orthopedic
UK Evidence-Informed Protocol
Carpal Tunnel Syndrome (CTS)
Compression of the median nerve as it travels through the fibro-osseous carpal tunnel at the wrist.
Clinical Overview:
Carpal Tunnel Syndrome occurs when elevated pressure inside the carpal tunnel compromises blood flow and signal transmission across the median nerve.
Living Anatomical Rig (WebGL)
03 — What Can It Feel Like?
Common Symptoms
Numbness and tingling in the thumb, index, middle, and radial half of the ring finger
Nocturnal symptoms waking the patient from sleep (often relieved by shaking the hand)
Clumsiness and dropping objects due to diminished fingertip sensation
Weakness in thumb abduction and pinch grip
04 — Movement Consequences
How It Affects Daily Function
Difficulty typing on keyboards, writing, or handling small objects like buttons
Weakness opening jars or holding steering wheels for extended drives
05 — Clinical Assessment
What Your Physiotherapist Evaluates
Phalen's Test (sustained wrist flexion for 60 seconds)
Tinel's Sign over the carpal tunnel
Carpal Compression Test (Durkan's test)
Thenar muscle bulk and strength testing (Abductor Pollicis Brevis)
06 — Treatment Options
Evidence-Informed Rehabilitation
Nocturnal neutral wrist splinting to reduce peak canal pressure
Median nerve and flexor tendon gliding exercises
Ergonomic adjustments for computer mice and workstation setup
Manual therapy for forearm flexor myofascial tension
07 — Rehabilitation Journey
*Timelines vary based on tissue biologyPhased Recovery Pathway
STAGE 01Weeks 1–3
Phase 1: Decompression & Night Splinting
Eliminate nocturnal awakenings and reduce nerve irritability
Focus: Neutral wrist splint fitting, ergonomic coaching, tendon glides.
STAGE 02Weeks 4–8
Phase 2: Nerve Mobilization & Grip
Restore full nerve glide excursion and functional pinch strength
Focus: Median nerve sliders, lumbrical strengthening, dexterity drills.
STAGE 03Weeks 8–12
Phase 3: Work Resilience
Sustain pain-free workstation endurance
Focus: Loaded forearm conditioning and sustained task tolerance.
08 — Home Support & Education
Daily Self-Management
Wear your neutral wrist splint consistently every night
Avoid sustained tight gripping or extreme wrist bending during daily tasks
Take 30-second micro-breaks every hour to perform gentle nerve gliding drills
09 — Urgent Safety Guidance
When to Seek Immediate Medical Attention
Severe visible wasting/atrophy of the thenar muscle pad at the base of the thumb
Constant loss of sensation in the fingertips lasting days without fluctuation
Sudden acute hand swelling and severe pain following a wrist fracture
10 — Clinical Questions
Frequently Asked Questions
Can Carpal Tunnel Syndrome be resolved without surgery?
Yes, mild-to-moderate CTS responds very favorably to conservative physical therapy, night splinting, and nerve gliding exercises.