Carpal Tunnel Syndrome

Carpal tunnel syndrome is the result of pressure on the median nerve as it travels into the hand through the carpal tunnel, a canal in the wrist created by the wrist bones with a ligament on top of the nerve. When this ligament gets thickened from overuse or certain medical issues, the tunnel becomes too small and the nerve does not have enough room.

Signs and Symptoms

The most common symptoms of carpal tunnel syndrome include:

  • Numbness or pins/needle sensations in the palm of the hand, including the thumb, index and middle fingers
    • Especially at night and in the morning
    • Made worse with pressure on the wrist or wrist bending
  • Weakness of the muscles in the hands and fingers
  • Decreased grip strength

Potential Causes

Carpal tunnel syndrome can be caused by repetitive wrist motions over time, such as typing or writing. 

Diagnosis

Diagnosis of carpal tunnel syndrome starts with a physical exam and medical history. Other procedures and tests may be needed to diagnose this condition, including x-rays , magnetic resonance imaging (MRI), computed tomography (CT), electromyogram and nerve conduction studies.

Treatment options

There are a few possible treatment options depending on the severity of your symptoms:

  • Medication to reduce inflammation
  • Therapy to stretch and strengthen the surrounding muscles
  • Wrist splints to rest and prevent movement in the wrist
  • Carpal tunnel releaseSurgical release is performed when nonsurgical treatments do not improve the symptoms. Carpal tunnel release surgery is performed through a small (less than one-inch) incision where the wrist meets the palm of the hand. The ligament on top of the nerve is cut and opened from the wrist to the palm under this incision. This does not cause any instability in the wrist or hand. The skin is then closed with stitches that will need to be removed in about two weeks. The surgery often takes less than 20 minutes, and mild sedation and numbing medicine is used. General anesthesia is not required.
Conditions

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