Carpal Tunnel Syndrome: A Burlington Physiotherapy Treatment Guide

Cogent Academy Blog

Folarin Babatunde PT PhD MScSEM MScPT BScPT

January 10, 2025

Patient holding a painful wrist due to carpal tunnel syndrome.

What Is Carpal Tunnel Syndrome?

Carpal tunnel syndrome (CTS) is a condition caused by pressure on the median nerve inside the carpal tunnel—a narrow passage in your wrist. This pressure leads to pain, numbness, tingling, and weakness in the wrist, hand, and sometimes the entire arm.

Although CTS can be severe enough to require surgery, many people experience lasting relief through physiotherapy. In fact, recent studies show that physiotherapy for carpal tunnel is not only effective but also more cost-efficient than surgery.

At Cogent Physical Rehabilitation Center in Burlington, our physiotherapists specialize in upper limb rehabilitation and evidence-based hand and wrist treatments that help restore function, reduce pain, and prevent recurrence.

Anatomy of the Carpal Tunnel

Common Causes of Carpal Tunnel Syndrome

Carpal tunnel syndrome can be caused by many factors, often linked to repetitive use and nerve irritation:

• Repetitive wrist and finger movements (typing, sewing, video gaming, assembly line work)

• Awkward wrist positions held for long periods

• Vibration exposure from tools (construction, mechanics, meat packing)

• Wrist injuries such as sprains, fractures, or dislocations

• Health conditions: diabetes, arthritis, thyroid imbalance, pregnancy, or menopause

• Fluid retention or inflammation

Signs and Symptoms of Carpal Tunnel Syndrome

CTS usually begins gradually and worsens over time. Common signs include:

• Numbness, tingling, or burning in the thumb, index, and middle fingers

• Night-time symptoms that wake you from sleep

• The urge to “shake out” your hands for relief

• Hand weakness and dropping objects unexpectedly

• Pain during activities like typing, gripping a steering wheel, or holding a phone

For related conditions, visit our page on wrist and hand conditions.

💡Studies show that bending your wrist upward increases pressure in the carpal tunnel about 10 times, while bending it downward increases it about 8 times.

Areas of numbness and tingling in the hand from carpal tunnel syndrome Burlington physiotherapy guide

Causes and Symptoms of Carpal Tunnel Syndrome

Table: Causes and symptoms of Carpal Tunnel Syndrome

Causes of CTS	Common Symptoms
Repetitive hand or wrist motions (typing, sewing, assembly-line work)	Numbness or tingling in the thumb, index, and middle fingers
Use of vibrating tools (construction, meat packing, mechanics)	Burning sensation or “pins and needles,” especially at night
Awkward wrist positions held for long periods	Hand weakness and dropping objects
Wrist injuries (sprain, fracture, dislocation)	Pain when gripping objects like a phone or steering wheel
Medical conditions (arthritis, diabetes, thyroid imbalance, pregnancy, menopause)	Symptoms worsen with activity and improve when “shaking out” the hands
Fluid retention or inflammatory disorders	Progressive loss of hand function if untreated

How Is Carpal Tunnel Syndrome Diagnosed?

Your Burlington physiotherapist can often diagnose CTS without extensive tests. Diagnosis usually involves:

• Reviewing your health history and daily activities

• Physical tests such as Phalen’s test (wrist flexion) and Tinel’s sign (tapping the nerve)

• Assessing grip strength and wrist mobility

• Examining posture of your neck, shoulder, and arm

• Referral for imaging or nerve conduction studies if necessary

Physiotherapy Treatment for Carpal Tunnel Syndrome in Burlington

💡A recent study found that choosing physiotherapy over surgery for CTS could save patients more than $39,000 in long-term costs while restoring hand function.

Conservative (Non-Surgical) Care

Early treatment with physiotherapy can often resolve CTS without surgery. Your plan may include:

• Patient education on posture, wrist positions, and ergonomics

• Stretching and strengthening exercises for the wrist, hand, and forearm

• Splinting at night to reduce discomfort

• Heat, ice, or manual therapy to relieve pain and stiffness

• Workplace modifications such as ergonomic keyboards or vibration-reducing gloves

• Nerve and tendon gliding exercises to reduce nerve pressure in the tunnel, reduce wrist swelling and improve median nerve function.

Burlington physiotherapist showing finger exercises for carpal tunnel nerve gliding

Carpal Tunnel Syndrome Treatment Options

Table: Comparison of conservative vs surgical treatment for carpal tunnel syndrome

Conservative (Non-Surgical) Treatment	Surgical Treatment
Patient education on wrist posture & ergonomics	Surgical release of the carpal tunnel to relieve nerve pressure
Stretching & strengthening exercises for wrist, hand, and forearm	Performed when symptoms are severe, persistent, or causing muscle wasting
Splinting (especially at night) to reduce discomfort	Requires recovery period and physiotherapy afterward
Manual therapy, heat/ice, and activity modifications	Risks include scar tissue, stiffness, or recurrence if habits don’t change
Workstation assessment & ergonomic adjustments	Usually considered after conservative care has failed
Cost-effective and supported by research as first-line care	May restore function when non-surgical care is no longer effective

Physiotherapy After Surgery

If surgery is required, rehabilitation plays an important role. At Cogent Rehab, post-surgical care includes:

• Scar management to reduce stiffness

• Nerve gliding exercises to restore mobility

• Strengthening programs for grip and wrist function

• Workstation setup guidance to prevent recurrence

Can Carpal Tunnel Syndrome Be Prevented?

