Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

The word Carpus comes from the Greek word "karpos" meaning "wrist." Your wrist is surrounded by bands of fibrous tissue that support the joint. The small space between this fibrous band and the wrist bone is called the carpal tunnel.

The median nerve passes through this tunnel to provide sensation to your thumb, index finger, and middle finger. Any condition causing swelling or tissue displacement within the carpal tunnel can squeeze and irritate this nerve.

When the median nerve is irritated, you experience the classic symptoms: tingling, numbness, and pain in the thumb, index finger, and middle finger. Left untreated, this can progress to weakness, muscle atrophy, and permanent nerve damage.

The Anatomy

Carpal Tunnel: A narrow passageway on the palm side of the wrist
Median Nerve: Controls sensation and movement in thumb and first three fingers
Flexor Tendons: Nine tendons that bend your fingers pass through the tunnel
Transverse Carpal Ligament: The "roof" of the tunnel that can't expand

Because the tunnel can't expand, any swelling inside it compresses the median nerve against the ligament—causing the symptoms of carpal tunnel syndrome.

Recognizing the Symptoms

Early Stage

Numbness or tingling in thumb, index, and middle fingers
Symptoms that come and go, often worse at night
Waking up with numb hands, needing to "shake them out"
Tingling when holding a phone, steering wheel, or book
Occasional dropping of objects

Progressed Stage

Constant numbness or tingling
Pain radiating up the forearm toward the shoulder
Weakness in the hand, difficulty gripping
Muscle wasting at the base of the thumb (thenar atrophy)
Difficulty with fine motor tasks (buttoning shirts, picking up small objects)

Severe/Chronic Stage

Permanent numbness
Significant muscle atrophy
Loss of grip strength
Inability to distinguish hot from cold by touch
Chronic pain affecting sleep and daily activities

Early intervention is critical. The longer the median nerve remains compressed, the more likely permanent damage becomes. If you're experiencing symptoms, don't wait to seek treatment.

What Causes Carpal Tunnel Syndrome?

For most patients, the exact cause remains unknown. However, any physical condition that puts pressure on the median nerve at the wrist can trigger carpal tunnel syndrome. The causes generally fall into three categories:

Medical Conditions

Underlying health issues that cause swelling, fluid retention, or changes in tissue composition can narrow the carpal tunnel:

Pregnancy: Fluid retention and swelling, especially in third trimester
Obesity: Increased pressure on the nerve and reduced blood flow
Hypothyroidism: Causes tissue swelling throughout the body
Diabetes: Can cause nerve damage and increased susceptibility
Rheumatoid Arthritis: Inflammation affects the tendons in the tunnel
Menopause: Hormonal changes can cause fluid retention

Repetitive Stress Injuries

Repetitive hand and wrist motions cause tendon inflammation that crowds the carpal tunnel. This is sometimes called repetitive strain injury (RSI):

Computer Work: Repetitive typing and mouse operation
Assembly Line Work: Repetitive gripping, twisting, or grasping
Power Tool Use: Vibration and repetitive gripping
Sports: Tennis, golf, racquetball—anything with repetitive wrist motion
Music: Piano, guitar, violin—hours of repetitive finger movements
Crafts: Knitting, sewing, woodworking

Trauma & Rare Conditions

Direct injury or rare diseases can also cause or contribute to carpal tunnel syndrome:

Wrist Fractures: Can narrow the tunnel or cause scar tissue
Dislocations: Misalignment puts pressure on the nerve
Sarcoidosis: Inflammatory disease affecting multiple organs
Amyloidosis: Abnormal protein deposits in tissues
Multiple Myeloma: Blood cancer affecting bone marrow
Leukemia: Can cause abnormal tissue deposits

Risk Factors That Increase Your Chances

Gender Women are 3x more likely to develop CTS (smaller carpal tunnels)

Age Most common between ages 40-60

Genetics Smaller carpal tunnels can run in families

Occupation Jobs requiring repetitive wrist flexion or vibrating tools

What About Tarsal Tunnel Syndrome?

The anatomy of the wrist and hand is remarkably similar to the ankle and foot. Tarsal comes from the Latin word "tarsus" meaning ankle. Just as the carpal tunnel exists in the wrist, the tarsal tunnel exists in the ankle.

