Carpal tunnel syndrome is compression of the median nerve in the carpal tunnel of the wrist, causing numbness and tingling in the thumb, index finger, middle finger and part of the ring finger, often at night. It affects approx. 3–5% of adults, more often women. In mild and moderate cases a physiotherapist selects a night splint, exercises and ergonomic changes, while the diagnosis is confirmed by a doctor.
Below we describe the typical symptoms, situations in which you need to see a doctor first, what a physiotherapist does, the limits of conservative treatment and 3 exercises with dosage.
In brief
- Carpal tunnel syndrome affects approx. 3–5% of adults, several times more often women.
- Numbness in 3.5 fingers (from the thumb to half of the ring finger) that wakes you at night is typical.
- Muscle wasting at the base of the thumb or constant numbness is a reason to see a doctor urgently.
- A physiotherapy consultation costs PLN 180, manual therapy PLN 180.
- The clinic in Rydułtowy: Mon–Fri 7:00–20:00, private visits only (not covered by NFZ, the Polish public health fund).
Contents
What are the symptoms of carpal tunnel syndrome?
The most common symptoms are numbness, tingling and burning in the thumb, index finger, middle finger and half of the ring finger. The symptoms get worse at night and early in the morning, as well as when holding a phone, a steering wheel or a boapprox. Many people shake their hand to make the symptoms go away. Over time, the grip may become weaker and you may drop small objects.
The little finger usually does not go numb – if it does, the cause may lie in another nerve or in the cervical spine. Risk factors include pregnancy, diabetes, an underactive thyroid, rheumatoid arthritis, being overweight and work involving repetitive wrist bending or vibration.
When should you see a doctor first with numb fingers?
See a doctor first if the numbness is constant and does not ease during the day, if there is visible muscle wasting at the base of the thumb, clear weakness of the hand, symptoms after an injury or a wrist fracture, or numbness in both hands combined with other symptoms. Sudden numbness of an arm with a drooping corner of the mouth or speech problems requires calling 112.
Carpal tunnel syndrome is diagnosed by a doctor on the basis of an examination, often also a nerve conduction study (EMG) or an ultrasound scan. On the Recommended specialists page you will find, among others, a neurologist the clinic works with — Radosław Bienek, MD, PhD. Numbness spreading from the neck requires an assessment of the spine – we describe this in our post on neck pain from computer work.
What can a physiotherapist do for carpal tunnel syndrome?
The physiotherapist assesses which activities make the symptoms worse, checks sensation, hand strength and the cervical spine, and then selects conservative treatment. The best documented option is a splint that keeps the wrist in a neutral position at night. This is supplemented by nerve and tendon gliding exercises, manual therapy of the wrist and changes to the workstation set-up and the way everyday activities are done.
Physical therapy treatments are also available at the clinic, e.g. laser therapy and ultrasound, but the evidence for their effectiveness in carpal tunnel syndrome is limited, so they are treated as an add-on. The physiotherapist decides on the number of visits individually after the consultation.
Physiotherapy consultationassessment of symptoms, choice of splint and exercises, ergonomic advice180 PLNManual therapywrist mobilisations and neuromobilisation techniques180 PLNPrices valid from 08.2026.
When is conservative treatment not enough?
Conservative treatment may not be enough in a severe form of the condition, i.e. with constant numbness, wasting of the thumb muscles and clear nerve damage on EMG, or when symptoms persist despite correctly using a splint and doing the exercises. In that case a doctor may suggest a steroid injection or nerve release surgery, i.e. cutting the transverse carpal ligament.
Physiotherapy does not replace surgery when it is indicated, and delaying surgery while nerve damage progresses may reduce the chance of sensation fully returning.
Which exercises can you do at home?
With mild symptoms, gentle tendon and nerve gliding exercises and stretching of the forearm muscles, done without causing numbness, are usually safe. The aim is to improve how the structures slide in the carpal tunnel, not to stretch the nerve. The 3 exercises below are general. If any of them increases the tingling, reduce the range of movement or stop the exercise.
