of carpal tunnel syndrome.
Wrist Brace. Your healthcare practitioner may suggest you wearing a wrist brace. Braces are generally useful when you have mild to moderate symptoms. It does not always work, but there are no side effects either. You will have to wear the brace at least for 3-4 weeks to see any improvements. The wrist brace is a support for your joints so make sure to wear it even during the day while you’re doing any activities that may flare up the pain.
How Can a Wrist Brace Help?
Most people put their wrists in flexed or awkward positions during sleep, resulting in a lot of pressure on the median nerve. A brace can help because it keeps your wrist in a neutral and comfortable position. You may also find it helpful to wear a brace during the day, especially during activities that trigger flare-ups.
After you take the wrist brace off, be sure to keep moving your wrist in order to maintain your flexibility at a good level. This will help you keep your muscles flexible and active.
Physiotherapy. A physiotherapy is a qualified medical professional who works to reduce your pain and help you regain strength and mobility. A physical therapist may suggest exercises called “gliding exercises”. These focus on the nerves and tendons mobility inside the joint passages. With the aim to improve the mobility and flexibility of the tendons and nerves inside the carpal tunnel, encouraging smooth movement and a reduction or median nerve irritation.
In the study of Fernandez et al 2015 has been found that surgery and physical manual therapies including desensitization maneuvers of the central nervous system were similarly effective at medium-term and long-term follow-ups for improving pain and function but that physical therapy led to better outcomes in the short term.
Osteopathic Therapy. Osteopathy is a manual treatment approach that uses several manual techniques to improve posture, reduce tension in your muscles and improve motion in your joints. Burnham et al 2015 showed that osteopathic treatment has some positive effects on the management of carpal tunnel syndrome. Results from the study showed transverse carpal ligament length was improved, and after 6 weeks treatment all the symptoms were improved including wrist functionality.
Massage Therapy. In the study of Elliot et al 2013 Massage therapy has shown to be an effective way to treat Carpal Tunnel Syndrome , in fact massage can relieve the symptoms and help you prevent the recurrence of the pain. Massage reduces muscle tension, lengthen muscle fascia which causes lack of flexibility and mobility in your arm and hand .
Massage therapy increases the blood flow to your joints and your muscles helping the inner healing process of our body structures.
If symptoms are ongoing for a prolonged period of time or you start to feel constant weakness in your muscles, tingling and pins and needles, then your GP may refer you for surgical intervention. There are a few different surgical interventions for carpal tunnel syndrome and these will be discussed with you by your surgeon. This will include risk and benefits for each procedure.
Usually the surgical operations which are performed are open and endoscopic. In both of them, your doctor cuts the ligament around the carpal tunnel to reduce the pressure on the median nerve and relieve your symptoms. After the surgery, the ligament will heal by itself, but with more space for the median nerve sliding.
Open surgery: during open carpal tunnel release surgery, the transverse carpal ligament is cut. This relieves pressure on the median nerve and in theory helps to reduce the symptoms of carpal tunnel syndrome.
With this type of surgery you do not need to stay in the hospital for the night and you can go home on the same day. During the operation local anaesthetic will be used so you will be wide awake.
Endoscopic surgery: with the help of a tiny little camera your surgeon will be guided when cutting the ligament. Typically to insert the camera, the surgeon will make small incisions in your wrist and sometimes also your arm. The cuts are really small, about a half-inch each.
After surgery you may be suggested to start doing physiotherapy to restore mobility of your wrist and to reduce your muscle tension around the muscles of your forearm and your hand.