carpal tunnel syndrome

Carpal Tunnel Syndrome

Early diagnosis and treatment is important in order to avoid any kind of permanent damage to the wrist nerve. As they say, prevention is better than cure, one should take care of their wrist positions while working. Alteration of activities is important. This includes taking frequent breaks from repetitive activities, and stretching before and after activities. A therapist may be helpful in reviewing ergonomic tips or performing a work place evaluation. For people with mild CTS, stopping or doing less of a repetitive movement may be all that is needed. Physiotherapy is often recommended as part of your treatment plan to reduce the pain, swelling and help in stretching the muscles and retinaculum around and strengthening them. A good physiotherapy program would include Navi Mumbai and Thane.

Physiotherapy is often recommended as part of your treatment plan to reduce the pain, swelling and help in stretching the muscles and retinaculum around and strengthening them. A good physiotherapy program would include

  • Carpal bone mobilization and flexor retinaculum stretching to open the carpal tunnel
  • Nerve and tendon gliding exercises to ensure full unrestricted nerve motion is available.
  • Muscle and soft tissue extensibility.
  • Comprehensive upper limb, wrist and hand ROM strengthening and endurance exercises.
  • Grip and pinch, thumb and forearm muscle strengthening in later phases.

A wrist splint can be worn to support and brace your wrist in a neutral position so that the nerves and tendons can recover. Splinting can work the best when done within three months of having any symptoms of CTS.

Generally, surgery is only an option for severe cases of CTS and if the other treatments have failed for a period of at least six months.


Ergonomics for carpal tunnel syndrome

Physiotherapy at Reliva involves three main components -: passive treatments, active treatments and education and self management. Passive treatments like heat/cold packs and electrotherapy (Ultrasound, TENS) are used to decrease acute pain and swelling. If you’re experiencing acute pain, you’ll most likely start with passive treatments as your body heals and/or adjusts to the pain. However, our goal is to take you towards active treatments which are therapeutic exercises including nerve gliding and stretching exercises with the strengthening of the muscles around prescribed in accordance with your overall condition and with changing dosage as you become stronger.

We also spend time in educating you about your condition, home exercises and dos and dont’s, so that you can continue to remain healthy at your home even after the treatment is complete.

exercises for carpal tunnel syndrome

ReLiva physiotherapist will help you to:


  • Quickly relieve pain and swelling
  • Nerve gliding exercises
  • Loosen stiff muscles and ligaments
  • Strengthen your wrist and hand muscles
  • Improve your everyday living

What is carpel tunnel syndrome?

Our wrist is made up of eight small bones. A ligament (also called retinaculum) lies across the front of the wrist. Between this ligament and the carpal bones is a space called the carpal tunnel. This carpel tunnel is a cramped up space, crowded with the muscle tendons attaching the forearm and the fingers and a median nerve.

The median nerve gives sensation to the thumb, index and middle fingers, and half of the ring finger. It also controls the movement of the small muscles at the base of the thumb.

Any tension in this canal due to various reasons can compress the median nerve giving rise to the symptoms. This is known as Carpal tunnel syndrome (CTS).

The main symptoms are pain, burning sensation, numbness and tingling in the thumb, index finger, middle finger, and the thumb side of the ring finger. Pain may extend up the arm. Weak grip strength may occur and after a long period of time the muscles at the base of the thumb may waste away.

Typically, burning, acing, tingling sensations in the hand are present in the night. It is relieved by shaking or massaging the wrist.


carpel tunnel             carpel tunnel syndrome


What causes carpel tunnel syndrome ?

As stated above, the symptoms occurring in carpel tunnel is due to the nerve compression leading to inflammation. This in turn produces pain, swelling and at times obstructed blood flow. Causes of carpal tunnel syndrome are:

Congenital: the carpal tunnel is simply smaller in some people than in others

  • Obesity
  • Rheumatoid
  • Repetitive movements: repeated use of vibrating hand tools; poor positioning of the wrists while using keyboards, mouse; repeated movements at the wrist such as playing piano, typing
  • Development of a cyst or tumor in the canal.
  • Diabetes
  • Thyroid dysfunction
  • Fluid retention from pregnancy or menopause
  • High blood pressure
  • Fractures or trauma to the wrist

    Something you may not know:

    Women are three times more likely to have CTS than men. It may be that the wrist bones are naturally smaller in most women, creating a tighter space through which the nerve passes. Women also deal with strong hormonal changes during pregnancy and menopause that makes them more likely to suffer from CTS.

fracture healing physiotherapy

Fracture: Leaving it half healed?

