Carpal Tunnel Syndrome

What Is Carpal Tunnel Syndrome?

Carpal tunnel syndrome, also called median nerve compression, is a condition that causes numbness, tingling, or weakness in your hand.

It happens because of pressure on your median nerve, which runs the length of your arm, goes through a passage in your wrist called the carpal tunnel, and ends in your hand. The median controls the movement and feeling of your thumb and the movement of all your fingers except your pinky.

Carpal Tunnel Syndrome Symptoms

Symptoms of carpal tunnel include:

• Burning, tingling, or itching numbness in your palm and thumb or your index and middle fingers
• Weakness in your hand and trouble holding things
• Shock-like feelings that move into your fingers
• Tingling that moves up into your arm

You might first notice that your fingers "fall asleep" and become numb at night. It usually happens because of how you hold your hand while you sleep.

In the morning, you may wake up with numbness and tingling in your hands that may run all the way to your shoulder. During the day, your symptoms might flare up while you’re holding something with your wrist bent, like when you’re driving or reading a book.

Early on in the condition, shaking out your hands might help you feel better. But after some time, it may not make the numbness go away.

As carpal tunnel syndrome gets worse, you may have less grip strength because the muscles in your hand shrink. You’ll also have more pain and muscle cramping.

Your median nerve can’t work the way it should because of the irritation or pressure around it. This leads to:

• Slower nerve impulses
• Less feeling in your fingers
• Less strength and coordination, especially the ability to use your thumb to pinch

Carpal Tunnel Syndrome Causes

Often, people don't know what brought on their carpal tunnel syndrome. It can be due to:

• Repetitive motions, like typing, or any wrist movements that you do over and over. This is especially true of things you do when your hands are lower than your wrists.
• Conditions like hypothyroidism, obesity, rheumatoid arthritis, and diabetes
• Pregnancy

Carpal Tunnel Syndrome Risk Factors

You might have a higher risk of getting carpal tunnel syndrome if you:

• Are a woman. Women are three times more likely than men to get it. This might be because they tend to have smaller carpal tunnels.
• Have a family member with small carpal tunnels
• Have a job in which you make the same motions with your arm, hand, or wrist over and over, such as an assembly line worker, sewer or knitter, baker, cashier, hairstylist, or musician
• Fracture or dislocate your wrist

Carpal Tunnel Syndrome Diagnosis and Tests

Your doctor may tap the palm side of your wrist, a test called Tinel sign, or fully flex your wrist with your arms extended. They might also do tests including:

• Imaging tests. X-rays, ultrasounds, or MRI exams can let your doctor look at your bones and tissues.
• Electromyogram. Your doctor puts a thin electrode into a muscle to measure its electrical activity.
• Nerve conduction studies. Your doctor tapes electrodes to your skin to measure the signals in the nerves of your hand and arm.

Carpal Tunnel Syndrome Treatment

Your treatment will depend on your symptoms and how far your condition has progressed. You might need:

• Lifestyle changes. If repetitive motion is causing your symptoms, take breaks more often or do a bit less of the activity that’s causing you pain.
• Exercises. Stretching or strengthening moves can make you feel better. Nerve gliding exercises can help the nerve move better within your carpal tunnel.
• Immobilization. Your doctor may tell you to wear a splint to keep your wrist from moving and to lessen pressure on your nerves. You may wear one at night to help get rid of that numbness or tingling feeling. This can help you sleep better and rest your median nerve.
• Medication. Your doctor may give you anti-inflammatory drugs or steroid shots to curb swelling.
• Surgery. If none of those treatments works, you might have an operation called carpal tunnel release that increases the size of the tunnel and eases the pressure on your nerve.

Carpal Tunnel Syndrome Complications

If you have carpal tunnel syndrome and don't treat it, the symptoms can last a long time and get worse. They could also go away and then come back. When you get a diagnosis early, the condition is easier to treat. You can avoid permanent muscle damage and keep your hand working the way it should.

Carpal Tunnel Syndrome Prevention

To avoid carpal tunnel syndrome, try to:

• Keep your wrists straight.
• Use a splint or brace that helps keep your wrist in a neutral position.
• Avoid flexing and extending your wrists over and over again.
• Keep your hands warm.
• Take breaks whenever you can.
• Put your hands and wrists in the right position while you work.

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