Massage Techniques for Carpal Tunnel Syndrome

Carpal tunnel syndrome results from compression of the median nerve within the carpal tunnel, a narrow passageway at the wrist formed by the eight tendons of the finger flexor muscles.

Symptoms of carpal tunnel syndrome include finger and wrist pain, numbness, and tingling that can eventually progress to weakness and loss of fine motor movement. It is the most common peripheral neuropathy often seen in people who work on computers for extended periods of time or perform repetitive hand movements as part of their job duties such as construction and factory work.

While the clinical practice guidelines for managing carpal tunnel syndrome from the American Academy of Orthopedic Surgeons do not directly support evidence for or against massage techniques for treating carpal tunnel syndrome, emerging evidence suggests beneficial outcomes of using massage and other related techniques for improving symptoms of the condition.

Massage for carpal tunnel syndrome can help decrease pain, increase range of motion, improve grip strength and functional hand use, and decrease symptoms like numbness and tingling by relaxing the finger flexor tendons surrounding the median nerve, thereby reducing compression.

Related: Symptoms of Carpal Tunnel Syndrome

Massage

Massage to the flexor tendons that form the carpal tunnel can help decrease tightness, pain, and irritation to the underlying median nerve. Massage techniques for carpal tunnel syndrome consist of the following:

  • Effleurage: Light circular strokes made with the palm of the hand used to increase blood flow to a particular area to warm it up and prepare for deeper massage.
  • Friction: Firm pressure applied to the bottom of the wrist, gliding up the arm toward the elbow to break up scar tissue and decrease swelling.
  • Petrissage: Deep kneading pressure used to increase blood flow and improve flexibility of tight muscles.
  • Shaking: Shaking of the arms can help calm down sensory receptors to help muscles loosen and relax.

Massaging the wrist and forearm in the following pattern has shown to help improve symptoms of carpal tunnel syndrome:

  • 30 seconds of effleurage 
  • 60 seconds of friction
  • 30 seconds of petrissage
  • 30 seconds of shaking
  • 30 seconds of effleurage 

This technique takes three minutes to complete and can be performed by yourself.

Nerve-gliding exercises

Carpal tunnel symptoms result from compression of the median nerve. Nerve gliding exercises for the median nerve can help decrease compression and pain by stretching the irritated nerve, allowing it to move more freely.

To perform median nerve gliding exercises, the wrist and fingers can be moved throughout six positions:

  1. With the wrist in a neutral position, bend the fingers and thumb to form a fist.
  2. With the wrist in a neutral position, extend the fingers and thumb straight up, keeping your thumb in line with your fingers.
  3. With the fingers extended, extend the wrist back.
  4. With the fingers and wrist extended back, move the thumb forward away from the fingers.
  5. Maintain the previous position and supinate the forearm by rotating your palm toward your face.
  6. Maintain the previous position and gently stretch the thumb back with the other hand.
median nerve gliding exercises

Rheumatology International

Each position is held for five seconds and repeated ten times. These exercises are performed with the neck and shoulder in a neutral position and the elbow bent at 90 degrees.

Tendon-gliding exercises

Tendon gliding exercises can help increase the range of motion and flexibility of the flexor tendons of the thumb and fingers. When these tendons become tight and inflamed, they compress the nearby median nerve and can cause pain, weakness, numbness, and tingling. When the tendons are stretched and pressure from the median nerve is released, symptoms can improve.

To perform tendon gliding exercises, the fingers will move through five positions:

  • Straight: Start with your fingers extended vertically, holding your fingers straight up
  • Hook: Bend just the tips of your fingers down toward your palm
  • Fist: Bend your fingers all the way down to form a fist.
  • Tabletop: Straighten your fingers out horizontally so that your hand forms a 90 degree angle.
  • Straight fist: From the tabletop position, bend the tips of your fingers down toward your palm while continuing to maintain a 90 degree angle in the fingers.
tendon gilding exercises

Rheumatology International

Stretching

Stretching the finger flexor muscles can help decrease muscle tightness and inflammation of the flexor tendons comprising the carpal tunnel. The finger flexors can be stretched by using your hand to bend your fingers backward, holding this position for 30 to 60 seconds and repeating several times each day. You should feel a stretch in both the fingers and the forearm.

Trigger Point Therapy

Trigger points are specific tight bands within a muscle that become very tender to the touch and refer pain to further parts of the body.

Common trigger points seen in patients with carpal tunnel syndrome include:

  • Four centimeters below crease of the elbow on the top of the forearm at a point along the extensor digitorum muscle
  • Four centimeters from the crease of the wrist toward the elbow in the middle of the underside of the forearm
  • Two centimeters from the crease of the wrist toward the fingers along the transverse carpal ligament of the wrist and origin of the thumb muscles
trigger points for carpal tunnel syndrome

Journal of Bodywork & Movement Therapies

Focusing massage on these specific areas can help decrease pain not only at these specific trigger points but can help alleviate pain referred into the hand and fingers.

Related: What Are Trigger Points and How Can PT Help?

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  2. American Academy of Orthopaedic Surgeons. Management of carpal tunnel syndrome evidence-based clinical practice guideline. Updated February 29, 2016.

  3. Elliott R, Burkett, B. Massage therapy as an effective treatment for carpal tunnel syndrome. Journal of Bodywork & Movement Therapies. 2013;17(3):332-338. doi.org/10.1016/j.jbmt.2012.12.003