Median nerve glide (six hand positions, for carpal tunnel)

How to move

1. Sit tall. Bend your elbow at your side so your forearm points forward, palm facing you, and make a loose fist with the thumb outside the fingers, wrist straight.
2. Straighten the fingers, keeping the thumb beside the index finger.
3. Keeping the fingers straight, bend the wrist back.
4. Keeping the wrist and fingers there, take the thumb out to the side.
5. Turn the forearm so the palm faces up.
6. Use the other hand to ease the thumb gently a little further out, then go back to the loose fist.
7. Pause in each position, and stop at the first sense of a pull or tingle; it should never hurt.

Form cues

• One step at a time: stop at the step where you first feel a pull.
• Keep the shoulder relaxed and keep breathing.
• Avoid: jumping straight to the last position, pushing into tingling, or straightening the elbow and tilting your head away at the same time, which pulls the nerve tight along its whole length.

Practice and cautions

Hold each position for about 7 seconds, 5 times through, 3 times a day: the protocol in a carpal tunnel trial (both groups in that trial did the glides, so it shows the dose, not the effect). In reviews, nerve glides improved carpal tunnel pain and function a little in the short term, on very low-certainty evidence, and they don't improve long-term outcomes.

A little extra tingling is expected but should fade within an hour; if it doesn't, do fewer or stop. Stop and see a GP if numbness becomes constant or spreads, or the thumb gets weaker. Skip the last step if the base of the thumb is arthritic or the thumb side of the wrist is sore (de Quervain's). It doesn't replace a night splint, or getting help when symptoms persist. This is movement education, not an assessment or treatment prescription. Stop for sharp or increasing pain, dizziness, or numbness or tingling that spreads, lasts more than an hour or comes with weakness; seek individual guidance for symptoms, injury or restrictions.