While not always preventable, you can reduce risk by:

• Maintaining good posture at work and home

• Taking frequent breaks during repetitive tasks

• Using ergonomic tools and supportive splints when needed

• Reducing unnecessary grip force when typing or writing

• Keeping your hands warm in cold environments

• Staying active and maintaining overall health

For more guidance, see our workstation setup guide on how to manage carpal tunnel syndrome in Burlington.

Why Choose Cogent Physical Rehabilitation Center in Burlington?

At Cogent Rehab, we provide personalized physiotherapy for hand, wrist, and nerve-related conditions, including carpal tunnel syndrome. Our team offers:

• Hands-on care and exercise-based therapy

• Ergonomic assessments for workstations

• Evidence-based treatment tailored to your lifestyle

• Collaborative care with doctors and surgeons when necessary

We are proud to help Burlington residents rebuild, promote, and enhance recovery.

FAQs for Carpal Tunnel Syndrome Physiotherapy in Burlington

Q1: Can physiotherapy cure carpal tunnel syndrome?

Physiotherapy cannot always “cure” carpal tunnel syndrome in the medical sense, but it can often eliminate symptoms and restore full function without surgery—especially in early and moderate cases. At Cogent Rehab Burlington, we use a combination of hands-on therapy, patient education, stretching and strengthening, splinting, and ergonomic modifications to relieve nerve compression. Many patients are able to return to work and daily activities without the need for surgical intervention.

Q2: How long does recovery take?

Recovery depends on the severity and duration of your symptoms.

• Mild CTS: Some people notice improvements in just a few weeks with consistent physiotherapy.

• Moderate CTS: It may take several months of treatment, especially if symptoms occur during work or sport activities.

• Severe CTS: If hand weakness and constant numbness are present, recovery may take longer and require both physiotherapy and medical consultation.

Our team in Burlington tailors treatment programs to fit your lifestyle, ensuring you progress at a safe but steady pace.

Q3: When is surgery necessary?

Surgery for carpal tunnel syndrome is typically recommended only when:

• Symptoms are severe and interfere with daily life

• Numbness and tingling are constant

• Muscle weakness or wasting is evident in the hand

• Conservative treatments, such as physiotherapy, splinting, and activity modification, have not provided relief

If surgery becomes necessary, physiotherapy after carpal tunnel release is critical for restoring mobility, reducing scar tissue, and regaining wrist and hand strength. Our wrist and hand physiotherapy services help patients recover quickly and prevent recurrence.

Q4: Can carpal tunnel syndrome come back after treatment?

Yes, CTS can return if the underlying causes—such as poor posture, repetitive wrist strain, or workplace ergonomics—are not addressed. That’s why part of your treatment plan at Cogent Rehab includes ergonomic education and workstation assessments. By teaching you how to protect your wrists and hands, we reduce the risk of recurrence.

Q5: What can I do at home to manage carpal tunnel syndrome?

Simple strategies can help reduce symptoms between physiotherapy sessions:

• Wear a night splint to keep the wrist in a neutral position

• Take frequent breaks from typing or tool use

• Perform gentle wrist and finger stretches

• Keep your hands warm, especially in cold environments

• Avoid forceful or repetitive gripping

Your physiotherapist will provide a personalized home exercise program to support your in-clinic care.

Take the First Step Toward Relief

Don’t let wrist pain, numbness, or hand weakness interfere with your work, hobbies, or daily life.

At Cogent Physical Rehabilitation Center in Burlington, our experienced physiotherapists provide evidence-based treatment for carpal tunnel syndrome to help you recover without surgery.

Book your assessment today and start your path to pain-free living.

Request an Appointment Online or call us directly at (905) 635-4422.

Book An Appointment Today

Sources

1. Carpal Tunnel Syndrome: A Summary of Clinical Practice Guideline Recommendations—Using the Evidence to Guide Physical Therapist Practice. JOSPT. 2019;49:359-360.

2. Osiak K, Elnazir P, Walocha JA, Pasternak A. Carpal tunnel syndrome: state-of-the-art-review. Folia Morphol. 2021;81:851-862.

3. Fernández-de-Las-Peñas C, Cleland J, Palacios-Ceña M, et al. The effectiveness of manual therapy versus surgery on self-reported function, cervical range of motion, and pinch grip force in carpal tunnel syndrome: a randomized clinical trial. J Orthop Sports Phys Ther. 2017;47(3):151–161

4. Cimpeanu M-C, Roman N, Grigorescu S, Grigorescu O-D, Miclaus RS. Management of "De Novo" carpal tunnel syndrome in pregnancy: a narrative review. J Pers Med. 2024;14:240.

5. Parish R, Morgan C, Burnett KA, et al. Practice patterns in the conservative treatment of carpal tunnel syndrome: survey results from members of the American Society of Hand Therapy. J Hand Ther. 2020;33(3):346–353