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Carpal tunnel syndrome is a condition characterized by compression of a nerve in the wrist that can interfere with a person's ability to use the wrist and the hand. In this condition, the median nerve is squeezed as it passes through the carpal tunnel. The carpal tunnel is an opening in the wrist that is formed by the carpal bones on the bottom of the wrist and ligaments across the top of the wrist. The median nerve provides sensory and motor functions to the thumb and three middle fingers.
Carpal Tunnel Syndrome: What You Need to Know
Carpal tunnel release is one of the most common hand conditions requiring surgery.
Symptoms may include tingling, pain, numbness or weakness in the thumb through ring fingers of the affected hand.
Women get carpal tunnel syndrome three times more often than men.
Carpal tunnel syndrome is a progressive condition that can worsen without proper care.
Symptoms of carpal tunnel syndrome often occur during pregnancy and can be alleviated with nonsurgical treatments. Symptoms often improve after delivery, but such patients are at higher risk of developing carpal tunnel syndrome later in life.
Carpal Tunnel Syndrome Causes
Most cases of carpal tunnel syndrome have no specific cause, although any or all of the following may be a contributing factor:
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)
Carpal Tunnel Syndrome Symptoms
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, index finger and middle finger
Pain or numbness that is worse at night, interrupting sleep
Difficulty manipulating small objects, such as buttoning a shirt or placing an earring
The above symptoms may get worse with driving.
The symptoms of carpal tunnel syndrome may be similar to other medical conditions or problems. Always see your health care provider for a diagnosis.
More Information About Carpal Tunnel Syndrome from Johns Hopkins Medicine
Frequent numbness and tingling in your hands could indicate carpal tunnel syndrome, which affects up to 6 percent of Americans. Learn more about the condition and treatment.
Carpal Tunnel Syndrome Diagnosis
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 examinations and 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.
Carpal Tunnel Syndrome Treatment
Your health care provider will figure out the best treatment for you based on:
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:
Surgery. This eases compression on the nerves in the carpal tunnel.
Injection. This may decrease the inflammation and size of tendons and other structures in the carpal tunnel and temporarily make more space for the nerve.
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 taken orally 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.
Surgery for Carpal Tunnel Syndrome
Surgery for carpal tunnel syndrome is usually done as 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, the hand and wrist are wrapped in a bulky but soft dressing to allow for gentle movement during recovery. You will probably have some pain after your surgery, which is 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.