- Tendon gliding. Go through 5 hand positions in turn: straight fingers, “hook” (fingertips bent), fist, “table top” (fingers straight, bent at the knuckles), straight fist. 5 repetitions of the whole sequence, 3 times a day.
- Median nerve gliding. Arm out to the side at shoulder height, elbow bent. Slowly straighten the elbow and bend the wrist back, while tilting your head towards the arm being exercised, then return. 5–10 repetitions, 2 times a day, without causing tingling.
- Wrist flexor stretch. Straighten the elbow, palm facing forward, and gently pull the fingers back with the other hand. 3 times for 20 seconds, 2 times a day.
If the pain gets worse or spreads, stop the exercise and consult a physiotherapist.
Good to know: bring your EMG or ultrasound result to the visit, if you have had one – it helps assess the degree of nerve compression.
You can read more about problems with the joints of the upper limb in our guide joint pain and injuries.
Summary
Carpal tunnel syndrome is compression of the median nerve which, in mild and moderate forms, is treated conservatively: with a night splint, exercises and ergonomics. Constant numbness and wasting of the thumb muscles require a doctor. A consultation in Rydułtowy costs PLN 180.
Frequently asked questions
Does carpal tunnel syndrome go away on its own?
In some people, especially with mild symptoms or during pregnancy, the symptoms may ease on their own. In others the condition progresses and the numbness becomes constant. That is why it is not worth waiting when symptoms are getting worse or the hand becomes weak – the diagnosis and the degree of nerve compression are best assessed by a doctor.
Will carpal tunnel syndrome in pregnancy go away after giving birth?
In many women, carpal tunnel symptoms that appear during pregnancy ease or resolve after giving birth, as tissue swelling goes down. In some they last longer. During pregnancy a night splint and gentle exercises are safe, while physical therapy treatments are chosen with caution, as some of them are contraindicated.
Does computer work cause carpal tunnel syndrome?
Research does not clearly confirm that computer work alone causes carpal tunnel syndrome, although it may worsen symptoms in people who already have it. A stronger link is described with work involving vibrating tools and a repetitive, forceful grip. Keeping the wrist in a neutral position and taking regular breaks helps.
Is rehabilitation needed after carpal tunnel surgery?
After nerve release surgery, many people regain function with simple home exercises. Physiotherapy can be helpful if stiffness, a weak grip or a tender scar persists. The scope of the exercises and when to start therapy are always decided in line with the recommendations of the surgeon who performed the operation.
Is carpal tunnel therapy painful?
Therapy is usually not painful. During the examination, the physiotherapist may do tests that briefly cause tingling in the fingers, which helps confirm the source of the symptoms. Manual therapy and exercises are chosen so that they do not increase the numbness. If anything feels unpleasant, say so straight away.
Do I need a referral to see a physiotherapist with carpal tunnel syndrome?
A referral is usually not required for a private visit at the “W zdrowym ciele” clinic. The clinic has no contract with the NFZ, and a consultation costs PLN 180. It is worth bringing your EMG result, the doctor’s report and your splint, if you already have one, so that the physiotherapist can check how well it fits.
Sources
- Erickson M. et al., Hand Pain and Sensory Deficits: Carpal Tunnel Syndrome. Clinical Practice Guidelines, JOSPT, 2019.
- American Academy of Orthopaedic Surgeons, Management of Carpal Tunnel Syndrome Evidence-Based Clinical Practice Guideline, 2016 (updated).
- NICE Clinical Knowledge Summaries, Carpal tunnel syndrome, updated.
About the author: Tatiana Grabowska, MSc – master’s degree in physiotherapy, licence to practise number PWZFz 11646 (Polish physiotherapist licence). Since 2013 she has run the “W zdrowym ciele” physiotherapy and rehabilitation clinic in Rydułtowy; she has about 12 years of professional experience. Physiotherapist’s profile
- Consultation180 PLN
- Referralnot needed
- ReceptionMon–Fri: 7.00–20.00
