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Carpal Tunnel Syndrome

What is carpal tunnel syndrome?

Carpal tunnel syndrome is numbness, tingling, weakness, and other problems in your hand because of pressure on the median nerve in your wrist.

The median nerve and several tendons run from your forearm to your hand. They pass through a small space in your wrist called the carpal tunnel. The median nerve controls movement and feeling in your thumb and first three fingers. It doesn't control movement of your little finger.

  • Symptoms

    Carpal Tunnel Syndrome

    Inflamed median nerve in carpal tunnel syndrome

    The carpal tunnel is a narrow space in the wrist. It contains wrist bones and a ligament (transverse carpal ligament) across the wrist where the palm and forearm meet. Tendons and the median nerve pass through this space to your hand. The median nerve supplies feeling and some movement to part of the hand.

    Carpal tunnel syndrome is usually caused when an illness or other problem makes the carpal tunnel space too small. This puts pressure on the median nerve and causes pain, tingling, and other symptoms.

    What are the symptoms of carpal tunnel syndrome?

    Carpal tunnel syndrome can cause tingling, numbness, weakness, or pain. Mild carpal tunnel symptoms most often affect the hand and sometimes the forearm. But they can spread up to the shoulder. You may first notice symptoms at night. Or you may notice stiffness in your fingers in the morning. You may be able to get relief by shaking your hand.

    With moderate or severe symptoms, you may have numbness or reduced strength and grip in your fingers, thumb, or hand. For example, you may have a hard time holding a fork or opening a jar.

    Symptoms most often occur in the thumb, index finger, middle finger, and half of the ring finger. If you have problems with your other fingers but your little finger is fine, this may be a sign that you have carpal tunnel syndrome. This is because the nerve involved in carpal tunnel syndrome doesn't affect the little finger.

  • Diagnosis

    How is carpal tunnel syndrome diagnosed?

    Carpal tunnel syndrome is usually diagnosed using:

    • Your medical history. The doctor will ask about any medical problems or illnesses, prior injuries, current symptoms, or daily activities that may be causing your symptoms.
    • A hand diagram. You may be asked to help fill in a diagram of your hand to show where you have numbness, tingling, or pain.
    • A physical exam. This includes comparing the strength of both hands.

    More testing

    If your symptoms are severe, if nonsurgical treatment hasn't improved symptoms, or if your symptoms aren't clearly caused by carpal tunnel syndrome, your doctor may recommend:

    Nerve testing.

    This checks the median nerve.

    X-rays.

    These can check for bone problems caused by past injury, arthritis, recently broken or dislocated bones, or tumors. X-rays aren't used to diagnose carpal tunnel syndrome. But they can be helpful for finding signs of arthritis or an old or new wrist or neck injury that may be adding to your symptoms.

    Ultrasound.

    This test looks at the size of the median nerve. The test doesn't cost much, and it's comfortable and quick. But its use for carpal tunnel syndrome diagnosis is still unproven and fairly uncommon.

    MRI.

    This imaging test can find swelling of the median nerve, narrowing of the carpal tunnel, or problems with circulation of blood through the carpal tunnel.

    Blood tests.

    These are sometimes done to check for a thyroid problem, rheumatoid arthritis, or another medical problem.

  • Prevention

    Preventing carpal tunnel syndrome

    If you spend a lot of time doing activities that involve forceful or repetitive hand or wrist movement or use of vibrating equipment, you have a higher risk for carpal tunnel syndrome. These activities can include driving, working with small tools, knitting, or using a sander. You can reduce your risk—and any hand pain or weakness you may already have—by taking a few simple steps.

    • Manage health conditions, and have a healthy lifestyle.

      Many health conditions and diseases make you more likely to get carpal tunnel symptoms. But you can help prevent carpal tunnel syndrome with a healthy lifestyle. Stay at a healthy weight. Manage other health conditions such as arthritis and diabetes. And don't smoke.

    • Use ergonomics.

      Arrange your activity and work space using ergonomic guidelines. Office ergonomics focuses on how a workstation is set up. This includes the placement of your desk, computer monitor, paperwork, chair, and work tools, such as a computer keyboard and mouse. The same ideas can help you arrange your position for other daily activities.

    • Use proper body mechanics.
    • Evaluate your daily routine.

      Check for activities that increase your risk of carpal tunnel syndrome.

    • Take frequent breaks from activities.

      During these breaks, rest, stretch, change positions, or alternate with another activity.

    Carpal Tunnel Syndrome: A Few Tips for Preventing It

  • Treatment

    How is carpal tunnel syndrome treated?

    Treatment for carpal tunnel syndrome is based on how serious it is, if there is any nerve damage, and if other treatment has helped.

    If your symptoms are mild, home treatment for 1 to 2 weeks is likely to relieve your symptoms. Try these tips.

    • Stop or change activities that cause numbness and pain.
    • Ice your wrist.
    • Take nonsteroidal anti-inflammatory drugs (NSAIDs).
    • Wear a wrist splint.

    Physical therapy or occupational therapy is sometimes used. You also may need medicine for carpal tunnel syndrome. Or you may need it for a health problem that made you likely to get carpal tunnel syndrome.

    Surgery is an option. But it's mostly used only when symptoms are so bad that you can't work or do other things even after several weeks to months of other treatment.

    The sooner you start treatment, the better your chances are to stop symptoms and prevent long-term damage to the nerve.


    Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.