Initial management of mild carpal tunnel syndrome includes

• A. Immediate surgical intervention
• B. NSAIDs
• C. Physical therapy
• D. Ergonomic changes to relieve pressure or wrist splinting

Answer: (D)

Reducing pressure on the median nerve is the main goal when carpal tunnel syndrome is mild. The best initial step is conservative: keep the wrist in a position that lowers tunnel pressure and lessen repetitive stress through ergonomic changes, with a wrist splint used especially at night. A neutral or slightly extended wrist position prevents the flexed posture that narrows the carpal tunnel, helping relieve symptoms while you sleep and during activities that provoke symptoms. Ergonomic adjustments—like adjusting keyboard and desk height, taking regular breaks, and modifying repetitive hand movements—address the underlying mechanical strain that contributes to compression.

Pain relief from NSAIDs can help comfort, but they don’t fix the compression itself, which is why they’re not the primary management. Physical therapy can be helpful as an adjunct, offering nerve-gliding exercises or targeted hand therapy, but the cornerstone for mild cases remains splinting and reducing provocative activities. Surgery is reserved for persistent or worsening symptoms despite conservative measures, or when there are signs of significant nerve damage.