Carpal Tunnel Syndrome

Carpal tunnel syndrome occurs when the median nerve to the hand is compressed as it passes through an opening between the wrist and the palm. Compression is often caused by swelling of the tendons and can be associated with repetitive motions like typing. Women experience carpal tunnel syndrome three times more often than men do.

What You Need to Know

  • Carpal tunnel syndrome is characterized by numbness and tingling in the thumb and fingers as well as possible hand pain.
  • The surgery to fix carpal tunnel syndrome is called carpal tunnel release. It is among the most common surgeries performed each year in the United States.
  • Carpal tunnel syndrome may be caused by sports and physical activities that require grasping (such as tennis), joint or bone diseases like arthritis or hormonal changes or imbalances, such as menopause or thyroid dysfunction.
  • If you have pain in the wrist or palm area, it may be caused by something besides carpal tunnel syndrome. You should see a medical professional to rule out other causes.
  • You may not need surgery to relieve the pain of carpal tunnel syndrome. Sometimes environmental remedies like creating an ergonomic work environment that promotes good posture can alleviate symptoms.

What is carpal tunnel syndrome?

Hand and wrist showing a normal carpal tunnel and the compressed median nerve in an inflamed carpal tunnel.

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.

This condition is a painful compression of a nerve in the wrist that can interfere with a person’s ability to use the wrist and the hand. Carpal tunnel syndrome is a progressive condition that can worsen without proper care.

Facts about carpal tunnel syndrome

Carpal tunnel release is one of the most common surgeries done in the U.S. Women get carpal tunnel syndrome 3 times more often than men. It usually occurs only in adults.

What causes carpal tunnel syndrome?

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)

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.
Endoscopic carpal tunnel surgery

Surgery for carpal tunnel syndrome

Surgery for carpal tunnel syndrome is usually done as an outpatient. Two types of carpal tunnel surgery are done: open surgery and endoscopic surgery. You may have local or general anesthesia, or both, for either surgery.

During open surgery, the surgeon cuts open your wrist. The tissue that is pressing on the nerves is cut. This relieves the pressure on the nerve.

During endoscopic surgery, the surgeon puts a long, thin rod through a tiny cut on the wrist. The rod, or scope, contains a camera and a light. The scope lets the surgeon to see inside your wrist. He or she cuts the tissue using tiny surgical tools.

After the surgery, your hand and wrist are wrapped and put into a splint. This will help to keep you from moving your wrist during your recovery. You will need to wear the splint for a week or two. You will probably have some pain after your surgery. It’s usually controlled with pain medication taken by mouth. You may also be told to sleep with your hand elevated to help ease swelling.

Recovery from carpal tunnel surgery is different for each person. If your nerve has been compressed for a long time, recovery may take longer. You will be encouraged to move your fingers and wrist a few days after surgery to help prevent stiffness.

You may need to adjust your work or home activities while you recover. Talk with your doctor about what you need to change.



Where is my carpal tunnel located?

Turn your hand so it’s facing you and bend your wrist. Your hand will come toward you. Your carpal tunnel is found in the area where your wrist bends.

What exactly is carpal tunnel syndrome?

Simply put, it’s a pinched nerve. Carpal tunnel syndrome happens when something causes swelling in this area and the swelling puts pressure the median nerve that travels through your wrist.

Why does carpal tunnel syndrome happen?

We don’t always know exactly why it happens. Many times it can be a combination of reasons. Research tells us you are more likely to get carpal tunnel syndrome if you:

  • Are pregnant (from fluid retention)
  • Had a wrist dislocation or fracture
  • Have arthritis
  • Have a thyroid condition
  • Have diabetes

What are common symptoms?

Symptoms can vary from person to person. Common symptoms include:

  • Pain
  • Numbness
  • Tingling
  • Weakness in the arm, hand, and fingers

Early on, symptoms are gradual and inconsistent. They may become worse depending on what you are doing and go away when those activities end. You may experience symptoms more at night. In advanced cases, symptoms can be nearly constant and very bothersome.

What are my treatment options?

Once it’s confirmed you have carpal tunnel syndrome, your doctor will explain all the treatment options that will be most successful for your unique situation. Together, you and your doctor will create an individualized treatment plan for your specific needs. The good news is that symptoms may often be relieved without surgery.

Your custom treatment plan may include:

  • Anti-inflammatory medications
  • Bracing
  • Physical therapy
  • Cortisone injections to reduce swelling
  • Surgery

What can I expect the results to be after treatment?

Everyone responds to treatment differently. The primary focus is to reduce swelling in the wrist around the nerve and decrease the pressure placed on it. The goal of treatment is to decrease or eliminate your symptoms and get your function back.

How long until I’m better?

There is a broad range of severity of this condition and recovery time varies. Talk to your doctor about what you can expect with your specific situation. When surgery is recommended, it usually takes several months to get your strength back to normal.