There's so many treatments to find relief from carpal tunnel syndrome, most are focused
on treating the symptoms and not the root problem.
The root problem is twofold.
One is weakness in the palm muscles right here that allow the ligament right there where
the carpal tunnel gets compressed and the nerve gets compressed, then that ligament
starts to sink down.
So strengthening muscles around here is really important and to is muscles up in the neck
and shoulder area, because that same nerve that comes out and innervates the hand and
the muscles here, it starts up in the neck.
And if it's getting compressed, and stretched up here, it can get double compressed, which
sets up those symptoms.
If we're moving forward, assuming that these two problems are the root cause of carpal
tunnel syndrome, then so many treatments out there that are commonly recommended by healthcare
professionals are actually going to make the problem worse over time.
So in this video, I'll be sharing with you the top 10 recommended treatments that actually
make carpal tunnel syndrome worse.
Number one is wrist stretches.
I see patients doing this all the time, where they take their hand like this and they extend
their elbow and stretch out their wrist in this position to get this area to stretch.
Or they'll do the opposite direction will they'll put push their hand downwards like
this, also the elbow extended to get this part of the arm to stretch.
The idea is you're trying to just loosen up muscles around the area.
And although there's good intent behind it, they're also stretching the nerves and nerves
do not like to be stretched.
So may feel good in the short term, but in the long term, it keeps the nerves aggravated
longer than they need to be.
This low level of chronic aggravation can make it extremely difficult for carpal tunnel
syndrome to go away completely.
Number two is a prayer stretch that looks like this.
Now it's basically doing this kind of a stretch but with both hands combined.
But this one gained popularity because one of the tests used to diagnose carpal tunnel
syndrome, called valence test is kind of the opposite of that same motion where you put
the backs of your hands together like so in this test to provocative test, meaning it
causes the symptoms to come on.
And so the thought behind it is if you go this direction, you're taking away the compression
that causes the symptoms to come on.
But unfortunately, it stretches the nerve.
It may feel good in the short term, but keeps the nerve angry in the long term.
Number three is risk neutral exercises with resistance.
So that just means you get a weight in your hand.
And then you're moving your wrist upwards against gravity like this.
You can also use a resistance band or one of those stretch bands, those big rubber bands
that they have in many physical therapy clinics to do the same motion where you have the band
out this way you're pulling this way.
And the idea is to strengthen the muscles that are in this part of the forearm, strengthening
the muscles that close your hand and move your wrist in this direction is a good idea
overall, for addressing the root problem of carpal tunnel syndrome.
But using only these muscles in the form and not strengthening the palm muscles, which
is what's going to lift that ligament off is a bad idea can put you into an imbalance.
So I like this exercise, but only when used in combination with other exercises that directly
strengthen the palm muscles.
If you're focusing very much on making these muscles stronger in the form, by curling your
wrists like this, you're potentially going to throw yourself into a worse imbalance that
just makes it harder to lift that ligament off the carpal tunnel.
Now weightlifting is also done in the opposite direction where you grab the weight this way
you're picking up your wrist in this direction to strengthen these muscles on the outside
part of the elbow, the extensors.
This directly feeds into the imbalance that causes this problem where the carpal tunnel
is compressed, because you're strengthening the muscles on the other side, which is going
to make these muscles on this side relatively weaker.
Most rehabilitation specialists that have their patients do these exercises are just
trying to comprehensively exercise everything in the area without paying mind to where the
imbalances they may not be trained in diagnosing and properly treating imbalances in the wrist.
There's really no reason to strengthen the wrist extensors unless you have a limitation
in motion.
But for most people that have carpal tunnel syndrome, they can get into the full range
of motion without needing the help themselves.
So gaining strength in that direction is not necessary.
If you can move both your wrist into full motion in this direction, then you don't need
more strength going in that direction because you really don't need to do very many things
with your wrist going upwards.
Number five is finger extension exercises.
These muscles share many of the muscles that go into the same area that helps your wrist
to extend.
