Carpal tunnel syndrome (CTS) is one of the most common nerve compression medical conditions of the upper extremity: it affects the hand and its surrounding structures leading to the inability to move both hand and wrist painless and perform normal daily tasks.

A new paper summarizing clinical practice guidelines has been recently published (May 2019) in the Journal of Orthopaedic & Sports Physical Therapy (www.jospt.org): it stated that in absence of proper care and treatment, irreversible changes in nerve function and structure can occur due to axonal damage and demyelination.

Etiology of CST

The carpal tunnel is an anatomical structure comprised of the very small wrist bones (carpal bones) and the carpal transverse ligament: the median nerve and the flexor tendons runs through this tunnel which is a very narrow channel aimed to protect both nerve and tendons. 

The median nerve originates from the brachial plexus (a group of nerves in the neck) and it represents one of the main nerves in the hand: its function is to control the muscles around the thumb as well as provide feeling in the fingers.

Repetitive and cumulative tasks, poor hand and wrist positions as well as other general health conditions are all factors that can contribute to the development of carpal tunnel syndrome: swelling of the flexor tendons and narrowing of the tunnel cause compression of the median nerve, leading to pain, numbness and weakness in the hand and wrist.

PainPod Protocols and Exercises to relieve CTS

Adopting an active lifestyle and participating in regular exercise, including specific hand/wrist exercises (plus see below) can be an effective way to treat the syndrome, alleviate pain, improve overall function and avoid surgery. In addition electrotherapy, specifically Transcutaneous Electrical Neuromuscular Stimulation (TENS), as provided by PainPod, can enhance these benefits. Recent research has supported the use of TENS for relief of CTS. 

We suggest the following protocol of PainPod stimulation together with some recommended exercises: 

PainPod application

PADS: Pad placement on the affected side, you can use only one channel and place the two pads as shown in the picture below 

MODE: 1 TIME: 20 minutes

Stretching exercise

Wrist flexion

15” of static stretch x 5 repetitions

Wrist extension

15” of static stretch x 3 repetitions

Nerve gliding exercises

Median nerve glides

10 Repetitions/day

Dynamic Mobility exercise

Wrist rolls 

2 sets x 20”

Reverse rolls

2 sets x 20”

Strength exercise

Finger curls

3 sets x 10 reps

Follow this routine daily during periods of severe pain and discomfort while reducing to 3-4 sessions per week to keep improving condition until the proper restoration of function.

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