"Carpal Tunnel Syndrome
and Gliding Exercises"
Patients with carpal tunnel syndrome are usually prescribed stretching
exercises by medical and chiropractic doctors, as well as physical
therapists. In this syndrome, the median nerve is often constricted by a
swollen nerve sheath, or malalignment of the wrist bones that form the
hole that the nerve glides through. If there is inflammation or scar
tissue, this can add to the constriction. For these reasons patients are
often given specific stretching exercises to help the nerve to glide
freely through the tunnel, easing pain.
But which exercises work best and are there some exercises that can
cause more harm than good? If the nerve is severely pinched in the
tunnel, a stretching exercise can cause the nerve itself to be elongated
and damaged, which of course, is not good. The idea is to get the nerve
to glide more freely without stretching the actual nerve.
Researchers from Australia (J Orthop Res July 2007) recently looked
into this because many patients find their gliding exercises actually
provoke symptoms and do not help. They studied wrist motions with and
without movement at neighboring joints, such as the elbow. They found
that when the wrist was extended (think of a waiter holding a tray of
food), and the elbow was also bent (flexed), then this caused less
strain to the actual nerve.
If you are performing exercises that do not seem to help, this could be
one aspect of your condition that is being overlooked. There are of
course a multitude of other factors that may be occurring as well.
Sometimes the nerve is not just constricted at the wrist but is also
pinched at the neck where it exits through tiny holes between the
vertebrae. When the nerve is compressed at both the neck and wrist, it
is referred to as double-crush syndrome.
Your doctor of chiropractic can assist you with obtaining an accurate
diagnosis of your problem-including a detailed neck examination. Good
care begins with an accurate diagnosis. Simply covering up your pain
with strong medications may not be the most sensible approach over the
long term because of common unintended side effects.
We can also assist in providing specific in-home exercises that do not
excessively stretch the median nerve and but do add to wrist
flexibility.