What Is Carpal Tunnel Syndrome?
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Medically reviewed by Forest Miller, MSOT
Carpal tunnel syndrome is a common neurological condition that causes pain, numbness, and tingling in the hand and fingers. It occurs when the median nerve, which runs from the forearm to the palm of your hand, becomes compressed or squeezed.
Wrist injuries, hormonal changes during pregnancy or menopause, repetitive wrist movements, and certain medical conditions such as arthritis or diabetes can lead to the development of carpal tunnel syndrome. Treatment focuses on symptom relief and preventing long-term nerve damage and may include wearing wrist splints, wrist exercises, and medications. Severe cases may require surgical treatment.
Between 1-5% of adults have carpal tunnel syndrome, which is most common in people between the ages of 40 to 60.
Carpal Tunnel Syndrome Symptoms
Carpal tunnel syndrome causes pain in the hands and wrist that feels like numbness, burning, or tingling sensations, especially in the thumb, index, middle, and ring fingers. Symptoms of carpal tunnel syndrome usually come on gradually and may come and go. You may notice symptoms initially appear at night in one or both hands, though your dominant hand may be more affected.
Other common symptoms of carpal tunnel syndrome include:
Pain, tingling, or a burning sensation in the palm and wrist that may radiate up the forearm and is especially noticeable during activities that involve bending or flexing the wrist
Fingers that feel swollen, even when they are not
As the condition progresses, symptoms may include:
Tingling, pins-and-needles sensation in the fingers during the day
Decreased range of motion (movement) in the fingers
A weakened grip, which may make it difficult to perform fine motor tasks, such as using a pen/pencil, buttoning a shirt, or holding small objects
Loss of sensitivity to temperature in the fingertips (e.g., cannot feel the difference between hot and cold)
What Causes Carpal Tunnel?
Carpal tunnel syndrome occurs when the median nerve—one of three major nerves in the wrist—becomes compressed or pinched. If you look at your palm, you can imagine the carpal tunnel as a protective, narrow pathway through which several tendons, blood vessels, and the median nerve pass. The tendons help move your fingers while the median nerve carries signals from your hand to your brain, allowing contractions in the small muscles of the hand to feel sensations like hot and cold temperatures.
When the carpal tunnel narrows, or the tissue surrounding the tendons becomes inflamed or swollen, it puts pressure on the median nerve and reduces blood supply. This leads to symptoms such as pain, burning, tingling, and numbness in the fingers and hand.
Risk Factors
Several factors can increase the risk of developing carpal tunnel syndrome, such as:
Injury to the wrist, such as a broken bone or sprain
Medical conditions that affect the joints or nerves, such as diabetes or rheumatoid arthritis
Repetitive movements with the hands and wrist, such as doing assembly line work, knitting, texting, or repeated use of vibrating tools such as drills, sanders, grinders, jackhammers, and lawnmowers
Hormonal changes that cause swelling and excess fluid, such as during pregnancy or menopause
Older age
Family history of carpal tunnel syndrome
Diagnosis
Carpal tunnel syndrome is diagnosed through a physical examination and diagnostic tests. Healthcare providers will look to identify the characteristic symptoms of the condition and rule out other potential causes of hand and wrist discomfort.
During the physical exam, your healthcare provider will assess your hand and wrist for signs of swelling, tenderness, warmth, or muscle weakness. They may also check for impaired sensation in your fingers and test your grip strength and reflexes with the following tests:
Tinel’s sign: For this test, a healthcare provider taps or presses lightly over the median nerve in the wrist to assess for tingling or electric shock-like sensations, which can indicate nerve compression.
Phalen maneuver: This test involves flexing your wrist for a minute to see if it elicits symptoms like numbness or tingling.
If your healthcare provider suspects you have carpal tunnel syndrome, they may order diagnostic tests to confirm the diagnosis:
Nerve conduction study (NCS): NCS measures the speed and strength of electrical signals as they travel along the median nerve to determine if the nerve is functioning properly.
Electromyography (EMG): EMG measures the electrical activity of muscles and can help evaluate the function of the median nerve and determine how severely the nerve is damaged.
Ultrasound: This is used to create a visual of the wrist structures, including the median nerve, to look for signs of swelling or compression.
Treatments for Carpal Tunnel Syndrome
Treatment for carpal tunnel syndrome focuses on relieving symptoms, improving hand function, and preventing further nerve damage. The specific treatment approach depends on the severity of symptoms and nerve damage.