If the sensory nerve passing through the tarsal tunnel (the posterior tibial nerve) becomes irritated by pressure, you'll experience numbness and tingling in the foot and toes—the same mechanism as carpal tunnel, just in a different location.

Tarsal tunnel syndrome is less common than carpal tunnel syndrome, but it responds to the same treatments—including cold laser therapy. The protocols are similar, adapted for the different anatomy of the ankle.

Traditional Treatment Options

Before we discuss laser therapy, it's important to understand the full spectrum of treatment options. Many patients try several approaches before finding what works for them—and laser therapy can be used alongside most other treatments.

Conservative Treatments

Wrist Splinting: Especially at night to keep wrist neutral
Activity Modification: Reducing or changing activities that worsen symptoms
Ergonomic Adjustments: Better workstation setup, keyboard positioning
Ice/Heat: Reducing inflammation and improving blood flow
Rest: Giving the inflamed tissues time to heal

Medical Interventions

NSAIDs: Anti-inflammatory drugs (ibuprofen, naproxen)
Corticosteroid Injections: Direct injection into the carpal tunnel
Oral Steroids: Short-term use to reduce inflammation
Diuretics: If fluid retention is contributing

Physical & Alternative Therapies

Physical Therapy: Stretching, strengthening, nerve gliding exercises
Acupuncture: Some patients report relief
Yoga: Stretching and strengthening exercises
Ultrasound Therapy: Deep tissue heating
Cold Laser Therapy: Photobiomodulation (detailed below)

Surgical Options

Carpal Tunnel Release: Cutting the transverse carpal ligament
Endoscopic Surgery: Minimally invasive approach
Open Surgery: Traditional approach with larger incision

Surgery is typically reserved for severe cases or when conservative treatments fail after 6+ months. Success rates are high, but recovery takes weeks to months.

Cold Laser Therapy for Carpal Tunnel

Cold laser treatment can be very effective in treating carpal tunnel syndrome. Unlike many conditions where we're cautious about recommending laser therapy, carpal tunnel shows a high success rate for patients willing to follow the full protocol.

How Laser Therapy Treats Carpal Tunnel

Reduces Inflammation

Laser energy penetrates deep into the wrist and forearm tissue, reducing the swelling that's compressing the median nerve. This addresses the root cause, not just the symptoms.

Stimulates Cell Repair

Photobiomodulation increases ATP production in damaged cells, accelerating the natural healing process for inflamed tendons and irritated nerve tissue.

Improves Blood Flow

Enhanced circulation brings more oxygen and nutrients to the damaged area while removing inflammatory waste products more efficiently.

Relieves Pain

Laser therapy triggers endorphin release and blocks pain signal transmission, providing relief while the underlying condition heals.

Treatment Protocol Considerations

Because the affected area in carpal tunnel syndrome can be quite large—spanning the wrist, palm, and sometimes extending into the forearm—a larger treatment head is recommended to ensure laser energy reaches all affected areas efficiently.

Treatment typically involves:

Direct treatment over the carpal tunnel (palm side of wrist)
Treatment of the forearm flexor muscles (often involved in the inflammation)
Treatment along the path of the median nerve
Sessions typically 2-3 times per week initially
Course of treatment usually 6-12 sessions depending on severity

The Critical Factor: Rest

Here's the honest truth about laser therapy for carpal tunnel: the hardest part of the protocol isn't the treatment—it's drastically reducing use of the damaged area until it stabilizes.

Most athletes go back to their sport as soon as pain subsides, then re-injure the area repeatedly so it never fully recovers. If the injury is work-related, it's extremely difficult to stop re-damaging the area.

This doesn't diminish laser therapy's effectiveness—it works. But it does mean laser therapy alone isn't a perfect solution if you can't also modify the activities causing the problem.

Why We Recommend Laser for Carpal Tunnel

If you browse other condition-specific articles on this site, you'll notice we don't always recommend laser therapy—unless the efficacy is high enough to justify it. Carpal tunnel is different.

