What is carpal tunnel syndrome?

Carpal tunnel syndrome is a condition that causes problems in your hand and wrist. It happens when the median nerve is squeezed (compressed) as it passes through the carpal tunnel. The carpal tunnel is an opening inside your wrist. It is formed by the carpal (wrist) bones underneath the median nerve and the transverse carpal ligament across the top of the median nerve. The median nerve provides sensory and motor functions to the thumb and three middle fingers. If it gets compressed or irritated, you may have symptoms.

What causes carpal tunnel syndrome?

Most cases of carpal tunnel syndrome have no specific cause. Things that may be part of the cause include:

• Frequent, repetitive, small movements with the hands, such as typing or using a keyboard.

• Frequent, repetitive, grasping movements with the hands, such as with sports and certain physical activities.

• Joint or bone disease. Examples are arthritis, osteoarthritis, and rheumatoid arthritis.

• Hormonal or metabolic changes. Examples are menopause, pregnancy, and thyroid imbalance.

• Changes in blood sugar levels, like with type 2 diabetes.

• Other conditions or injuries of the wrist. Examples are strain, sprain, dislocation, break, and swelling and inflammation.

• Family history of carpal tunnel syndrome.

Who is at risk for carpal tunnel syndrome?

Women get carpal tunnel syndrome 3 times more often than men. The risk increases during pregnancy. It generally occurs only in adults. You may be at risk if you have an underlying health problem, such as diabetes or kidney failure. These conditions put you at risk for nerve compression, including carpal tunnel syndrome.

What are the symptoms of carpal tunnel syndrome?

The most common symptoms include:

• 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 seem like other health conditions or problems. Always see your doctor for a diagnosis.

How is carpal tunnel syndrome diagnosed?

Your doctor will check your health history and give you a physical exam. They may advise electrodiagnostic tests on your nerves. These tests are also known as nerve conduction studies and electromyography. They are the best way to diagnose carpal tunnel syndrome. The tests stimulate the muscles and nerves in your hand to see how well they work. Ultrasound can also diagnose carpal tunnel in many people.

How is carpal tunnel syndrome treated?

Your doctor will discuss different treatment choices with you. Treatment will depend on your symptoms, age, and general health. It will also depend on how bad the condition is.

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 medicines. These are taken by mouth (oral) or injected into the carpal tunnel space. These ease the swelling.

• Work area changes. Changing the position of your computer keyboard or making other ergonomic changes can help ease symptoms.

• Exercise. Stretching and strengthening exercises can help when your symptoms are better. A physical or occupational therapist may watch you do the exercises. Yoga can also help.

• Surgery. You may need surgery if the condition doesn’t get better with other treatments or go away on its own. This surgery is called carpal tunnel release. This eases compression on the nerves in the carpal tunnel.

Key points about carpal tunnel syndrome

• Carpal tunnel syndrome happens when the median nerve is squeezed (compressed) as it passes through the carpal tunnel in the wrist.

• Women get carpal tunnel syndrome 3 times more often than men. It generally occurs only in adults.

• Symptoms include weakness when gripping objects, pain or numbness in hands, and a “pins and needles” feeling in the fingers.

• To diagnose carpal tunnel syndrome, you may have electrodiagnostic tests. These tests stimulate the muscles and nerves in your hand to see how well they work.

• Treatment may include splinting your hand, medicines, work area changes, exercise, or surgery.

Next steps

Tips to help you get the most from a visit to your doctor:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your doctor tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new directions your doctor gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your doctor if you have questions, especially after office hours or on weekends.