Carpal Tunnel Syndrome (CTS) is one of the most common causes of hand pain, numbness and tingling. It can make everyday tasks like typing, driving, gripping objects or even fastening buttons frustrating and uncomfortable. Many people also find that symptoms are worse at night, disturbing their sleep and leaving their hand feeling stiff or numb in the morning.
The good news is that many cases of Carpal Tunnel Syndrome respond well to conservative treatment. At Great Northern Physiotherapy, we’ll assess the cause of your symptoms, identify the severity of the nerve compression and create a personalised, evidence-based treatment plan to help reduce pain, improve hand function and support your recovery every step of the way.
Symptoms
Carpal Tunnel Syndrome develops when the median nerve becomes compressed as it passes through the carpal tunnel (narrow space made of bones and a thick band of tissue) in the wrist.
Common symptoms include:
- Tingling or pins and needles in the thumb, index, middle and part of the ring finger
- Numbness in the hand, particularly at night
- Hand pain or pain in the wrist
- Symptoms that wake you from sleep
- Weakness when gripping objects
- Frequently dropping items
- Difficulty with fine motor tasks, such as fastening buttons
- A feeling of swelling in the fingers, even when no swelling is present
- Symptoms that worsen during activities such as driving, typing or holding a phone
In more advanced cases, the muscles at the base of the thumb may become weaker, making gripping and pinching more difficult.
Causes
Carpal Tunnel Syndrome occurs when pressure increases within the carpal tunnel, compressing the median nerve. This pressure can develop gradually and is often the result of several contributing factors rather than a single cause.
Common risk factors include:
- Repetitive hand or wrist movements
- Prolonged keyboard or mouse use
- Manual work involving gripping tools
- Pregnancy
- Diabetes
- Thyroid disorders
- Rheumatoid arthritis
- Previous wrist injuries
- Fluid retention
- Age-related tissue changes
Although work activities can aggravate symptoms, they are rarely the sole cause. Often, several factors combine to increase pressure around the nerve.
Diagnosis
A detailed physiotherapy assessment can usually diagnose Carpal Tunnel Syndrome without the need for immediate investigations.
During your appointment, we’ll discuss:
- Where your symptoms occur
- When they started
- Whether symptoms wake you at night
- Activities that aggravate your hand
- Your occupation and hobbies
- Any relevant medical conditions
We’ll then carry out a thorough assessment, including:
- Wrist and hand movement
- Grip strength
- Thumb muscle strength
- Sensation testing
- Nerve function assessment
- Special clinical tests for Carpal Tunnel Syndrome
- Examination of the neck and upper limb if appropriate
If symptoms are severe or the diagnosis is unclear, nerve conduction studies may be recommended to assess how well the median nerve is functioning.
Diagnostic ultrasound can also be helpful in assessing the median nerve and identifying structural changes within the carpal tunnel.
Treatment Options
Comprehensive Physiotherapy Assessment
Understanding why the median nerve has become irritated is the first step towards effective treatment.
Our physiotherapists assess not only your wrist but also your hand function, work activities and upper limb mechanics to create a treatment plan tailored to your individual needs.
MANUAL THERAPY
Manual therapy can help improve wrist mobility, reduce soft tissue tightness and improve movement around the median nerve.
Treatment may include:
- Wrist joint mobilisation
- Soft tissue massage
- Neural mobilisation (“nerve gliding”)
- Forearm muscle release
- Advice on activity modification
Hands-on treatment is combined with education and rehabilitation exercises to provide the best long-term outcomes.
Rehabilitation Exercises
Exercise helps improve nerve mobility, restore hand strength and maintain wrist function.
Your programme may include:
- Median nerve gliding exercises
- Tendon gliding exercises
- Wrist mobility exercises
- Grip strengthening
- Thumb strengthening
- Forearm stretching
- Functional hand exercises
Exercises are carefully progressed according to your symptoms to avoid unnecessarily irritating the nerve.
Splinting and Activity Advice
For many people, wearing a neutral wrist splint at night can significantly reduce symptoms by preventing prolonged wrist flexion while sleeping.
We’ll also advise on:
- Workplace ergonomics
- Keyboard and mouse positioning
- Activity modification
- Load management
- Practical strategies to reduce pressure on the median nerve during everyday tasks
Injection Therapy and Surgical Referral
If symptoms are severe or don’t improve with conservative treatment, ultrasound-guided corticosteroid injection may be recommended to reduce pressure within the carpal tunnel.
Where significant nerve compression or persistent weakness is present, we may recommend referral to a hand specialist to discuss carpal tunnel release surgery. Most procedures are performed as day-case surgery and have excellent outcomes when appropriately indicated.
Self-management
There are several simple steps that can help manage Carpal Tunnel Syndrome alongside physiotherapy.
We often recommend:
- Wearing a wrist splint at night if advised
- Avoiding prolonged positions that bend the wrist
- Taking regular breaks from repetitive activities
- Completing your prescribed exercises consistently
- Modifying workstation setup where appropriate
- Varying repetitive tasks throughout the day
- Maintaining general upper limb strength and mobility
Early management often helps prevent symptoms from progressing.
Recovery Timelines
Recovery depends on how long symptoms have been present and the severity of the nerve compression.
Typical expectations include:
- Mild symptoms: 4–8 weeks
- Moderate symptoms: 2–3 months
- Following injection or surgery: Recovery varies depending on individual circumstances
Starting treatment early generally leads to faster recovery and reduces the risk of permanent nerve irritation.
When to Seek Help
Arrange an assessment if:
- Tingling or numbness keeps returning
- Symptoms are disturbing your sleep
- Your grip strength is worsening
- Everyday tasks are becoming difficult
- Symptoms have persisted for more than a few weeks
Seek medical advice promptly if you develop:
- Significant weakness in your thumb
- Constant numbness that doesn’t improve
- Noticeable muscle wasting at the base of the thumb
- Sudden loss of hand function following injury
Early assessment is important to help prevent long-term nerve damage.
Clinically Reviewed By
Phil Williams
Director and Consultant Physiotherapist
Restore Comfort and Confidence in Your Hands
Carpal Tunnel Syndrome can make even simple daily tasks frustrating, but effective treatment is available. With an accurate diagnosis and a personalised rehabilitation programme, most people experience significant improvements in pain, strength and hand function.
Our experienced physiotherapists will help you understand your symptoms, reduce pressure on the median nerve and support your recovery every step of the way.
Book your initial assessment today and take the first step towards comfortable, confident hand function.
CARPAL TUNNEL SYNDROME FREQUENTLY ASKED QUESTIONS
Some mild cases improve with activity modification and splinting, but persistent symptoms often benefit from physiotherapy to reduce nerve irritation and improve hand function.
No. Many people recover successfully with conservative treatment, particularly when symptoms are identified early. Surgery is generally reserved for more severe or persistent cases.
Many people naturally sleep with their wrists bent, increasing pressure within the carpal tunnel. This is why night splints are often recommended.
Yes. Physiotherapy can reduce symptoms by improving wrist mobility, encouraging normal nerve movement, strengthening the hand and providing practical advice to reduce irritation.
Not usually. Most people make an excellent recovery with appropriate treatment, particularly when symptoms are managed before significant nerve damage develops.
Related PHYSIO SERVICES
To support your recovery, your physiotherapist may recommend one or more of our related services:
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