Carpal Tunnel Syndrome
Also known as Median nerve compression
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is carpal tunnel syndrome?
Carpal tunnel syndrome occurs when the median nerve is compressed as it passes through a narrow channel at the wrist. It causes numbness, tingling and pain in the thumb, index, middle and half of the ring finger, classically waking people at night. Early treatment with splinting is often effective, while long standing compression can cause permanent muscle wasting.
Causes
- Increased pressure within the carpal tunnel
- Tenosynovitis from repetitive hand use
- Fluid retention, as in pregnancy
- Wrist fracture or arthritis narrowing the tunnel
- Systemic conditions including hypothyroidism and diabetes
Symptoms
- Numbness and tingling in the thumb, index and middle fingers
- Symptoms that wake the person at night
- Relief from shaking or hanging the hand down
- Aching in the wrist or forearm
- Weak grip and dropping objects
- Wasting of the muscle at the base of the thumb in advanced cases
Risk factors
- Repetitive or forceful hand and wrist work
- Vibrating tool use
- Pregnancy
- Diabetes and hypothyroidism
- Rheumatoid arthritis
- Obesity
Diagnosis
- Characteristic symptom distribution and night waking
- Tinel and Phalen provocation tests
- Nerve conduction studies to confirm and grade severity
- Ultrasound of the median nerve
- Thyroid function and glucose testing for underlying causes
Treatment
- Night wrist splint in a neutral position
- Activity and ergonomic modification
- Corticosteroid injection into the carpal tunnel
- Treating underlying thyroid or glucose abnormalities
- Carpal tunnel release surgery for severe or persistent cases
Self care
- Wear a neutral wrist splint at night, which is often the most effective step
- Take regular breaks from repetitive or vibrating tasks
- Adjust workstation height so wrists stay straight
- Shake or hang the hand down for immediate night relief
- Avoid sleeping with wrists curled
- Treat underlying thyroid or glucose problems
When to see a doctor
Book an appointment if:
- Numbness persisting despite night splinting
- Symptoms disturbing sleep most nights
- Weak grip or dropping objects
- Wasting of the muscle at the base of the thumb
- Symptoms in both hands
- Numbness during pregnancy that is not settling after delivery
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Keep wrists in a neutral position during repetitive work
- Take frequent short breaks and vary tasks
- Use ergonomic tools and reduce vibration exposure
- Manage diabetes, thyroid disease and weight
- Address symptoms early before muscle wasting develops
Outlook
Mild to moderate carpal tunnel syndrome often improves with night splinting alone, and pregnancy related cases usually resolve after delivery. Corticosteroid injection gives temporary relief for many. Surgical release is highly effective and durable, with best results when performed before permanent nerve damage and thumb muscle wasting appear.
Common questions
Why are symptoms worse at night?
Many people sleep with the wrist bent, which raises pressure in the carpal tunnel, and fluid redistributes when lying flat. This is why a neutral night splint is often the first and most effective treatment.
Does computer use cause carpal tunnel syndrome?
The evidence linking ordinary keyboard work to carpal tunnel syndrome is weak. Forceful, repetitive and vibrating tool work carries a much clearer association than typing.
Is surgery usually successful?
Carpal tunnel release relieves symptoms in the large majority of appropriately selected patients. Results are best before significant muscle wasting develops, which is an argument for earlier assessment.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.