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Improved Posture and Stretch Reverse Carpal Tunnel Syndrome and Tendonitis Pain

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By Erik Nieuwenhuis MS, PT St. Luke’s WorkSmart Injury Prevention Specialist and WELLness Consultant 712-279-1842

What happens to your posture after sitting down at your computer workstation or desk for 30 minutes or longer? 

Awkward posture habits at work and home are the leading causes of headaches, carpal tunnel syndrome, lower back pain and tendonitis of the shoulder, elbow, wrists and thumbs. This month, I encourage you to take back control of your musculoskeletal health and improve your daily vitality at work, home and play. 

The forward head and slouched sitting posture is the most common and damaging of all posture habits in the 21st century workplace. This awkward posture can lead to Musculoskeletal Disorders or injuries such as headaches, back pain, shoulder tendonitis, rotator cuff strains or tears, wrist tendonitis and more. 

The great news is that you have the power to reverse and correct the forward head posture and slouched sitting habits, but it takes daily awareness and some work by you. The payoff for your musculoskeletal health and vitality will be huge! 

Forward head posture (FHP) is a round shoulders posture habit. This places the ligaments of the upper back on a sustained stretch, creating mechanical and nutritional stress leading to pain and swelling. The FHP posture also reduces the normal curve of the lower back leading to increased time spent in a “flat back or forward bending” posture. Overtime, this posture increases the risks of muscle fatigue and injury to the lumbar spinal discs. This is very similar to a domino effect. When your head goes forward and down, your spine’s arch changes, increasing muscle fatigue and joint wear and tear. 

How many of you walk with your head down? If you do, change this habit today and keep your head up! This will reverse the negative domino effect detailed above and help to maintain a lordosis or “inward curve” in your lower back. Your whole body: neck, shoulders, arms and lower back will thank you! 

The forward head posture places the neck muscles on the side of your neck and shoulders to face an excessive workload and posture demands daily at work, home and play. This compression of nerves and blood vessels in the neck and shoulder can increase the risk of MSD problems further down the upper extremities overtime. This is called thoracic outlet compression or reduced circulation of the blood supply and nerves to the working upper extremities (elbows, wrists, and hands). 

I have been fortunate and blessed to have discovered a powerful recipe of WorkSmart posture habits and ergonomics, musculoskeletal self-care techniques and lifestyle factors that will reverse and treat nasty Carpal Tunnel Syndrome and Tendonitis complaints; many times without surgery.

  • Improve your computer workstation setup by making sure your monitor is at the correct height (approximately eye level for most people without bifocals or trifocals). If you use a laptop, set your computer on a three-inch binder to raise the monitor height and reduce FHP risks. 
  • Perform daily WorkSmart stretching two to three times per day as detailed below based on your medical history, job and what you do in your free time.
  • Perform the Snakebite technique two to three times each week as needed until your symptoms resolve. 
  • Perform ice massage one to four times daily for 2 to 4 minutes until numb over the inflamed and painful tendons or nerves. 
  • Drink at least 40+ ounces of water daily, working towards half your body weight in ounces.
  • Perform strength training or circuit training with strengthening components two or three more times each week. 

I highly recommend that you perform five important stretches from the St. Luke’s WorkSmart Stretching Plan, at least two to three times per day or up to every hour as needed. These stretches include: reach for the sky, neck stretches (3 positions), chin tuck, and the wrist and elbow stretches with rotation. These will all greatly reduce the MSD risks noted above and help to maintain a good blood supply. 

A median nerve stretch (the carpal tunnel nerve) should also be performed two to three times per day or more as needed. Just the reverse of the wrist stretch, this stretch calls for putting your palm down instead of palm up, and gently pulling back your fingers towards your head. Pull straight back, holding two to three seconds and repeat up to four times. Then do two to four reps of this median nerve stretch with fingers turned in across front of your body and with fingers turned out away from your body at shoulder level. 

Research has shown the median nerve stretch to reverse 50% to 60% of carpal tunnel like symptoms of numbness and tingling to the first four fingers, improve your grip strength and reduce your occasional sharp and stabbing pains. 

Are you sitting up taller now? Improving your lifestyle habits and taking care of the only body you were blessed with will allow you to improve your musculoskeletal health. 


  1. The Work Injury Consulting Practice by Lauren Hebert DPT, OCS 1998.
  2. WorkSmart – The Industrial Athlete Manual by Lauren Hebert DPT, OCS 96’ from IMPACC USA 
  3. Atlas of Human Anatomy by Frank H. Netter, MD Plate 25 The Scalene and Prevertebral Muscles, Ciba 1995 8th Edition. 
  4. Explain Pain course in Lincoln, NE on March 12-13, 2011 by Adriaan Louw, PT, M.App.Sc(physio), GCRM, CSMT.