Carpal Tunnel Syndrome

The carpal tunnel is a narrow passage on the palm side of the wrist, bordered by bones and a band of tissue. The median nerve and several tendons run through it. Carpal tunnel syndrome occurs when this nerve is compressed, leading to numbness, tingling, pain, and sometimes weakness in the hand.

It is one of the most common nerve compression conditions. Symptoms usually start gradually and may come and go at first. They often affect the thumb and the index, middle, and part of the ring finger, because these areas are supplied by the median nerve.

The main symptoms are tingling, numbness, and an aching or burning feeling in the thumb and first two or three fingers. Many people notice symptoms most at night or on waking, and shaking or moving the hand can bring relief. Discomfort can sometimes spread up the forearm.

Over time, gripping objects may feel weaker and you may drop things or struggle with fine tasks such as fastening buttons. In longer-standing cases, the muscle at the base of the thumb can shrink, and numbness may become more constant rather than coming and going.

Carpal tunnel syndrome develops when anything reduces the space in the tunnel or increases pressure on the median nerve. Often no single cause is found. Contributing factors can include repetitive or forceful hand and wrist use, a previous wrist injury, and the shape of your wrist.

It is more common during pregnancy and in people with conditions such as diabetes, an underactive thyroid, rheumatoid arthritis, and obesity. Fluid retention and hormonal changes can also play a part. It often affects both hands, although usually one is worse.

A doctor can often diagnose carpal tunnel syndrome from your symptoms and a hand examination. They may gently tap over the nerve or ask you to hold the wrist bent to see whether this brings on tingling, and they will check sensation and the strength of the thumb muscles.

If the diagnosis is unclear or surgery is being considered, nerve conduction studies and electromyography can measure how well the median nerve is working. An ultrasound scan is sometimes used. These tests also help rule out other causes of hand symptoms, such as nerve problems in the neck.

Mild to moderate cases often improve with simple measures. Wearing a wrist splint, especially at night, keeps the wrist in a neutral position and can ease symptoms. Adjusting activities that strain the wrist, taking regular breaks, and treating any underlying condition can also help. Pregnancy-related cases frequently settle after the baby is born.

If symptoms persist, a corticosteroid injection into the carpal tunnel can reduce swelling and relieve pressure on the nerve, sometimes for several months. When symptoms are severe or do not respond, carpal tunnel release surgery cuts the tissue pressing on the nerve to create more space. It is a common procedure, and many people get lasting relief, though recovery of strength and feeling can take time.

There is no guaranteed way to prevent carpal tunnel syndrome, but you can reduce strain on your wrists. Taking breaks from repetitive hand tasks, keeping a relaxed grip, maintaining a neutral wrist position, and setting up your workspace comfortably may help. Managing conditions such as diabetes and thyroid problems is also worthwhile.

The outlook is generally good, particularly when treatment starts before nerve damage becomes severe. Many people improve with non-surgical care, and surgery is effective when needed. Constant numbness or noticeable weakness should be assessed without long delay, because long-standing nerve compression can lead to lasting loss of feeling or muscle wasting.