Carpal tunnel syndrome

The carpal tunnel is a narrow passageway in your wrist formed by the carpal bones on the palm side and the transverse carpal ligament across the top. It protects the median nerve, which provides sensory and motor functions to your thumb plus your index and middle fingers.

Carpal tunnel syndrome occurs when there is pressure on the median nerve as it passes through the carpal tunnel.

Woman holding tablet

Causes and warning signs of carpal tunnel syndrome

Most cases of carpal tunnel syndrome have no specific cause, but any of the following may be part of the combination:

  • Family history of carpal tunnel syndrome.
  • Frequent and repetitive motions with the hands, such as typing or using a keyboard.
  • Frequent, repetitive, grasping movements with the hands as in sports and certain physical activities like working on an assembly line.
  • Joint or bone disease, like arthritis, osteoarthritis or rheumatoid arthritis.
  • Hormonal or metabolic changes, like menopause, pregnancy, or thyroid imbalance, and changes in blood sugar levels, as in type 2 diabetes.
  • Injuries of the wrist, like a strain, sprain, dislocation or break, or swelling and inflammation.

The most common warning signs and symptoms of carpal tunnel syndrome include:

  • Burning pain or tingling in the fingers, especially the thumb and the index and middle fingers.
  • Numbness or a swollen feeling in the fingers or base of the thumb.
  • Pain or numbness that is worse at night and may interrupt sleep, due to the accumulation of fluid in the arm and hand from inactivity and lying down.
  • Weakness when gripping objects.

Because the symptoms of carpal tunnel syndrome may mimic other health conditions or problems, see a UCHealth provider for a proper diagnosis.

Our treatments for carpal tunnel syndrome

If diagnosed early, your UCHealth specialist might be able to treat your symptoms of carpal tunnel syndrome without surgery.

Your treatment might first include:

Activity changes. When your hand and wrist are in the same position for too long, symptoms occur. Changing or modifying your job or recreational activities can help.

Bracing or splinting. Keeping your wrist in a straight or neutral position reduces pressure on the median nerve, including at night.

Nerve gliding exercises. Help the median nerve move more freely within the carpal tunnel.

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen.

Steroid injections like corticosteroid or cortisone, a powerful anti-inflammatory agent that can be injected into the carpal tunnel.

Outpatient procedure: carpal tunnel release

If nonsurgical treatment does not work or your symptoms are severe, your orthopedic specialist may recommend surgery, called a carpal tunnel release, which is an outpatient procedure.

There are two different surgical techniques for a carpal tunnel release, but both involve cutting the carpal ligament to relieve the pressure on the median nerve. Complete recovery may take up to a year, and your personalized treatment plan may include a referral to a hand therapist to maximize your recovery.

References

Orthoinfo: American Academy of Orthopaedic Surgeons. Carpal Tunnel Syndrome (https://orthoinfo.aaos.org/en/diseases–conditions/carpal-tunnel-syndrome/)

National Institute of Neurological Disorders and Stroke (NINDS). Carpal Tunnel Syndrome Fact Sheet (https://www.ninds.nih.gov/carpal-tunnel-syndrome-fact-sheet)

American Association of Neurological Surgeons (AANS). Carpal Tunnel Syndrome (https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Carpal-Tunnel-Syndrome)