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Myofascial Massage For Carpal Tunnel

From Dr. Z - Carpal tunnel syndrome specialist

How to Perform Myofascial Massage for Carpal Tunnel Syndrome

Myofascial massage for carpal tunnel syndrome effective for eliminating the pain and numbness that's characteristic of this disorder. How does it work? The answer means understanding what this condition is all about.


Included in this article:

  • What causes carpal tunnel syndrome?
  • How to solve the tendon problem
  • How to perform myofascial massage for carpal tunnel
  • Tips for a better experience
  • Do’s and Don’ts of myofascial massage for carpal tunnel
  • Summary
man's painful face

What causes carpal tunnel syndrome?

Carpal tunnel syndrome focuses on your flexor tendons. These tendons run from your mid-forearm to your fingertips and allow you to pinch and grasp. Sometimes the tendons become inflamed or swollen in a type of dysfunction called tendinopathy. (Most people commonly call it tendonitis.) Actually, the flexor tendons can swell almost anywhere, from your fingers to your mid-forearm. But it's when they swell in your wrist that we have the problem of carpal tunnel syndrome.



flexor tendons

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The role flexor tendons play

Tendon swelling usually occurs as a result of excessive hand and finger use. This is called repetitive stress. The stressed tendons form microscopic rips on their surface, like frayed ropes. To heal those rips, tendons develop adhesions (like tiny scars) over each rip. And since tendons run in bundles, the adhesions between tendons rub against each other as the tendons slide past one another. 


The constantly rubbing adhesions irritate the tendons. The result is that the tendons become inflamed and begin to swell. 


When flexor tendons swell along your forearm, the result is usually pain at the point of swelling. It normally occurs between your wrist and elbow. This can be treated relatively easily and effectively. However, if the swelling occurs deep inside your wrist joint, the result is carpal tunnel syndrome.

cross section illustration of the wrist

Flexor tendons inside the carpal tunnel space

When your forearm’s flexor tendons swell inside your wrist joint, the result is not just simple pain at that point. It's carpal tunnel syndrome.


Inside the wrist joint, the flexor tendons pass through a narrow passageway called the carpal tunnel space (see illustration above). In addition, the median nerve (a major nerve to the hand) also runs alongside the tendons inside the carpal tunnel space.


When the flexor tendons swell inside the already-crowded carpal tunnel space, they push against the (much softer) median nerve. This compresses the nerve. And this nerve compression is what causes all of the symptoms of carpal tunnel syndrome. They include pain, numbness, tingling, burning, weakness, and clumsiness in your hand and fingers.

median nerve and tendon inside the wrist

How to solve the tendon problem

So what’s the best way to eliminate carpal tunnel symptoms? You must relieve pressure on the median nerve. This pressure relief can be achieved using one of two methods: surgery or myofascial massage.

1. SURGERY to eliminate carpal tunnel syndrome

open release surgery for carpal tunnel

The first method to decompress the median nerve is using surgery. Surgery creates more space for the swollen tendons so they don't push against the nerve. 


In short, the surgeon cuts the transverse carpal ligament located deep inside your wrist joint. Surgery can be either open (as shown on the left) or endoscopic.


Cutting the ligament allows your wrist bones to instantly snap apart. As the bones separate, they give your tendons more room to expand without crushing the median nerve. 


The only major problem with surgery is that – in about 2-3 years – that extra space fills up with scar tissue. Then, in about 50% of patients, the problem resumes all over again and symptoms return.

2. MYOFASCIAL MASSAGE to eliminate carpal tunnel syndrome

myofascial massage for carpal tunnel

The second method to relieve pressure on the median nerve is using myofascial massage (also called myofascial release massage). This technique kneads and shears the skin over your flexor tendons. 


The motion breaks up the tendons' adhesions immediately below the skin. When the adhesions are broken up they are carried away by the body's circulatory and lymphatic system. As a result, tendon inflammation naturally subsides. This means that the un-swollen tendons no longer crush the median nerve. Symptoms then resolve. 


Myofascial massage for carpal tunnel is a permanent solution to this disorder. It also does not require surgery.
myofascial massage using the CarpalRx

How to perform myofascial massage for carpal tunnel

Myofascial massage is a type of manual or manipulative therapy designed to relieve carpal tunnel syndrome. It effectively breaks up the adhesions on tendons which cause this disorder.

Getting started

You will need three things to properly perform myofascial massage for carpal tunnel syndrome. 

