Carpal Tunnel Syndrome Without Surgery: Why the Palmaris Longus Is the Muscle to Release
What carpal tunnel syndrome feels like
Numbness and tingling in the thumb, index and middle fingers, worse at night or after a day at the keyboard. A hand that goes to sleep on the steering wheel. Weak grip, dropped objects, a dull ache that runs from the palm up the inside of the forearm to the elbow. The standard explanation is that the median nerve is being compressed inside the carpal tunnel at the wrist, and the standard treatments are a splint, a cortisone injection, and finally surgery to cut the ligament over the tunnel and make room.
What is actually pulling the tunnel shut
In Releasology's experience the room is missing for a specific mechanical reason. The palmaris longus originates at the medial epicondyle on the inside of the elbow, runs down the front of the forearm and inserts onto the bases of three metacarpal bones in the palm. When it fatigues into spasm from gripping, typing, tools, racquets or instruments, it shortens and pulls the distal carpal ridge down into the ventral plane of the wrist. That crunches everything inside the carpal tunnel and shuts the median nerve down completely. The same pull at the other end of the muscle inflames its origin at the elbow, which is golfer's elbow (medial epicondylitis). Carpal tunnel syndrome and golfer's elbow are one muscle. In our experience every case of true carpal tunnel syndrome is a palmaris longus in spasm.
What the release does
The palmaris longus does not need to be cut; it needs to be released. Modality 21 releases it by hand along its full length from the medial epicondyle to the palm. When it lets go the carpal bones lift back out of the tunnel, and the wrist usually gives a series of cracks like a chiropractic adjustment as the distal carpal ridge moves back to where it belongs. The numbness clears as the nerve comes back on line. The modality also teaches a self-release for maintenance, because the muscle that fatigued once from keyboard or tool work will fatigue again.
Why the pronators are not the whole story
The pronator teres and pronator quadratus also press on the median nerve on its way to the hand, and they are released when they are involved (Modality 23). But they produce discomfort, aching and irritation rather than the full syndrome with the hand going numb. When a client has both rotation pain (turning a key, a doorknob, a jar lid) and numbness, both groups are released, but the palmaris longus is the one that closes the tunnel.
When the source is higher up
Sometimes the forearm keeps re-spasming because the nerve supply to it is pinched above. The radial nerve runs under the axillary-radial noose at the back of the shoulder (Modality 19), and the brachial plexus itself passes through the scalenus anterior in the neck (Modality 03). A practitioner works on the source, works around the source, and then focuses back in until every muscle in the chain releases.
When to see a physician
Persistent numbness with visible wasting of the muscles at the base of the thumb should be evaluated by a physician, as should any sudden loss of sensation or strength. Releasology is hands-on muscle release, not a medical diagnosis.
The Releasology modality for this
Modality 21 · Carpal tunnel and golfer's elbow: palmaris longus release. Read what the release relieves, the FAQ, and the free preview lesson on that page.
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Frequently asked questions
Can carpal tunnel be released without surgery?
In our experience yes, because the compression comes from the palmaris longus in spasm pulling the carpal ridge into the tunnel. Release the muscle and the room in the tunnel comes back without cutting anything.
Why does the wrist crack during the release?
The palmaris longus had pulled the distal carpal bones down into the ventral plane of the wrist. When the muscle releases the bones move back into place, and that movement is the crack. It is the tunnel reopening.
Is golfer's elbow related?
It is the same muscle. The palmaris longus pulls on its origin at the inside of the elbow and on its insertion in the palm at the same time, so golfer's elbow and carpal tunnel very often arrive together and leave together.
Releasology is hands-on muscle release taught and practised in Los Gatos, California by Royal Jacobs and certified practitioners. It is not medical diagnosis or treatment. Book a session or see all 78 conditions.
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