Carpal Tunnel Syndrome

Last updated date: 08-Jul-2023

Originally Written in English

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

Carpal tunnel syndrome is characterized by the compression on the median nerve as it enters the hand. The median nerve runs down the palm side of the hand (also referred to as the carpal tunnel). 

The median nerve is responsible for sensation (the capability to feel) in the index finger, thumb, long finger, and a portion of your ring finger. It sends an impulse towards the muscle that leads to the thumb. Generally, carpal tunnel syndrome can affect one or both hands.

Carpal tunnel syndrome is caused by swelling inside your wrist. It can cause weakness, numbness, and tingling on the hand side closest to your thumb. Treatment typically alleviates the tingling and numbness while also restoring hand and wrist function.


Symptoms of Carpal Tunnel Syndrome 

Carpal tunnel syndrome signs and symptoms typically appear steadily and include:

  • Numbness or tingling

Numbness and tingling of the fingers or hand are possible symptoms. The thumb, index, mid, and ring fingers are normally affected, except the little finger. You may experience an electric shock-like sensation in these fingers.

This sensation might travel up the arm from your wrist. The symptoms frequently arise when you hold things like a phone, steering wheel, or newspaper, or they can awaken you from a deep sleep. Most people tend to "shake out" their hands in an attempt to alleviate these symptoms. Over time, the numb sensation might become constant or permanent. 

  • Weakness 

You can develop hand weakness and even drop objects. This could be because of numbness in hand or weakness in the pinching muscles of your thumb that the median nerve also regulates.

Consult your medical provider if you have carpal tunnel syndrome symptoms that affect your regular activities as well as sleeping patterns. If left untreated, permanent damage to the nerve and muscle can arise. 


Causes of Carpal Tunnel Syndrome 

The carpal tunnel, which is also referred to as the carpal canal, is a rigid, narrow pathway of the bones and ligaments in the hand base. The carpal tunnel also houses the median nerve as well as the tendons. 

The carpal tunnel can narrow due to irritation and inflammation of the tendons. It can also narrow down when another swelling exerts pressure over the median nerve.

The median nerve controls sensations in the thumb, palm, and three other fingers. The muscle that moves the thumb across the palm such that it touches the little finger is also controlled by the median nerve. However, it has no control over the little finger.

The pressure exerted on this nerve can cause numbness, pain, and weakness in the wrist and hand. As a result, it could trigger pain radiating up the arm and sometimes towards the shoulder.

Carpal tunnel syndrome can occur due to a variety of reasons. On the other hand, it’s most likely in people who; 

  • Often apply a lot of wrist movement
  • Get exposed to vibration
  • Use the fingers repeatedly, such as when typing.

At times, there is no apparent cause. However, the following are thought to be the most frequent causes of carpal tunnel syndrome:

  • Motions that are repeated
  • Use of vibrating hand tools repeatedly. 
  • Work-related stress
  • Carpal tunnel syndrome pregnancy due to edema or retention of fluid
  • Inflammatory, rheumatoid, or degenerative arthritis
  • Hypothyroidism, also known as an underactive thyroid (a condition in which the thyroid gland produces insufficient thyroid hormone).
  • Diabetes
  • Trauma, including dislocation of the wrist or fracture
  • Structural issues with the wrist joint
  • Wrist lesions
  • A carpal tunnel cyst or tumor
  • Overactive pituitary gland 
  • Any form of inflammation or swelling in the tendons


Carpal Tunnel Diagnosis 

To know if you have carpal tunnel syndrome, the doctor or orthopedists can inquire about your symptoms. They can also perform one or more diagnostic tests and procedures such as:

  • Physical exam

The medical provider will perform a comprehensive physical examination. This involves examining the sensation around the fingers as well as the muscles strength in hand. Most people experience symptoms when they bend their wrist, tap, or just press on the nerve.

  • Symptoms history

The medical provider will thoroughly examine the pattern of the symptoms. The median nerve does not supply sensation to the little finger. Hence, the symptoms involving that particular finger could indicate something else apart from carpal tunnel syndrome. 

The symptoms of carpal tunnel typically appear when holding a newspaper, phone, or steering wheel. At times, they arise during the night and might wake you up. In other cases, you may develop numbness in the morning when getting up.  

