Quick Summary
If numbness, tingling or weakness in your hand keeps you awake at night, you may have carpal tunnel syndrome — compression of the median nerve at the wrist.
Because this is a nerve compression condition, our HCPC-registered physiotherapists focus on specialised manual therapy and targeted exercises tailored to your specific needs.
Research suggests that hands-on care combined with nerve and tendon gliding exercises may ease symptoms and improve hand function in mild-to-moderate cases.
What Is Carpal Tunnel Syndrome?
Carpal tunnel syndrome (CTS) is the most common nerve entrapment condition. It is caused by compression of the median nerve as it passes through the carpal tunnel — a narrow passageway at the wrist bordered by the carpal bones and the transverse carpal ligament, through which the median nerve and nine flexor tendons travel.
Raised pressure within the tunnel — often linked to thickening of the tissue surrounding the flexor tendons — compresses the nerve and reduces its blood supply. Symptoms are typically worse at night, because fluid accumulates and many people sleep with the wrist bent, further raising pressure within the tunnel.
CTS is very common: research estimates that around one in ten people will develop it at some point in their life, and carpal tunnel decompression is the most frequently performed elective hand operation in England (Wiberg et al., Journal of Plastic, Reconstructive & Aesthetic Surgery, 2022).
CTS is usually graded as mild (intermittent night-time tingling), moderate (daytime symptoms with some loss of sensation and grip) or severe (constant numbness with weakness and wasting of the thumb muscles). Evidence shows physiotherapy is most effective in mild-to-moderate cases, before lasting nerve damage develops (Erickson et al., JOSPT, 2019).
Do You Experience These Symptoms?
✓ Numbness and tingling in the thumb, index, middle and half of the ring finger
✓ Symptoms that are worse at night and often wake you from sleep
✓ An urge to shake or flick your hand for relief
✓ Pain or pins and needles that may radiate up into the forearm
✓ Weakness of grip, clumsiness, or dropping objects
✓ Difficulty with fine tasks such as fastening buttons or opening jars
✓ In advanced cases, wasting of the muscles at the base of the thumb
These symptoms can be treated.
The sooner you begin, the better your chances of a smoother recovery.
What Causes Carpal Tunnel Syndrome?
• Female sex and hormonal factors
Carpal tunnel syndrome is roughly twice as common in women as in men, with UK research showing a prevalence of around 3.1% of adults.
Hormonal changes affecting fluid balance are thought to contribute to this difference.
• Pregnancy
Fluid retention in later pregnancy raises pressure within the carpal tunnel.
Pregnancy-related CTS is common but usually transient, often settling after delivery.
• Repetitive or forceful hand use
Prolonged wrist bending, repetitive gripping and vibration exposure can aggravate the median nerve.
Work involving sustained awkward wrist postures is a recognised contributor, though it is rarely the sole cause.
• Metabolic and inflammatory conditions
Diabetes, an underactive thyroid, obesity and rheumatoid arthritis all raise the risk of CTS.
UK research shows the odds of developing CTS are more than doubled in people with diabetes or rheumatoid arthritis (Wiberg et al., 2022).
• Age and other factors
CTS most often develops between the ages of 40 and 60.
Previous wrist fracture, genetic predisposition and a higher body weight are also associated with the condition.
How We Treat Carpal Tunnel Syndrome at J&J Therapy
Hands-On Manual Therapy
Our physiotherapists use hands-on techniques aimed at reducing strain on the median nerve and improving how it moves and glides. These include carpal and wrist joint mobilisation, soft tissue work to the forearm muscles, and neurodynamic (nerve gliding) techniques directed at the median nerve and, where appropriate, the neck and upper limb. Research suggests manual therapy can match the medium- and long-term outcomes of surgery for many people with mild-to-moderate CTS.
Shockwave Therapy*
For conditions involving direct nerve compression such as carpal tunnel syndrome, our care emphasises specialised manual therapy and targeted exercises — the most appropriate approach for your specific needs. Rather than shockwave therapy, our physiotherapists focus on techniques that help the median nerve move freely and reduce the strain on it, alongside a tailored home exercise programme and practical advice.
Targeted Exercise Programme
We design a targeted home programme that may include nerve and tendon gliding exercises to encourage smooth movement within the tunnel, wrist and forearm strengthening and stretching, and practical ergonomic advice for your desk, keyboard and daily tasks. We can also guide you on wearing a night splint in the neutral position, which evidence shows may ease night-time symptoms in mild-to-moderate cases. Where symptoms are severe or fail to improve, we will refer you appropriately for further assessment.
When to Seek Urgent Medical Help
While most symptoms are not serious, urgent medical attention is required if you experience any of the following:
Constant (rather than intermittent) numbness in your hand that does not come and go
Weakness or visible wasting of the muscles at the base of your thumb, or increasing difficulty gripping and frequently dropping objects
Rapidly worsening symptoms developing over a short period
Symptoms suggesting another cause — such as neck pain with arm symptoms, numbness spreading beyond the hand, or symptoms in both hands with other neurological changes
FAQs About Carpal Tunnel Syndrome
Do I need surgery for carpal tunnel syndrome?
Not usually. Most people with mild-to-moderate CTS improve with conservative care such as a night splint, targeted exercises and manual therapy. Surgery is generally reserved for severe cases, when there is muscle wasting or weakness, or when symptoms do not improve after a trial of conservative treatment.
How long does recovery take?
It varies from person to person. Some people notice improvement within a few weeks of starting conservative care, and research shows around a third of untreated cases resolve within six months. Persistent or severe cases may take longer or need onward referral.
Will a wrist splint help?
A neutral-position night splint is a recommended first-line option and may ease night-time symptoms, though evidence for long-term benefit is limited. Our physiotherapists can advise on the correct fit and how to use it.
Is carpal tunnel syndrome caused by typing?
Typing alone is not a proven single cause, but repetitive or forceful hand use and sustained awkward wrist postures can aggravate symptoms. Good ergonomics, a well set-up workstation and regular breaks can help reduce the strain.
What about carpal tunnel syndrome in pregnancy?
CTS in pregnancy is common and usually caused by fluid retention. It often settles after delivery, so gentle conservative measures such as a night splint are preferred during pregnancy. If symptoms persist after your baby is born, we can assess and treat them.
This page is for general information only and does not replace professional medical advice.
Reviewed by Lavya Arigalayan, MSc, HCPC Registered Physiotherapist.
Last reviewed:
2026년 8월 20일