But sometimes people will have you individually exercise the fingers only to extend them and
open them.
But because the tendons and muscles run on the opposite side of the hand from where the
problem is you're going to feed into the imbalance and make it worse like with wrist extension
if you can move your fingers up all the way as far as they can And it's about the same
on both sides, you can have a limitation in motion.
And there's really no reason to strengthen and practice moving in that direction.
Because most people can open their hand all the way.
If you have a finger injury, or osteoarthritis, some limitation, there's potential for you
to increase your motion in this direction, then exercising extension of your fingers
would be appropriate.
But for most, it's not necessary, and it only worsens the problem.
Number six is nerve flossing.
This concept is good in thought and theory, but is usually not practical.
I'll tell you why what it is, is there's nerves that come off your neck that go through your
shoulder, your elbow, your arm, all the way to your fingertips, and the one that's affected
in carpal tunnel syndrome is called the median nerve.
It's the one that goes right through this part of your arm and goes to these three fingers,
where people often get pain, numbness, and tingling, the symptoms that come with carpal
tunnel syndrome.
And so if you put your arm in this position, and then you extend your wrist this way, and
begin to straighten out your elbow, watch out, don't do this, because it might make
things worse.
This adds tension to the median nerve.
And the idea is that if you move your head away as you bend your elbow towards and then
do the opposite, that if you do this, you're flossing the nerve through the space that
it lives in.
However, this tends to add tension to the nerve.
And it doesn't address the root problem by fixing the strength and the palm muscles right
here with the strength in the shoulder and neck muscles.
It's only moving the nerve back and forth.
And if it's moving through a compressed area in the wrist and in the neck, you're potentially
just squeezing it and sliding it back and forth.
And this is often aggravating early on in my career, I had patients do this and I would
find that they would only get more aggravated, they'd say,
Well, no matter what position I do it, how little I move, I feel the symptoms come on
anyway, this tends to aggravate the nerves.
And it's not a good thing to be doing long term.
In some people, it may provide some short term relief.
That's great, do it if you can get the short term relief out of it.
But if it's making things worse, stop, it's not a good idea, we need to fix the root imbalance
first.
Number seven is using risk splints or braces.
This is one of the first recommendations that healthcare professionals will often give patients
with carpal tunnel syndrome.
And it's a good one to start out with.
Because if you immobilize the wrist, it can protect it from getting into funny positions,
especially if you have pain at night, as people often do with carpal tunnel syndrome.
It'll protect you from putting your wrist in an awkward position while you're sleeping,
that can really aggravate the nerve.
But even throughout the day, if you can decrease how much you're moving your wrist and arm
around your hand, that can allow the inflammation to calm down so that it's more tolerable.
However, it's not fixing the root muscle imbalance getting the strength back here in the palm,
or up here in the shoulder.
So it's not a good long term solution.
And the problem I often see by the time we see patients here in the clinic with this
is that they've given up on using the brace or the splint because they started there and
they say it's been six weeks.
So this thing helped the beginning and then the symptoms came back after a while.
That's how it's supposed to be.
What needs to happen is you have to have the right expectations that this is only buying
you some time so that you can get the right exercises started and begin to solve the root
problem.
You can't rely on the brace to fix carpal tunnel syndrome for the long term.
Even healthcare professionals don't fully understand this.
And they'll tell patients try this brace if that doesn't work, then we'll move on to the
next thing injections or medications or therapy or surgery.
And they're going through using a brace systematically trying only that then moving on to something
different and trying only that while leaving behind the brace when really it should be
used the brace and at the same time, do the right exercises because a brace isn't going
to solve the problem.
Number eight is medications.
Now your doctor might tell you to take over the counter medications, or maybe even prescription
medications or maybe you've tried over the counter medications before going to the doctor.
We all know that these are only short term relief and not intended to solve the root
problem.
And that's okay, you might use them to get better sleep at night or to be able to tolerate
activities better throughout the day.
