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If you have carpal tunnel syndrome, common nerve compression, you may wonder how to prevent it from worsening.

Carpal tunnel exercises are one step you can take. Doctors often recommend physical or occupational therapy along with wrist splinting as first-line treatment options for those with mild to moderate carpal tunnel.

Here’s what you should know about carpal tunnel syndrome, what exercises may help, and which to avoid.

What Is Carpal Tunnel Syndrome?

Your carpal tunnel is a narrow tube of ligaments and bones at the base of your hand and wrist. Your median nerve, which runs through your forearm and wrist, travels through it into your palm. Tendons that bend your fingers also travel through the carpal tunnel.

Your median nerve provides feeling and movement to your thumb, index, middle, and thumb-side parts of your ring finger. It also controls some muscles at the base of your thumb.

Carpal tunnel syndrome, or CTS, happens when the median nerve gets pressed or squeezed at your wrist from swelling in the carpal tunnel. Common first signs include numbness, tingling, and thumb and index finger weakness. Over time, you may feel pain in your hand, wrist, and forearm. These symptoms can sometimes worsen at night while sleeping.

What Exercises Help with Carpal Tunnel Syndrome?

What’s the best exercise for carpal tunnel syndrome (CTS)? The answer depends on how bad your CTS gets. Exercise may prove helpful for those with mild to moderate CTS.

If your carpal tunnel symptoms are severe or sudden (such as from an injury), exercise won’t help. Instead, you’ll need medical treatment right away.

Exercises during physical therapy

Doctors who treat CTS often recommend that you see a physical or occupational therapist to help you get started on the right exercise for you. They can teach you how to do these exercises with the proper form to avoid injury.

For some of these exercises, the therapist actually needs to move and stretch your hand and wrist on the side with CTS. The movements and stretches they can do include:

Neurodynamic technique (NT)

A therapist usually does NT therapy while you’re lying down. This technique involves bending and then stretching your arm at the elbow.

Carpal bone mobilization technique (CBMT)

CBMT is when the physical therapist uses their thumbs to apply pressure on both sides of the carpal bone at the base of your hand, on both the top side of your hand and on the palm side. They usually do this while you’re lying down.

Your therapist will let you know how often you may need CBMT. It’s common to need this several times a week for several weeks.

At-home carpal tunnel stretches and exercises

The American Academy of Orthopaedic Surgeons lists these stretches you can do at home for CTS. You should do these stretches before activity for the day and throughout the day.

Medial nerve glide stretches

Place your CTS hand in these five positions for 10 to 15 repetitions once a day, six to seven days a week. Before doing these exercises, apply heat to your hand for 15 minutes. After doing them, apply a cold pack for 10 minutes.

Hold each position for three to seven seconds.

1. Make a fist with your thumb over your fingers.
2. Point your fingers straight up, keeping them all close together.
3. Keep your fingers straight up and together, rotate your hand so that your palm is facing you, and bend your hand backward toward your forearm.
4. Turn your hand so your palm faces up. Keep all your fingers close together except your thumb. Extend that out from your hand.
5. Keep your fingers, wrist, and thumb extended. Reach under the back of your hand with your other hand and gently stretch your thumb downward.

Tendon gliding exercises (TGE)

According to a comparison study in Pain Research and Management, TGE seems to be the most effective after NT or CBMT. For the study, TGE involved making and moving through five distinct positions in the CTS hand. Participants held each position for seven seconds, doing each set of five positions three times.

1. Straight. Hold all your fingers straight up, like you’re making a stop sign.
2. Hook. Make a hook with all your fingers except your thumb. You do this by only bending the top two knuckles of your digits
3. Full fist. Make a fist, with your thumb folded over your other fingers.
4. Tabletop. Hold all your fingers, except the thumb, straight out and bent at the knuckles on your palm. The thumb should stick out to the side. The fingers are perpendicular to the forearm, like half a capital T.
5. Straight fist. Make a fist without curling the tips of your fingers. Your thumb should stick out and not fold over your other fingers.

In the comparison study, participants did these exercises three times a week for three weeks.

Before doing these exercises, apply heat to your hand for 15 minutes. After doing them, apply a cold pack for 10 minutes.

Wrist extension stretch

Do this for five repetitions, four times a day, five to seven days a week:

• Hold out your CTS arm in front of you, but don’t lock your elbow.
• Bend your wrist like you’re making a “stop” sign.
• Use your other hand to pull your CTS hand’s fingers toward you gently.
• When you feel a stretch in your forearm, hold it for 15 seconds.

Wrist flexion stretch

Do this for five repetitions, four times a day, five to seven days a week:

• Straighten your arm with your palm facing down.
• Bend your wrist so your fingers point downward.
• Use your other hand to pull your hand toward your body gently.
• When you feel a stretch in the outside of your forearm, hold it for 15 seconds.

Intrinsic stretch

Make a hook with all your fingers except your thumb and use your other hand to gently pull the hooked fist back toward your forearm.

What movements should I avoid with carpal tunnel syndrome?

When you have CTS, avoid any exercise, hobby, or work that bends your wrists into flexion and puts pressure on them. Also, avoid using equipment or machinery that causes vibration in your wrist, which can worsen symptoms. You should also try to avoid sustained gripping that causes pressure in the carpal tunnel from the muscle in your hand.

When Should I See a Doctor for Carpal Tunnel?

If you think you have carpal tunnel, first see your doctor right away. They can help you figure out what’s causing your CTS and get you the right treatment.

With long-term or untreated CTS, your fingers may feel numb all the time. You may struggle to grab and hold small objects, and you may have difficulty with fine motor control activities like zippers or buttons. You may also have pain that shoots through your fingers, wrist, and forearm.

Left untreated, CTS can cause long-term damage to your median nerve. It can even lead to disability in the affected arm and hand. Other treatment options include steroid injections and surgery.