Lifestyle Modifications
Making small adjustments to your daily activities can minimize strain on your wrist to help reduce symptoms. This can include:
Practice good posture and maintain proper hand and wrist alignment during tasks
Talk to your employer about adapting your workplace and adjusting job demands to reduce stress on your wrists
Use assistive devices or ergonomic tools designed to reduce strain on the wrists
Avoid repetitive hand and wrist movements when possible, and take regular breaks when performing repetitive tasks
Apply ice/cold compresses to your wrist to reduce pain and inflammation
Wear a wrist splint during daily activities, work tasks, and while sleeping to keep your wrist in a straight (neutral) position
If another medical condition is causing or worsening your symptoms, treating the condition (e.g., diabetes, rheumatoid arthritis) may help reduce or eliminate carpal tunnel symptoms.
Wrist Exercises
Carpal tunnel exercises can help reduce stiffness, improve flexibility, and strengthen the muscles surrounding the wrist. You can do stretches and exercises several times daily to help reduce tension in your wrists and relieve pressure from the median nerve. Your healthcare provider may refer you to a physical therapist or recommend specific exercises or stretches for carpal tunnel syndrome, such as:
Wrist extension stretch
Wrist flexion stretch
Prayer stretch
Median nerve glides
Tendon glides
Finger stretch
Thumb to pinky stretch
As you perform carpal tunnel exercises and stretches, remember to go gently and slowly and stop if you feel pain or discomfort.
Medications
Over-the-counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDs), such as Advil (ibuprofen), Aleve (naproxen), or Tylenol (acetaminophen), can help reduce inflammation and pain in the wrist to reduce symptoms of carpal tunnel syndrome. Prescription-strength NSAIDs or corticosteroid injections may be prescribed for more severe cases.
Surgery
In cases where carpal tunnel symptoms are severe or non-surgical treatments have not provided adequate relief, surgery—called carpal tunnel release—may be considered. During the procedure, the transverse carpal ligament that serves as the ‘roof’ of the carpal tunnel is cut and divided to expand the carpal tunnel space and relieve pressure on the median nerve. This procedure is performed in one of two ways:
Open carpal tunnel release: A small incision is made in the palm to access the carpal tunnel, and the transverse carpal ligament is cut to relieve pressure on the median nerve.
Endoscopic carpal tunnel release: A minimally invasive surgical technique in which tiny incisions are made near the wrist, and an endoscope (camera) helps the surgeon see and release the transverse carpal ligament.
Prevention
You can lower your risk of developing carpal tunnel syndrome or reduce flare-ups of symptoms by taking certain preventive measures, such as:
Avoid prolonged repetitive hand and wrist movements
Maintain good posture to keep your wrists in a straight, neutral position
Take regular breaks to stretch and rest your hands and wrists, especially during activities that involve repetitive movements
Set up your workspace in an ergonomically friendly way to ensure proper alignment of your wrists and hands to reduce strain.
Avoid bending your wrists while you sleep; wearing a wrist splint at night can help ensure your wrists stay properly aligned.
Complications
Left untreated, carpal tunnel syndrome can progress and lead to more severe symptoms and complications, including:
Permanent damage to the median nerve
Atrophy (shrinkage) of the hand muscles
Chronic pain that can significantly impact daily activities and reduce your quality of life
Reduced hand function, which can make certain activities—such as gripping small objects, writing, or buttoning clothes—challenging or impossible
Poor sleep due to painful symptoms at night, which can disrupt sleep patterns
Living With Carpal Tunnel
While carpal tunnel syndrome is a chronic condition, treatment—including lifestyle modifications, wrist stretches, and medication—can help manage symptoms. If non-surgical treatments are not helpful, the success rate of surgery is between 75 to 95%.
Living with a chronic, painful condition like carpal tunnel syndrome can take a toll on your emotional health. Some people find it helpful to join support groups with others with carpal tunnel syndrome, and support from family and friends can help you make the necessary lifestyle adjustments to help manage symptoms.
Frequently Asked Questions
Is carpal tunnel syndrome arthritis?
No, carpal tunnel syndrome is not arthritis. While both conditions can affect the hands and wrists, they are different. Carpal tunnel syndrome involves compression of the median nerve in the wrist, whereas arthritis refers to joint inflammation.
At what age do people get carpal tunnel?
Carpal tunnel syndrome can occur at any age, but it is more common in adults between the ages of 40 and 60.
Can carpal tunnel go away on its own?
Carpal tunnel syndrome symptoms may improve or even resolve on their own in mild cases or in situations where the underlying cause is temporary, such as during pregnancy. In most cases, carpal tunnel syndrome does not go away on its own and may require treatment to relieve symptoms and prevent long-term complications.
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