Just be sure to have the right understanding about pain medications, even if they're prescription
strength pain medications, they're only taking away the pain temporarily and not solving
the root problem.
They can make your muscles stronger and they can alleviate the space inside the carpal
tunnel or up here in the neck and shoulder where the nerves live as well.
Number nine is injections.
Sometimes doctors will offer you an injection as a way to get some pain relief.
And so they'll inject right here in the area where the carpal tunnel is some sort of cortisone
steroid injection so that you can get inflammation relief and pain relief like with taking medication
by mouth whether it's over the counter or prescription.
The injected medication is only by new short term relief.
And you should be working on the right exercises to fix the muscle imbalance so that you're
not having to get the next injection and rely on more medications.
I've seen too many patients rely on taking medications by mouth or getting injections
with the X expectation that it's going to resolve a carpal tunnel problem.
And in reality, it's not it's only bind in time.
And if the muscles aren't strengthened properly, then they tend to get weaker and weaker over
time.
And this sets them up to be in a worse position months later, when the symptoms come back
on, they can't take any more medications because of side effects are the doctors limiting them
or whatever the case is, and now they're the weakest they've ever been.
And they're having to dig themselves out of a pretty deep hole when it comes to strengthening
to resolve the root problem.
This leads me to Number 10, carpal tunnel release surgery, when people are desperate,
and they've tried many things, and doctors have tried many things with their patients,
they might recommend carpal tunnel release surgery.
This has been marketed as an easy surgery because you go in and come out the same day,
the incisions are tiny, they make it seem like it's not that big of a surgery.
And in theory, this surgery seems like the right thing to do.
And like such a simple procedure, I'll show you here in the skeleton, the ligament that
they're cutting sits right here, my finger is right over the trapezium bone and the Pz
formed bone.
And right in that space is the carpal tunnel.
And so by cutting open the ligament right there, there, there's pressure released, and
the nerve now has space to move around and not get irritated.
The problem with that is that that ligament holds those bones together and holds the arch
of the palm together well like that.
And if you lose the connection, the stability there, then it's going to be a bigger challenge
to strengthen the muscles properly and get the space there to be alleviated.
In other words, you're going to be at a disadvantage when you go to strengthen and address the
root problem.
I'm not saying it can't be done, it's just going to be harder, very likely, carpal tunnel
release surgery might be right for you.
If your symptoms are bad enough, if you feel like you want it, you need it totally fine.
Just understand the implications of it mechanically at the hand, it puts you in not the best position
to strengthen the root muscle imbalance so that you can get the long term relief.
I can't tell you how many patients I've had here in the clinic that had had a failed carpal
tunnel release surgery because they had that area released.
Their muscles have already wasted away and atrophied and they only get weaker after surgery,
they use your hands less and less and it sets up other problems besides the carpal tunnel.
So be sure to think carpal tunnel release surgery through and make sure to try addressing
the root muscle imbalance.
Which by the way, here in the description of this video down below, there is a playlist
called carpal tunnel syndrome help where you can find videos with exercises and more information
about carpal tunnel syndrome, which takes me to my last point here, I've already covered
all 10 treatments that could make it worse, let me tell you how to make it better.
So strengthening these muscles in the palm.
By using a device like this when a grip strengthener they can go this can go a long way in getting
these muscles right here to get thicker and stronger to allow that ligament to lift off
the carpal tunnel and the median nerve.
This in combination with exercises where you shrug where you work, your muscles that help
you to shrug helps to get the pressure off your nerves up in your neck.
So if you can see here on the skeleton, these yellow things right here, these nerves that
come off the bones of the neck, these bundled together in the run under the collarbone and
if you don't have very strong shrugging muscles, then the weight of your arm pulls down in
the collarbone right here comes down and pushes onto these nerves.
Which can create what's called a double crush effect where you crush the nerves up here
and then down at the wrist at the carpal tunnel strengthening the muscles in both areas is
usually solving the root problem so that you can have long lasting relief from carpal tunnel
syndrome.
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