Carpal Tunnel Syndrome


  • Stable, neutral position
  • Slightly elevated wrist
  • Be sure there is no pressure on Median Nerve
  • Pillow under the legs


  • Cold press if swelling
  • Heat if performing fascial work
  • Check in, visual, vocal and tactile


  • High tone in wrist flexors:
    • Perform 2 neuromuscular techniques
    • Negotiate trigger points
    • Stretch, but be aware of the Median Nerve
  • Perform fluid techniques if swollen – start with pumping at clavicle first
  • Fascial techniques at Flexor Retinaculum
    • Negotiate fascial work and let them know it may burn or feel a dragging sensation
  • Joint mobilization at carpals
    • Grade 1 or Grade 2 oscillations


  • Check in with client throughout
  • Ask if client is experiencing any tinging, where is it and how long does it last?
  • If the client lets you know it’s getting worse, move distally and do gentle fluid techniques
  • Tell client to show you and tell you where the pain is and if it goes away

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