Four patients with carpal tunnel syndrome, unresponsive to routine conservative care, underwent treatment with myofascial release manipulation and self-stretching. Magnetic resonance imaging analysis of the cross-sectional area of the carpal tunnel and electrodiagnosis were performed before and after treatment. The patients improved clinically. The nerve conduction studies showed concomitant reduction in distal latencies or increase in motor response amplitudes. Magnetic resonance imaging demonstrated that the anteroposterior and transverse dimensions of the carpal canal significantly increased after treatment. This study demonstrates that the carpal canal is a distensible structure with the potential to yield to a relatively simple, aggressive, nonsurgical treatment for carpal tunnel syndrome.