How Physiotherapy Can Help Treat Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is one of the most common nerve-related wrist conditions, affecting countless individuals who spend long hours working at computers, driving, or performing repetitive hand movements. At Proactive Health in Richmond, BC, our physiotherapists specialize in carpal tunnel treatment using evidence-based, hands-on techniques to relieve pain, restore wrist mobility, and prevent recurrence.

What Is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome occurs when the median nerve — the main nerve running through your wrist — becomes compressed within the carpal tunnel, a narrow passageway formed by bones and ligaments. This compression restricts nerve function, leading to pain, numbness, tingling, and weakness in the hand or fingers.

While repetitive computer work is a common trigger, other contributing factors include:

• Frequent wrist or hand movements (typing, gripping, or lifting)

• Poor posture or prolonged wrist flexion

• Swelling due to arthritis, fluid retention, or injury

• Hormonal or metabolic changes (such as pregnancy, diabetes, or thyroid issues)

Common Symptoms & Causes of Carpal Tunnel Syndrome

Carpal Tunnel Syndrome usually develops gradually, with mild discomfort that worsens over time. Early recognition is key to preventing long-term nerve damage.

Typical symptoms include tingling or numbness in the thumb, index, and middle fingers, weakness or difficulty gripping objects, and wrist or forearm pain that may radiate up the arm. Many people also experience nighttime tingling or “pins and needles” sensations that disturb sleep.

Common Causes of Carpal Tunnel:

• Repetitive wrist or hand movements (typing, gripping, lifting)

• Poor posture or prolonged wrist flexion

• Swelling from arthritis, fluid retention, or injury

• Hormonal or metabolic changes, such as pregnancy or diabetes

If left untreated, ongoing compression of the median nerve can lead to chronic pain, weakness, and reduced hand function. Early physiotherapy helps relieve pressure, restore mobility, and prevent permanent impairment.

How to Test If You Have Carpal Tunnel Syndrome

If you suspect you may have Carpal Tunnel Syndrome, there are a few simple at-home tests that can help you identify possible symptoms before seeking professional care. While these tests can indicate nerve irritation, only a licensed physiotherapist or healthcare professional can provide a formal diagnosis through a clinical assessment and nerve testing.

1. Phalen’s Test (Wrist Flexion Test)

Bring the backs of your hands together in front of you, with your wrists fully bent and fingers pointing downward (like an upside-down prayer position). Hold this position for 30–60 seconds.

• Positive result: Tingling, numbness, or pain in the thumb, index, or middle fingers suggests median nerve compression.

2. Tinel’s Sign

Gently tap along the inside of your wrist where the median nerve passes through the carpal tunnel.

• Positive result: A tingling or “electric shock” sensation radiating into the fingers can indicate Carpal Tunnel Syndrome.

3. Hand Weakness or Grip Test

Notice whether you struggle to grip small objects like a pen, key, or cup, or if you tend to drop items unexpectedly.

• Positive result: Weakness in grip strength or fine motor control may point to nerve involvement.

4. Sensory Self-Check

Run your thumb and fingers over textured surfaces. If you feel dullness, reduced sensitivity, or “pins and needles,” this can also be a sign of nerve compression.

If any of these tests reproduce your symptoms, it’s important to schedule a Carpal Tunnel assessment with a physiotherapist. At Proactive Health in Richmond, BC, our team performs detailed strength, mobility, and nerve function evaluations to confirm the diagnosis and design an individualized treatment plan.

How Physiotherapy in Richmond, BC Can Help

Physiotherapy is one of the most effective non-surgical treatments for Carpal Tunnel Syndrome. At Proactive Health, we focus on restoring nerve mobility, improving muscle strength, and addressing the root cause of your symptoms to ensure long-term recovery.

1. Hands-On Therapy and Soft Tissue Release

Manual therapy techniques help release tight muscles and fascia around the wrist and forearm, easing pressure on the median nerve and improving circulation.

2. Median Nerve Glides and Mobility Exercises

Targeted nerve gliding exercises restore proper nerve movement through the carpal tunnel, reducing irritation and promoting healing.

3. Strengthening and Postural Correction

We strengthen the wrist, forearm, and shoulder muscles to enhance support and reduce nerve compression — particularly important for individuals with desk or computer-based jobs.

4. Ergonomic Assessment and Education

Our Richmond physiotherapists assess your workstation setup and daily habits, providing guidance on wrist positioning and activity modifications to prevent flare-ups.

5. Modalities and Pain Relief

Therapies such as ultrasound, wrist taping, or cold therapy can be incorporated to reduce inflammation and promote tissue recovery.

Can You Treat Carpal Tunnel Without Surgery?

Yes, many people can manage Carpal Tunnel Syndrome without surgery through conservative treatment. At Proactive Health in Richmond, BC, we use physiotherapy, exercise, and ergonomic adjustments to relieve pressure on the median nerve and restore wrist function naturally.

Non-surgical treatment often includes:

• Manual therapy and nerve gliding exercises

• Posture correction and strengthening programs

• Wrist bracing or taping for stabilization

• Ergonomic modifications to reduce repetitive strain

In most mild to moderate cases, consistent physiotherapy and proper self-management can significantly reduce symptoms and eliminate the need for surgery.

