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Carpal Tunnel Syndrome

If you have carpal tunnel syndrome, you are not alone. Between 3% and 6% of the adult population have this condition, which causes pain, numbness, stiffness and weakness in the hand and wrist. Doctors are not sure what causes carpal tunnel syndrome, but certain repetitive movements such as typing or sewing may lead to the condition.

What is carpal tunnel syndrome?

Carpal tunnel syndrome happens when the median nerve is compressed (squeezed) by swelling around the nerve. The median nerve runs through the palm side of the hand, allowing you to feel sensation in your thumb, index finger, middle finger and part of the ring finger.

Carpal tunnel syndrome can lead to weakness, pain and numbness and tingling on the side of the hand near the thumb, especially at night.   

What causes carpal tunnel syndrome?

The inflammation and swelling that causes nerve compression may happen for many different reasons. However, it can be related to other medical conditions including:

  • Diabetes
  • Thyroid problems
  • Fluid retention (swelling)
  • Pregnancy
  • High blood pressure
  • Autoimmune diseases (such as rheumatoid arthritis)
  • Injuries or trauma

Repetitive motions can also cause swelling and compression on the median nerve. These motions include:

  • Heavy typing or awkward wrist position while using a keyboard or mouse 
  • Long-term use of tools that vibrate (such as hand or power tools)
  • Overextension of the wrists and hands from activities like typing, video games or playing the piano

What are the symptoms of carpal tunnel syndrome?

Symptoms usually start slowly and get worse over time. Common symptoms include:

  • Tingling or numbness: This can be in the fingers, thumb or hand and can move to the wrist and lower arm. It may also feel like a mild electric shock.
  • Pain in the joints: Pain usually starts in the palm or fingers and can spread all the way up the arm to the shoulder.
  • Weakness: Carpal tunnel syndrome can affect your grip and ability to pinch small objects.

More severe nerve compression may cause muscle atrophy (wasting away of the muscles) at the base of the thumb and a loss of the ability to tell the difference between hot and cold temperatures.

Symptoms can be worse at night and make sleep difficult for people with carpal tunnel syndrome. In fact, sleeping with your wrists and fingers curled tightly can increase your risk of carpal tunnel syndrome. 

Who is at risk for carpal tunnel syndrome?

Because repetitive motions are sometimes linked to carpal tunnel syndrome, people with jobs that use keyboards, power tools, sewing machines, assembly lines, etc. may be at higher risk. Regularly playing video games or excessive cell phone use could also increase risk. 

While it’s possible for children to develop symptoms of carpal tunnel syndrome, it’s much more common in adults. According to the National Institute of Neurological Disorders and Stroke, women are three times more likely to develop carpal tunnel syndrome than men. People living with diabetes or other conditions that affect nerve health may also be at a higher risk. 

How is carpal tunnel syndrome diagnosed?

If you have pain or numbness in your hand or wrist, your health care provider will ask you about your activities and health history, as well as look for signs of tenderness or swelling near your median nerve.

Some providers may also use nerve conduction studies or electromyography (EMG) to check your nerve function. An EMG uses a mild electrical current to measure how fast your nerves work. If the nerves in your hand are slow, this may mean you have carpal tunnel syndrome.

What are some other conditions that look like carpal tunnel syndrome?

Spinal cord compression in the neck (cervical radiculopathy)

When a nerve is pinched in your neck, it can lead to nerve issues throughout your body. Cervical radiculopathy shares some symptoms with carpal tunnel syndrome. In fact, about half of people with spinal cord compression also have carpal tunnel syndrome. People with spinal cord compression may also have bladder and bowel control issues, numbness or pain in their legs or other issues related to nerve damage.


Any joint in your body can have arthritis, including your hands, wrists, and fingers. Arthritis develops with age and/or overuse, as cartilage breaks down in your joints. While carpal tunnel syndrome and arthritis can both be painful, arthritis doesn’t usually cause tingling or numbness. It is possible to have both conditions.


Just like carpal tunnel syndrome, tendonitis (soreness in the tissues that connect your muscles to your bones) is often caused by overuse. Inflammation (swelling) of the tendons can create soreness and stiffness in the joint. But like arthritis, tendonitis does not usually cause numbness or tingling. 


Neuropathy means you have nerve damage in your body. Neuropathy can be caused by age and/or conditions such as diabetes. People undergoing chemotherapy may also be at higher risk for neuropathy. 

Tingling, numbness, or pain may show up in the hands and fingers because of neuropathy. If you have neuropathy elsewhere in your body, carpal tunnel syndrome may be ruled out as the cause of your hand and wrist discomfort.

How is carpal tunnel syndrome treated?

Non-surgical treatment options

Treatment for carpal tunnel syndrome will be most effective if it is started as soon as possible. It includes these simple steps:

  • Taking time to rest the hands and wrists throughout the day
  • Avoiding activities that make your symptoms worse
  • Applying ice or cold packs to reduce swelling
  • Using wrist splints or braces, particularly at night
  • Stretching and physical therapy
  • Medication to reduce pain or inflammation, such as NSAIDs (nonsteroidal anti-inflammatory drugs)

Your provider may also recommend a corticosteroid injection to relieve pain and swelling. An ultrasound machine may be used to help your provider guide the injection and make sure it reaches the right area.

Surgical treatment options

If your symptoms don’t respond to other treatments or get worse, surgery may be the next step.

The goal of surgery is to get rid of pressure on the median nerve. The most common surgical treatment for carpal tunnel syndrome is called carpal tunnel release surgery. During the procedure your surgeon will cut through the transverse carpal ligament to create more space for the median nerve and surrounding tendons. During the healing process, the ligament tissues will gradually grow back together while allowing for more space for the nerve. 

This surgery can be done using two different methods:

  • Open surgery - This procedure is done by making an incision to the palm of the hand over the carpal tunnel and cutting through the ligament to free the nerve from pressure.
  • Endoscopic surgery - Performed using small incisions, a scope and a tube with a camera and a light. This allows for the surgery to be done with minimal invasiveness, less pain and shorter recovery time.

Your health care provider will help determine which surgical option is best for you.   

Whatever treatment path you choose, you should be able to keep working - but with a few changes. Your provider may recommend a brace, a change in posture or more breaks than usual. If you have surgery, an extended break from the repetitive motion may also be necessary while you heal.

You should also work with your provider to make sleep more comfortable. This may include changing your sleep position, wearing a brace or splint to bed or taking natural sleep aids.

What is recovery like following carpal tunnel syndrome surgery?

Relief of nighttime pain usually happens immediately, but numbness may take weeks or even months to go away. Any skin incisions will heal within a few weeks.

You may have pain, swelling and stiffness as you heal. Your surgeon will recommend that you slowly begin using your hand and wrist after the ligament has healed. It is important to carefully follow your provider’s directions.

Who treats carpal tunnel syndrome?

If you have pain or tingling in your hand or wrist and think you may have carpal tunnel syndrome, schedule an appointment with a Banner Health orthopedic specialist.