  • A willing partner
  • Skin lotion
  • Commitment to 15 minutes of time, morning and evening, for at least 30 days

Follow these 8 easy Steps

Step 1

Establish a regimen. In order to completely eliminate carpal tunnel symptoms, you must receive myofascial massage for at least 30 days. More severe symptoms, particularly numbness and tingling, will require 2-3 additional weeks. 

Step 2

Rub skin lotion around the palm-side area of your wrist joint. Cover about 1-2 inches of the forearm. This will reduce skin irritation resulting from the massage.

Step 3

Place your hand on a firm surface, like a table or your lap, with your palm facing up. Next, your partner will hold your wrist area with both hands. Both of their thumbs should be on your wrist, about 1 inch apart. See image below.

myofascial release massage motions

Step 4

Your partner should rotate both of their thumbs in a circular motion. The speed of rotation should be about once every 1-2 seconds. The circular thumb motions must be counter-rotating (moving in opposing directions). And the thumbs repeat the circular pattern over and over. When properly done, the shearing force makes the skin look like it’s being kneaded, like bread dough.

Step 5

Never keep the massaging thumbs in the same area of the forearm for more than a few rotations. Instead, move the rotations slightly up and down your lower wrist and forearm by 1-2 inches.

Step 6

Perform the kneading massage for 15 minutes. Rotating the thumbs in one spot for a few rotations, then moving them by an inch, should cover your entire lower wrist after about 1-2 minutes. Then simply repeat the pattern over and over again until the rotating thumbs have kneaded the entire lower forearm multiple times. 

Step 7

This 15-minute massage must be performed morning and evening, for a minimum of 30 days. About 2-3 additional weeks will be required to eliminate more severe symptoms, particularly severe numbness and tingling. 

Step 8

Be patient. Myofascial massage for carpal tunnel is not an overnight cure for this disorder. Therefore, faithfully follow your daily regimen for at least 30 days. Keep in mind that it (literally) took years for you to acquire carpal tunnel syndrome. So this remedy will not relieve symptoms overnight.

hand massage

Tips for a better experience

The following tips will help you get the most from your massage technique.

1. Find a quit place for you and your partner to perform your daily massages. Minimal distractions are best. Background music or television can help the time go faster.


2. The circular rotating motions should be moved up and down your forearm, as well as side-to-side. This will ensure complete coverage.


3. Most therapists use as much massage pressure as the patient can bear without it being too uncomfortable.


4. Immediately after your evening massage, warm you hand and wrist with a heating pad. It’s best if you roll the heating pad into a tube so that both sides of your hand & wrist are warmed. You can hold the rolled-up shape with adhesive tape. Use a low or medium heat setting. Heat increases healing blood flow and helps boost the effects of the massage.

rolled up heating pad

Do’s and Don’ts of myofascial massage for carpal tunnel

Follow these 8 easy Steps

Do

1.  Do encourage you and your partner to persist with the therapy. The healing in your wrist joint requires time, and you won’t see changes occurring overnight.


2. Do get into a routine, at an appointed time, and in a quiet place. You can use music or television in the background to help make the time go faster.


3. Do stay positive and upbeat. The 30-day healing process may feel like nothing is happening from one day to the next. But your wrist is healing every day – and time will prove it. Rather than looking for daily changes, try to feel week-to-week changes. That's how you will notice the biggest difference.

vibrating percussion massager

Don't

1. Don’t continually massage over the same spot. Rather, move the rotating thumbs around and around the wrist and lower forearm area. Try to cover as much area as possible.


2. Don’t try to perform myofascial massage for carpal tunnel on yourself. It just won’t work because you need two counter-rotating thumbs to knead the skin and underlying tissues.


3. Don’t skip your twice-daily (morning and evening) massage sessions. Consistency and persistence are the keys. Otherwise, you’re just wasting time.


4. Don’t use a vibration massager on your hand or wrist. Such tools will only make symptoms worse in the long-run.

Summary

Carpal tunnel syndrome occurs because adhesions bog down flexor tendons. This causes tendon inflammation and swelling. The swollen tendons push on the median nerve inside the wrist joint. It's this nerve crushing that causes all of the symptoms of carpal tunnel, like pain and numbness in the fingers and hand. Myofascial massage for carpal tunnel can relieve the symptoms of this disorder without the need for surgery. That's because the massage breaks up the adhesions which caused the problem in the first place. But myofascial massage for carpal tunnel must be performed properly and under the right conditions. 

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