Treatment Options for Carpal Tunnel Syndrome

Carpal Tunnel Syndrome can range from mild tingling to chronic pain and weakness. The best treatment depends on symptom severity and daily activity demands. At Proactive Health, our physiotherapists use a comprehensive approach combining manual therapy, targeted exercise, and education to relieve pain and restore function.

1. Physiotherapy and Manual Therapy

Physiotherapy is typically the first-line treatment. A physiotherapist identifies whether nerve compression stems from repetitive strain, tight musculature, or joint dysfunction, and tailors a plan that may include:

• Soft tissue release and joint mobilizations

• Median nerve glides

• Strength and posture training

Regular physiotherapy sessions improve circulation, restore movement, and help prevent recurrence — often avoiding the need for surgery altogether.

2. Wrist Bracing or Splinting

Wrist braces help maintain a neutral wrist position, especially during sleep, when the wrist may flex unintentionally. This reduces inflammation and relieves pressure on the median nerve.

3. Ergonomic and Lifestyle Adjustments

Small adjustments in your daily routine can make a big difference:

• Keep wrists straight and elbows at 90° while typing

• Adjust chair and desk height for alignment

• Take micro-breaks every 20–30 minutes to stretch

• Avoid prolonged gripping or resting wrists on hard surfaces

Our Richmond physiotherapists often incorporate workplace assessments into treatment plans to ensure long-term success.

4. Medications and Injections

For moderate cases, anti-inflammatory medications or corticosteroid injections can temporarily reduce swelling. However, these address only symptoms — not the underlying mechanical issues — making physiotherapy essential for lasting improvement.

Surgical Intervention: Carpal Tunnel Release

If symptoms persist after conservative care or if nerve compression causes significant weakness, surgery may be recommended. The most common procedure is Carpal Tunnel Release (CTR) — designed to relieve pressure on the median nerve by cutting the transverse carpal ligament, the structure forming the roof of the carpal tunnel.

There are two main surgical approaches to Carpal Tunnel Release, both highly effective and commonly performed under local anesthesia as outpatient procedures, meaning you can return home the same day.

1. Open Carpal Tunnel Release
This traditional approach involves a small incision (typically 2–5 cm) in the palm of the hand. Through this opening, the surgeon carefully identifies and cuts the transverse carpal ligament to relieve pressure on the median nerve. Open release allows direct visualization of the affected area and is often chosen for patients with more severe or chronic symptoms.

2. Endoscopic Carpal Tunnel Release
This minimally invasive method uses a thin, flexible camera (endoscope) inserted through one or two small incisions. The surgeon views the structures on a screen and releases the ligament from the inside. This approach usually results in:

• Smaller incisions and scars

• Less post-operative tenderness

• Faster initial recovery times

Both procedures have high success rates and are designed to restore nerve function, reduce pain, and prevent further nerve damage.

What to Expect After Surgery

Following surgery, your hand may be wrapped in a light bandage or splint to protect the wrist and limit movement. Mild pain, stiffness, and swelling are common during the first few days. Most patients can begin gentle finger and wrist movement within 24–48 hours to promote circulation and reduce stiffness.

Typical recovery timeline:

• Light activity or desk work: 2–4 weeks

• Manual labour or heavy lifting: 6–12 weeks

• Full recovery: varies depending on severity, healing rate, and physiotherapy participation

The Importance of Physiotherapy After Carpal Tunnel Surgery

Even after successful surgery, physiotherapy is essential for full recovery. Surgery relieves pressure on the nerve, but it does not automatically restore muscle strength, flexibility, or coordination. Without structured rehabilitation, stiffness, scar tissue buildup, or weakness can delay your return to normal activity.

At Proactive Health in Richmond, BC, our post-surgical physiotherapy programs are designed to:

• Regain motion: Gentle exercises prevent stiffness and promote healing.

• Manage scar tissue: Manual therapy minimizes adhesions and sensitivity around the incision.

• Restore strength: Progressive exercises rebuild grip and dexterity.

• Reduce swelling and pain: Targeted modalities aid recovery and comfort.

• Prevent recurrence: Ergonomic and activity retraining ensures long-term wrist health.

Most patients resume normal activity within 6–12 weeks, depending on their recovery progress and the type of surgery performed.

Carpal Tunnel Syndrome Treatment in Richmond, BC

At Proactive Health, our Richmond physiotherapy team provides personalized, one-on-one care to help you recover from Carpal Tunnel Syndrome — whether through conservative management or post-surgical rehabilitation. We focus not only on treating wrist pain, but also on improving posture, mobility, and strength for lasting results.

Book Your Physiotherapy Assessment Today
Don’t let wrist pain or numbness limit your daily life. Contact Proactive Health in Richmond, BC, today to book your Carpal Tunnel Syndrome physiotherapy appointment and start your recovery journey.

📍 Proactive Health – 13351 Commerce Pkwy Unit 1128, Richmond, BC
🌐 Book online at https://proactivehealthonline.janeapp.com/