  • X-ray

Doctors can sometimes advise getting an x-ray of the impaired wrist to rule out other possible wrist pain causes, including arthritis or a fracture. X-rays, on the other hand, are ineffective when it comes to diagnosing carpal tunnel syndrome.

  • Nerve conduction analysis

A variation of electromyography involves taping two electrodes to the skin. A slight shock is then administered via the median nerve to determine whether electric impulses in the carpal tunnel are slowed. Doctors can use this test to diagnose the disorder as well as to rule out other possibilities. 

  • Electromyography

This diagnostic test detects the minute electric discharges that occur in muscles. The procedure involves inserting a tiny-needle electrode in the target muscles to measure the electric activity that occurs during muscles contraction and relaxation. Electromyography tests can also detect muscles damage that the median nerve controls while also ruling out other possibilities.


Carpal Tunnel Diagnosis Treatment 

Carpal Tunnel Diagnosis Treatment 

The treatments for carpal tunnel syndrome can be non-surgical or surgical, depending on the pain severity, symptoms, and weakness. Both approaches carry different advantages and disadvantages. Orthopedists typically recommend non-surgical treatments for less severe issues, enabling you to carry on with day-to-day activities uninterrupted. On the other hand, surgical treatments may be beneficial for more severe conditions and have a high success rate. 

Nonsurgical treatments:

Nonsurgical treatments for carpal tunnel syndrome, if detected early, can help enhance the associated symptoms. They include:

  • Wrist splinting

This involves placing a splint to keep the wrist still when sleeping. This could help ease numbness and tingling at night. Even if you only place the splint during the night, it might prevent symptoms during the day. For pregnant women, nighttime splinting might be a great alternative. This is because it doesn't require using any drugs to function effectively. 

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)

For the short term, NSAIDs, including ibuprofen (Advil, Motrin IB, and others), can assist in relieving carpal tunnel syndrome-associated pain. Nonetheless, there is no evidence proving that these drugs enhance carpal tunnel syndrome.

  • Corticosteroids

To ease pain, the provider can inject a corticosteroid like cortisone into the carpal tunnel. He or she may use an ultrasound to help direct the injections in some cases.

Corticosteroids reduce inflammation as well as swelling, allowing the median nerve to be relieved of pressure. When addressing carpal tunnel syndrome, oral corticosteroids are not usually as useful as injections. 


Surgical treatments:

Carpal tunnel syndrome surgery

If the symptoms of carpal tunnel syndrome are severe or fail to recover from other treatments, surgery might be necessary. Carpal tunnel syndrome surgery aims to ease pressure on the median nerve by cutting across the ligament that is pressing on it.

The medical provider can conduct surgery using one of two methods:

  • Endoscopic surgery 

To view the carpal tunnel, the surgeon will use an endoscope, a telescope-like tool attached to a small camera. The ligament is cut via one or two tinny incisions or cuts made on the wrist or hand. To guide the device cutting the ligament, other surgeons can recommend ultrasound rather than a telescope. 

For the first several days or weeks, endoscopic surgery can cause less pain compared to open surgery.

  • Open surgery

To free the affected nerve, the surgeon creates a cut on the palm around the carpal tunnel. He or she then cuts through the ligament. Before undergoing this open surgery, discuss with the surgeon about the pros and cons of every approach. Some of the risks associated with surgery are:

  • Incomplete or partial release of the ligament
  • Infections of the wound
  • Formation of scars
  • Damage to the blood vessels or nerves

During the recovery process following the operation, the ligament tissues steadily re-grow, making more space for the nerve. Internal healing normally takes a few months, although the skin restores in a matter of weeks.

Once the ligament heals, the medical provider usually advises you to use the hand again, gradually returning to normal use. You should, however, do so as you initially avoid forceful hand movements or extreme positions of the wrist.



Carpal tunnel syndrome is a progressive and painful condition caused by a compression of the median nerve within the wrist. Nerve swelling, tendons inflammation, or swelling due to other reasons around the carpal tunnel causes median nerve compression. 

Carpal tunnel syndrome, if left untreated, can trigger negative effects on a person's life quality. The median nerve can eventually get severely damaged. This results in permanent numbness around the fingers and persistent weakness of the muscles innervated by the median nerve.