Carpal Tunnel Syndrome: Symptoms, Nerve Gliding Exercises and Treatment
Updated: Oct 20
Carpal tunnel syndrome (CTS) is the most common nerve compression problem in the arm. It causes tingling, numbness and weakness in the hand, often waking people at night. The good news is that most mild to moderate cases improve with conservative care, including splinting, activity changes and nerve gliding exercises (sometimes called nerve flossing). Here's what causes carpal tunnel, how to tell if you have it, and the exercises and treatments that help.
What Is Carpal Tunnel Syndrome?
The carpal tunnel is a narrow passage on the palm side of the wrist, formed by the wrist bones and a strong ligament. The median nerve and nine finger tendons pass through it. When pressure in the tunnel rises, the median nerve becomes irritated, causing symptoms in the hand.
Symptoms
Numbness or tingling in the thumb, index, middle and half of the ring finger
Symptoms that wake you at night or are worse first thing in the morning
Shaking or flicking the hand to "wake it up"
Weak grip, clumsiness or dropping things
Aching that can spread into the forearm
In advanced cases, wasting of the muscle at the base of the thumb
Causes and Risk Factors
Repetitive or forceful hand use, especially with the wrist bent, and vibrating tools.
Prolonged wrist flexion, such as sleeping with the wrists curled.
Pregnancy and fluid retention.
Diabetes, thyroid conditions and rheumatoid arthritis.
Wrist fractures or arthritis that change the shape of the tunnel.
Is It Really Carpal Tunnel?
Not all hand tingling is carpal tunnel. A pinched nerve in the neck, or compression of nerves at the elbow or forearm, can cause similar symptoms. A thorough exam of the neck, shoulder, elbow and wrist helps find the true source. If symptoms are severe or not improving, nerve conduction studies ordered by your doctor can confirm the diagnosis and its severity.
Nerve Gliding (Nerve Flossing) Exercises
Nerve gliding exercises gently move the median nerve through the tissues around it. They can help reduce symptoms, especially when combined with splinting. Movements should be gentle; you may feel mild stretch or tingling, but it should settle quickly. Stop if symptoms increase.
Median Nerve Glide
Start with your arm out to the side, elbow bent and palm facing up.
Slowly straighten your elbow and extend your wrist and fingers back.
Tilt your head toward the same side as your hand, then return to the start.
Repeat 10 times, 1 to 3 times a day.
Tendon Glides
Move your fingers through five positions, holding each for 3 seconds: straight fingers, hook fist, full fist, tabletop (knuckles bent, fingers straight) and straight fist. Repeat 5 to 10 times. These help the tendons slide smoothly through the tunnel.
Other Treatments That Help
Night splints: a wrist splint that keeps the wrist neutral overnight is one of the most effective first steps.
Activity and workstation changes: keep the wrist straight when typing, take regular breaks and reduce grip force. Our guide to spine and posture exercises can help with overall desk setup.
Manual therapy: soft tissue work and mobilization of the wrist, forearm, elbow and neck.
Acupuncture: some studies suggest it can help relieve symptoms. Learn about acupuncture in Saanichton.
Shockwave therapy: emerging research suggests radial shockwave may help mild to moderate cases. Ask us whether shockwave therapy is suitable for you.
Medical options: corticosteroid injections can provide relief, and surgery to release the ligament is effective for severe or persistent cases.
When to See Your Doctor
See your doctor promptly if you have constant numbness, muscle wasting at the base of the thumb, significant weakness, or symptoms that aren't improving after several weeks of conservative care. These may need nerve testing or a surgical opinion.
Frequently Asked Questions
How long does carpal tunnel take to heal?
Mild cases often improve within a few weeks to a few months of splinting and exercise. More severe or long-standing cases can take longer or may need surgery.
Can a chiropractor help carpal tunnel?
Chiropractors can assess whether your symptoms are coming from the wrist, elbow or neck, and provide manual therapy, nerve gliding exercises, splinting advice and workstation changes. We refer for medical care when needed.
Does nerve flossing work?
Nerve gliding is a low-risk exercise that helps some people, particularly alongside splinting. It works best as part of a broader plan rather than on its own.
Book an Assessment
If you're dealing with hand numbness or tingling, book online or call Saanichton Chiropractic Group at 250-223-0200. See also our tennis elbow guide for other causes of forearm pain.
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