Carpal tunnel syndrome (CTS) is an entrapment neuropathy caused by compression of the median nerve as it travels through the wrist’s carpal tunnel.

  • Early symptoms of carpal tunnel syndrome include pain, numbness, and paresthesias.
  • Symptoms typically present, with some variability, in the thumb, index finger, middle finger, and radial half (thumb side) of the ring finger.
  • Pain also can radiate up the affected arm. With further progression, hand weakness, decreased fine motor coordination, clumsiness, and thenar atrophy can occur.

(Carpal tunnel syndrome – Symptoms and causes, 2022)



Anatomical and Nerve Pathway

The median nerve is derived from the medial and lateral cords of the brachial plexus. It contains fibers from roots C5-T1. After originating from the brachial plexus in the axilla, continue down the arm, initially lateral to the brachial artery. The nerve enters through the anterior of the forearm which is the cubital fossa. In the forearm, the nerve travels between the flexor digitorum profundus and flexor digitorum superficialis muscles (TeachMeAnatomy, 2022).



Muscle supply





Physiotherapy Treatment:


  1. Soft tissue mobilization


Soft tissue mobilization is a manual physical therapy by uses hands-on techniques on your muscles, ligaments, and fascia in order to break adhesion and optimize your muscle function. If a patient has tightness of muscles this might also cause the entrapment of the nerve which causes numbness to fingers so soft tissue mobilization might help to relieve the symptoms (Seo, L. A., 2022).



2. Stretching


Stretching exercises with specific holding might help to relieve the muscle tightness which causes pain and numbness to the hand. The above 2 picture is the stretching exercise for wrist flexor and biceps which is helpful in this condition, hold for 15 sec and repeat 10 times, 2 sets a day.



3. Nerve gliding exercises


Nerve gliding exercise help to reduce the numbness of the hand. First, hold the wrist and elbow flexed and the head inclined to the opposite side. Then follow by extending the wrist and the elbow completely while moving the head toward the same side.



4. Electrical Stimulation


Electrical stimulation work to manage pain and discomfort because it helps to disrupt pain signals. When electrical stimulation is activated, it sends vibrations and pulses up through the nervous system and mimics those pain signals (Admin, P. B., 2022).




  1. Carpal tunnel syndrome – Symptoms and causes. (2022, February 25). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/symptoms-causes/syc-20355603
  2. (2022, September 4). The Median Nerve – Course – Motor – Sensory. https://teachmeanatomy.info/upper-limb/nerves/median-nerve/
  3. Seo, L. A. (2022, July 25). What to Wear to Physical Therapy. PT Central. https://ptcentral.org/treatment/soft-tissue-mobilization/
  4. Admin, P. B. (2022, January 3). How To Use a TENS Machine for Carpal Tunnel. Royal Treatment Therapeutics. https://www.royaltreatmenttherapeutics.com/tens/how-to-use-a-tens-machine-for-carpal-tunnel/


Prepared by Loo Zhen Heng

Physiotherapist from Your Physio

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