Physio for carpal tunnel: hand numbness and tingling

What is carpal tunnel syndrome?

Carpal tunnel syndrome happens when the median nerve, which runs through a narrow passage at the front of the wrist, is squeezed or irritated. The nerve supplies feeling to the thumb, index finger, middle finger and part of the ring finger, and some of the small muscles in the hand.

Common signs

• Tingling, pins and needles or numbness in the thumb, index and middle fingers
• Symptoms that wake you at night, or are worse when you wake up
• Relief when you shake or flick your hand
• Aching in the hand or forearm
• Clumsiness or dropping things as the condition progresses

What can contribute

Carpal tunnel has several possible contributors. Pregnancy and hormonal changes, diabetes, thyroid conditions, arthritis, previous wrist injury, repetitive or forceful hand tasks, and holding the wrist bent for long periods can all play a part. Often there is more than one factor.

How a physio or hand therapist can help

Physios, along with occupational therapists who specialise in hand therapy, assess the wrist, hand, neck and nerve, and work out how severe it is. Care often includes:

• Education about what is happening and what makes it worse
• A night splint that keeps the wrist in a neutral position
• Adjusting hand tasks, tools and workstation setup
• Nerve gliding exercises and general hand and forearm exercises
• Advice on when it is time to see your doctor about further tests or other treatment

Mild or early symptoms often respond to these steps. If symptoms are constant or getting worse, your doctor may arrange nerve tests or talk to you about an injection or surgery.

Pregnancy and carpal tunnel

Swelling in pregnancy can cause carpal tunnel symptoms, particularly in the later months. They often settle after the baby arrives. Tell your midwife, doctor or physio about it. Our guide to physio during pregnancy covers what else a physio can help with.

When to see a doctor soon

• Constant numbness that does not come and go
• Weakness in the hand, wasting of the muscle at the base of the thumb or dropping things
• Symptoms in both hands with neck pain, or numbness spreading up the arm
• Symptoms after a wrist injury or fracture
• Severe or rapidly worsening symptoms

Costs and funding

Fees vary by clinic and by whether you see a physio or a hand therapist. See our cost guide for typical prices and rebates.

Common questions

This guide is general information, not medical advice. Talk to your doctor or physio about your own situation.