Carpal tunnel syndrome is caused by pressure on the median nerve. The carpal tunnel is a narrow passageway surrounded by bones and ligaments on the palm side of your hand. When the median nerve is compressed, the symptoms can include numbness, tingling and weakness in the hand and arm.
The anatomy of your wrist, health problems and possibly repetitive hand motions can contribute to carpal tunnel syndrome.
Proper treatment usually relieves the tingling and numbness and restores wrist and hand function.
Carpal tunnel syndrome symptoms usually start gradually and include:
Tingling or numbness. You may notice tingling and numbness in your fingers or hand. Usually the thumb and index, middle or ring fingers are affected, but not your little finger. You might feel a sensation like an electric shock in these fingers.
The sensation may travel from your wrist up your arm. These symptoms often occur while holding a steering wheel, phone or newspaper, or may wake you from sleep.
Many people “shake out” their hands to try to relieve their symptoms. The numb feeling may become constant over time.
- Weakness. You may experience weakness in your hand and drop objects. This may be due to the numbness in your hand or weakness of the thumb’s pinching muscles, which are also controlled by the median nerve.
When to see a doctor
See your doctor if you have signs and symptoms of carpal tunnel syndrome that interfere with your normal activities and sleep patterns. Permanent nerve and muscle damage can occur without treatment.
Carpal tunnel syndrome is caused by pressure on the median nerve.
The median nerve runs from your forearm through a passageway in your wrist (carpal tunnel) to your hand. It provides sensation to the palm side of your thumb and fingers, except the little finger. It also provides nerve signals to move the muscles around the base of your thumb (motor function).
Anything that squeezes or irritates the median nerve in the carpal tunnel space may lead to carpal tunnel syndrome. A wrist fracture can narrow the carpal tunnel and irritate the nerve, as can the swelling and inflammation caused by rheumatoid arthritis.
Many times, there is no single cause of carpal tunnel syndrome. It may be that a combination of risk factors contributes to the development of the condition.
A number of factors have been associated with carpal tunnel syndrome. Although they may not directly cause carpal tunnel syndrome, they may increase the risk of irritation or damage to the median nerve. These include:
- Nerve-damaging conditions.
- Inflammatory conditions.
- Body fluid changes.
- Other medical conditions.
There are no proven strategies to prevent carpal tunnel syndrome, but you can minimize stress on your hands and wrists with these methods:
- Reduce your force and relax your grip.
- Take short, frequent breaks.
- Watch your form.
- Improve your posture.
- Change your computer mouse.
- Keep your hands warm.
Your doctor may ask you questions and conduct one or more of the following tests to determine whether you have carpal tunnel syndrome:
History of symptoms.
- Nerve conduction study.
Treat carpal tunnel syndrome as early as possible after symptoms start. In the early stages, simple things that you can do for yourself may make the problem go away. For example:
- Take more-frequent breaks to rest your hands.
- Avoid activities that make symptoms worse.
- Apply cold packs to reduce swelling.
Other treatment options include wrist splinting, medications and surgery. Splinting and other conservative treatments are more likely to help if you’ve had only mild to moderate symptoms that come and go for less than 10 months. If you have numbness in your hands, you need to see a doctor.
If the condition is diagnosed early, nonsurgical methods may help improve carpal tunnel syndrome, including:
- Wrist splinting.
Nonsteroidal anti-inflammatory drugs (NSAIDs).
If carpal tunnel syndrome is caused by rheumatoid arthritis or another inflammatory arthritis, then treating the arthritis may reduce symptoms of carpal tunnel syndrome. However, this is unproved.
Surgery may be appropriate if your symptoms are severe or don’t respond to other treatments. The goal of carpal tunnel surgery is to relieve pressure by cutting the ligament pressing on the median nerve.
The surgery may be performed with two different techniques:
- Open surgery.
Discuss the risks and benefits of each technique with your surgeon before surgery. Surgery risks may include:
- Incomplete release of the ligament
- Wound infections
- Scar formation
- Injuries to the nerves or blood vessels
Integrate alternative therapies into your treatment plan to help you cope with carpal tunnel syndrome. You may have to experiment to find a treatment that works for you. Always check with your doctor before trying any complementary or alternative treatment.
- Yoga. Yoga postures designed for strengthening, stretching and balancing the upper body and joints may help reduce pain and improve grip strength.
- Hand therapy. Early research suggests that certain physical and occupational hand therapy techniques may reduce symptoms of carpal tunnel syndrome.
- Ultrasound therapy. High-intensity ultrasound can be used to raise the temperature of a targeted area of body tissue to reduce pain and promote healing. Research shows inconsistent results with this therapy, but a course of ultrasound therapy over several weeks may help reduce symptoms.
Lifestyle and home remedies
These steps may provide temporary symptom relief:
- Take short, frequent breaks from repetitive activities involving the use of your hands.
- Lose weight if you are overweight or obese.
- Rotate your wrists and stretch your palms and fingers.
- Take a pain reliever
- Wear a snug, not tight, wrist splint at night. You can find these over-the-counter at most drugstores or pharmacies.
- Avoid sleeping on your hands.
If pain, numbness or weakness recurs and persists, see your doctor.