Most fractured (broken) bones will heal in usually six weeks. But that is only half of the problemFracture: Leaving it Half healed

Unfortunately when you have enough stress placed through your body to fracture a bone, there’s usually a lot of other soft tissues and structures that have been damaged in the process. Add to that the common use of immobilisation in plaster, you’ll have joint stiffness and considerable muscle weakness.

This may even effect joints that don’t seem related to the break. For example, a fractured shoulder may result in a very stiff elbow or wrist just because you were keeping your shoulder in a sling for a few weeks.

Fractures like most injuries, come in many forms from relatively minor fractures to major life threatening injuries.  The following information will allow you to find out where your fracture fits in this continuum so you have a better understanding of what it is, how and why it occurred, what the healing process involves and what you can do to assist this process.


broken bone   What is a Fracture?

A Fracture happens when there is a break in the continuity of a bone.  It is common and on an average a person has two fractures, during a lifetime.

Most of the time, fractures are caused by a sudden injury that loads, stresses or pressurises the bone more than it can take – such as trauma from motorvehicle accidents or falls.

A Fracture may also be the result of some medical conditions which weaken the bones, for e.g. Osteoporosis, some cancers or osteomyelitis.

Your risk of fracture depends, in part, on your age. Broken bones are very common in childhood, though children fractures are generally less complicated than fractures in adults. Most human bones are surprisingly strong and can generally stand up to fairly strong forces. However, if that force is too powerful, or there is something wrong with the bone, it can fracture.

As you age, your bones become brittle and you are more likely to suffer fractures from falls that would not occur when you are young. The older we get the less force our bones can withstand.

Types of Fracture:Types of Fracture in bones

  1. Open/Compound fracture – when the bone breaks through the skin and damages the underlying tissue. Fractures that are open to the outside are more prone to infection.
  2. Closed/simple fracture – when bone breaks but the skin is intact showing no wound on the outside.
  3. Displaced fracture – when the bone cracks and/or moves away from its usual alignment.
  4. Non-displaced fracture – when the bone cracks but stays in alignment.

A broken bone requires Immediate Medical Attention for proper healing and alignment of bone. Following a fracture, the patient will first be managed by a doctor, who will decide on management option, be it conservative or surgical. Conservative management of broken bones can be done with immobilization with casting or splinting.

Most fractured bones usually take 6 weeks to heal but that is only half of the problem.

Treatment Of Fractures (Post CAST Removal) : Do not leave it half healed!

A lot of soft tissues and structures gets damaged due to fracture and after immobilization in plaster for several weeks, you tend to get pain, joint stiffness and considerable muscle weakness. This may even affect other joints as well resulting into hindrance in dailiy activities.

Physiotherapy Rehab is required to regain the muscle strength and function.

When Should You Start Physiotherapy?

Physiotherapy is often recommended by doctors to accelerate the healing process once bone is aligned. Physiotherapy manipulation, electrotherapy, joint mobilization techniques and exercises will aid strengthening the bone and the surrounding tissue. This process will help the patient recovery by accelerating healing, reduce pain and swelling, and improve range of motion.

The type of therapy will, of course, differ based on the type of fracture. But in general, therapy begins when the cast is removed. Strengthening and aggressive range of motion exercises usually must wait until the bone has healed.  The Physiotherapist may also assess the requirement and suggest and train you to use assistive devices during the recovery. Gait training is also done wherever, required.


  • Seek treatment at an early stage
  • Ensure your physiotherapist provides you with home exercises.

More Information?

Please contact one of our clinics directly for advice specific to your fracture. You can make an appointment with ReLiva Physiotherapy & Rehab at any stage. This is especially important if you believe you are not making satisfactory progress in your recovery, or if your mobility is compromised.

This article is purely for general information. Please contact your healthcare expert for specialised medical care. Please go through our Disclaimer and Privacy policy.

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