What is carpal tunnel syndrome?

Carpal tunnel syndrome is when the median nerve is compressed as it passes through the carpal tunnel. The carpal tunnel is an opening in your wrist that is formed by the carpal bones on the bottom of the wrist and the transverse carpal ligament across the top of the wrist. The median nerve provides sensory and motor functions to the thumb and 3 middle fingers. If it gets compressed or irritated, you may have symptoms.

Most cases of carpal tunnel syndrome have no specific cause, although any or all of the following may be a contributing factor:

• Frequent, repetitive, small movements with the hands (such as with typing or using a keyboard)
• Frequent, repetitive, grasping movements with the hands (such as with sports and certain physical activities)
• Joint or bone disease (for example, arthritis, osteoarthritis, or rheumatoid arthritis)
• Hormonal or metabolic changes (for example, menopause, pregnancy, or thyroid imbalance)
• Changes in blood sugar levels (may be seen with type 2 diabetes)
• Other conditions or injuries of the wrist (for example, strain, sprain, dislocation, break, or swelling and inflammation)
• Family history of carpal tunnel syndrome

What are the symptoms of carpal tunnel syndrome?

These are the most common symptoms:

• Weakness when gripping objects with one or both hands
• Pain or numbness in one or both hands
• “Pins and needles” feeling in the fingers
• Swollen feeling in the fingers
• Burning or tingling in the fingers, especially the thumb and the index and middle fingers
• Pain or numbness that is worse at night, interrupting sleep

The symptoms of carpal tunnel syndrome may be similar to other medical conditions or problems. Always see your health care provider for a diagnosis.

How is carpal tunnel syndrome diagnosed?

Your provider will check your medical history and give you a physical exam. He or she may recommend that you have electrodiagnostic tests on your nerves. These tests are the best way to diagnose carpal tunnel syndrome. Electrodiagnostic tests stimulate the muscles and nerves in your hand to see how well they work.

Treatment of carpal tunnel syndrome

Your health care provider will figure out the best treatment for you based on:

• Your age
• Your overall health and medical history
• How bad your wrist is right now
• How well you tolerate specific medications, procedures, or therapies
• How bad the disease is expected to get
• Your opinion or preference

Treatment may include:

• Splinting your hand. This helps keep your wrist from moving. It also eases the compression of the nerves inside the tunnel.
• Anti-inflammatory medication. These may be oral or injected into the carpal tunnel space. These reduce the swelling.
• Surgery. This eases compression on the nerves in the carpal tunnel.
• Worksite changes. Changing position of your computer keyboard or making other ergonomic changes can help ease symptoms.
• Exercise. Stretching and strengthening exercises can be helpful in people whose symptoms have gotten better. These exercises may be supervised by a physical or occupational therapist.