We see a high success rate treating carpal tunnel in patients who:

Follow the full treatment protocol (don't stop after a few sessions)
Drastically reduce activities that stress the wrist during treatment
Use proper ergonomics and splinting as adjunct therapy
Give the tissue time to stabilize before returning to full activity

Cold laser therapy can be used in conjunction with all other treatments—physical therapy, splinting, anti-inflammatory drugs, and even as part of post-surgical recovery.

Recommended Lasers for Carpal Tunnel

For carpal tunnel treatment, you want adequate power to penetrate to the median nerve (not extremely deep, but through several layers of tissue), appropriate wavelengths for inflammation and nerve tissue, and ideally a broader treatment head to cover the entire affected area efficiently.

Professional Choice

Class 4 Lasers

For practitioners treating multiple carpal tunnel patients, Class 4 systems like the EVOlaser or ReGen Laser offer faster treatment times and deeper penetration. The higher power means you can treat the entire wrist/forearm area in 5-10 minutes rather than 20-30.

View Class 4 Options

Home Use

Class 3B Lasers

For home treatment or clinical use where Class 4 isn't necessary, the Avant LZ30 series provides excellent results. The dual wavelength (808nm IR + 637nm Red) addresses both deep tissue and surface inflammation. Treatment times are longer but results are comparable.

View Class 3B Options

Budget Option

TerraQuant/MR4

The super-pulsed technology of the TerraQuant series can be effective for carpal tunnel, especially for home users prioritizing safety. The MR4 Activ or LaserStim models work well for self-treatment protocols.

View TerraQuant Options

Prevention & Long-Term Management

Ergonomic Best Practices

Keep wrists neutral (not bent up or down) while typing
Position keyboard and mouse at elbow height
Use a wrist rest for support during pauses, not while typing
Take breaks every 20-30 minutes to stretch
Consider ergonomic keyboards and vertical mice
Ensure adequate lighting to prevent hunching forward

Exercises & Stretches

Wrist Flexor Stretch: Extend arm, pull fingers back gently
Wrist Extensor Stretch: Extend arm, pull fingers down gently
Nerve Gliding: Specific exercises to mobilize the median nerve
Tendon Gliding: Moving fingers through specific positions
Wrist Circles: Gentle rotation in both directions
Grip Strengthening: Once acute phase has passed

Lifestyle Modifications

Maintain healthy weight to reduce overall inflammation
Manage underlying conditions (diabetes, thyroid, arthritis)
Avoid sleeping on your hands or with wrists bent
Use night splints to keep wrists neutral during sleep
Stay hydrated to maintain healthy tissue
Consider anti-inflammatory diet modifications

Frequently Asked Questions

How quickly will I see results from laser therapy?

Many patients notice improvement within the first few sessions—reduced tingling, better sleep, less pain. However, full resolution typically requires 6-12 sessions over several weeks, and you must reduce activities that stress the wrist during this time. Rushing back to full activity too soon is the most common reason for treatment "failure."

Can laser therapy help if I've already had surgery?

Yes. Laser therapy can accelerate post-surgical healing, reduce scar tissue formation, and help with residual symptoms that sometimes persist after carpal tunnel release surgery. It's also useful if symptoms return months or years after surgery.

Is laser therapy a permanent fix?

Laser therapy treats the current inflammation and nerve irritation. If you return to the activities that caused the problem without modification, symptoms will likely return. Long-term success requires combining laser therapy with ergonomic changes, exercises, and possibly ongoing maintenance treatments.

Can I treat myself at home?

Yes, home treatment is effective for carpal tunnel. Many of our customers successfully treat themselves with Class 3B lasers like the Avant LZ30 Home or TerraQuant systems. The key is consistency—treating regularly as directed rather than sporadically.

Should I use laser therapy instead of surgery?

Laser therapy is worth trying before surgery for mild to moderate cases. Surgery is typically reserved for severe cases or when conservative treatments (including laser) fail after 6+ months. However, if you have significant muscle wasting or constant numbness, don't delay surgical consultation—permanent nerve damage is possible if compression continues too long.

What wavelength is best for carpal tunnel?

The 800-860nm range (infrared) provides good penetration to the median nerve and surrounding tissues. Adding 630-660nm (red) helps with surface inflammation and tendon issues. Dual wavelength systems like the Avant series are ideal because they address both deep and superficial components of the condition.

Carpal Tunnel Syndrome & Laser Therapy