Carpal tunnel syndrome is a painful disorder of the hand caused by pressure on nerves that run through the wrist. Symptoms include numbness, pins and needles, and pain particularly at night. Anything that causes swelling inside the wrist can cause carpal tunnel syndrome, including repetitive hand movements, pregnancy and arthritis. Possible treatments include rest, splinting, cortisone injections and surgery. The carpal tunnel The carpal tunnel is a narrow passageway in the wrist, which opens into the hand.
It is surrounded by the bones of the wrist underneath and the transverse carpal ligament across the top. The median nerve runs through the carpal tunnel and gives feeling to the thumb, forefinger, middle finger and half of the ring finger.
Many tendons also pass through this carpal tunnel and if any swelling occurs, the large median nerve can easily be compressed, causing carpal tunnel syndrome. Flexor tendons run through the carpal tunnel into the hand. These tendons are covered by a smooth membrane called the tenosynovium and allow hand movement. Any thickening from inflamed tendons or other causes of swelling can reduce the amount of space inside the carpal tunnel.
If left unchecked, the median nerve is squashed against the transverse carpal ligament until the nerve cannot function properly. Numbness and pain are the result. It can affect one or both hands.
The muscles of the thumb are also serviced by the median nerve. A person with advanced carpal tunnel syndrome may find they cannot properly use or move their thumb any more, and may find it difficult to grasp objects. Symptoms of carpal tunnel syndrome The symptoms of carpal tunnel syndrome include: Numbness Pins and needles Pain, particularly at night Darting pains from the wrist Radiated or referred pain into the arm and shoulder Weakness of the hand The little finger and half of the ring finger are unaffected.
Causes of carpal tunnel syndrome In some cases the cause cannot be found. Sometimes there is a combination of factors such as: Arthritis — various types of arthritis, especially rheumatoid arthritis, can cause inflammation and swelling Pregnancy — the hormones associated with pregnancy cause general fluid retention, which can compress the nerve.
Carpal tunnel syndrome triggered by pregnancy usually goes away soon after birth Wrist fractures — bone fragments can irritate the tenosynovium or reduce the amount of space in the carpal tunnel Congenital factors — some people have a smaller carpal tunnel than others Overuse injury — the tendons in the carpal tunnel can become irritated and inflamed by awkward postures or repetitive hand movements. Risk factors of carpal tunnel syndrome Some people are at higher risk of developing carpal tunnel syndrome, including: Women between the ages of 40 and 60 years Pregnant women People with certain types of arthritis Anyone who experiences a period of rapid weight gain People who use their hands repetitively in their day-to-day activities, such as typists or assembly line workers.
At first, the pain and stiffness may be slight. But they may increase until your hand hurts all the time. You can suffer permanent damage if the cause is not addressed. Surgery for carpal tunnel syndrome Surgery is one treatment option for carpel tunnel syndrome.
The surgeon makes an incision cut less than 5 cm long in your palm, and perhaps into the wrist as well, to expose the transverse carpal ligament. Paying careful attention to hand posture and avoiding activities that overextend your wrist are also important strategies for reducing symptoms.
Physical therapy exercises may be helpful as well. Treating your carpal tunnel syndrome early with physical therapy and lifestyle changes can lead to significant long-term improvement, and eliminate symptoms. Although unlikely, untreated carpal tunnel syndrome can lead to permanent nerve damage , disability, and loss of hand function. Check out these tips for relieving your carpal tunnel symptoms.
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Health Conditions Discover Plan Connect. Carpal Tunnel Syndrome. Medically reviewed by William Morrison, M. What is carpal tunnel syndrome? What causes carpal tunnel syndrome? Who is at risk for carpal tunnel syndrome? What are the symptoms of carpal tunnel syndrome? How is carpal tunnel syndrome diagnosed?
Most cases of carpal tunnel syndrome have no specific cause, although any or all of the following may be a contributing factor:. Frequent, repetitive, grasping movements with the hands such as with sports and certain physical activities. Other conditions or injuries of the wrist for example, strain, sprain, dislocation, break, or swelling and inflammation.
The symptoms of carpal tunnel syndrome may be similar to other medical conditions or problems. Always see your health care provider for a diagnosis. I see patients with problems of the hand and upper extremity as well as patients who have tumors as I have a specialty in Orthopaedic Oncology. If the diagnosis is not clear, we may refer patients to have a nerve conduction study as well. Your fingers are free to move and you may have some soreness in your wrist but, generally, patients get back to regular activities after about two to four weeks.
Patients who have long-standing or severe symptoms may require a longer period of time and may not get back a hundred percent of their function that they had before. It can recur although we often see this 10, 15 years down the line and that can be treated if it comes up.
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.
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.
Worksite changes. Changing position of your computer keyboard or making other ergonomic changes can help ease symptoms.
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