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Carpal tunnel syndrome is the name for pain, tingling, and other problems in your hand caused by pressure on the median nerve in your wrist. The median nerve and several tendons run from your forearm to your hand through a small space in your wrist called the carpal tunnel.
- The median nerve controls feeling and movement in your thumb and first three fingers
- Carpal tunnel syndrome can cause numbness, weakness, a tingling feeling or pain in the fingers or hand
- Some people may have pain in their arm between their hand and their elbow.
Causes and risk factors
Carpal tunnel syndrome is commonly caused by activities that require repeated motions, which is why it is also known as a repetitive stress injury. These movements can be related to work (such as typing on a keyboard), home activities, hobbies or sports. Additional causes include:
- Conditions or illnesses that can cause arm pain, swelling in the joints and soft tissues in the arm, or reduce the blood flow to the hands, including obesity, rheumatoid arthritis and diabetes
- Smoking, which may contribute to carpal tunnel syndrome by affecting the blood flow to the median nerve
Symptoms
- Carpal tunnel symptoms frequently occur at night, and can often be severe enough to awaken you from sleep
- Symptoms most often occur in the thumb, index finger, middle finger, and half of the ring finger.
- If you have problems with your other fingers but your little finger is fine, this may be a sign that you have carpal tunnel syndrome. A different nerve gives feeling to the little finger.
- Symptoms include numbness, weakness, tingling and pain
Diagnosis and treatment
Your physician will take your medical history to find out about any illnesses, prior injuries, or repetitive activities that may be causing your symptoms. Additional diagnostic tests can include:
- Nerve testing (electromyogram) and nerve conduction studies: These procedures are used to evaluate any loss of normal functioning in the median nerve.
- X-rays: Although X-rays cannot diagnose carpal tunnel syndrome, they can be used to check for bone problems caused by past injury, arthritis, tumors or fractures.
- MRI (magnetic resonance imaging): This imaging procedure can be used to detect swelling of the median nerve, narrowing of the carpal tunnel, or blood circulation problems.
Treatment options
Carpal tunnel symptoms can often be treated on your own. If you start to have symptoms of carpal tunnel damage, follow these initial treatments to avoid continuing damage to the nerve:
- Stop activities that cause numbness and pain. Rest your wrist longer between activities.
Ice your wrist for 10 to 15 minutes 1 or 2 times an hour.
- Take nonsteroidal anti-inflammatory drugs (NSAIDs)s uch as ibuprofen to relieve pain and reduce swelling.
- Wear a wrist splint at night to keep your wrist in a neutral position. This takes pressure off your median nerve. Your wrist is in a neutral position when it is straight or only slightly bent. Holding a glass of water is an example of your wrist in a neutral position.
- Do exercises to keep your fingers and wrist from getting stiff, but don't continue this if pain or numbness result.
Surgical options
If home treatments have not helped your symptoms, or if nerve testing shows that nerve function is being affected, carpal tunnel release surgery may be an option.
UCSD orthopedic surgeons have experience and expertise in treating carpal tunnel through both open and endoscopic release surgery. Depending on your condition, endoscopic release, which is a minimally invasive surgical technique, may be used for less scarring and a faster recovery time.
Carpal tunnel release surgery is used to reduce the pressure on the median nerve in the wrist. The surgeon will cut the ligament that forms the top of the carpal tunnel, which will relieve pressure on the median nerve. Any other tissue that may be putting pressure on the median nerve can also be removed during surgery, making more room in the tunnel and relieving pressure on the nerve.
Open carpal tunnel release surgery, which allows the doctor to see more of the inner tissues, requires an incision in the palm and wrist.
Endoscopic carpal tunnel release surgery, can be done with small incisions in the wrist only, or in the wrist and palm.
Your surgeon will discuss your surgical options depending on your individual condition. After surgery, rehabilitation such as physical therapy or exercises may be prescribed to improve mobility and restore function.
Schedule an appointment
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