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.

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Carpal tunnel syndrome can worsen over time

When the median nerve gets compressed or irritated, numbness and tingling in your hand and wrist will often occur. In most cases, the condition results from a combination of factors, not just a single cause.

Carpal tunnel syndrome typically happens only to adults, and women are three times more likely to get carpal tunnel syndrome than men. It typically doesn’t go away on its own, and it will only get worse over time.

Personalized treatment at UCHealth

Whether you’ve already been diagnosed, or you’re wondering why you’re experiencing tingling and numbness in your hand and wrist, make an appointment with a UCHealth orthopedic specialist so we can provide the right treatment for your case.

Without treatment, carpal tunnel syndrome will worsen over time and may result in permanent nerve damage. Let us work with you on a personalized treatment plan to restore full function to your hand.

Before you come in for medical advice and a physical examination, you can try the Phalen’s sign test at home. Hold your arms out in front of you and flex your wrists down, letting your hands hang down for a minute. If you feel tingling, numbness or pain in your fingers within sixty seconds, you may have 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.

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.

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)