Carpal Tunnel Syndrome

Carpal tunnel syndrome is a common condition caused by compression of the median nerve as it passes through a narrow passage in the wrist (the carpal tunnel), leading to numbness, tingling, and weakness in the hand.

• Numbness or tingling in the thumb, index, middle, and part of the ring finger, often worse at night
• Pain in the wrist or hand, which may spread up the forearm
• Weakness in the hand, particularly affecting grip strength or fine tasks such as buttoning clothing
• Symptoms often improve temporarily with shaking or changing the position of the hand

• Results from compression of the median nerve within the carpal tunnel, a narrow passageway in the wrist.
• Risk is increased by repetitive hand or wrist movements, certain occupations involving repetitive wrist strain, pregnancy (due to fluid retention), obesity, diabetes, and thyroid disease.
• In some cases, no specific underlying cause is identified.

• Diagnosed clinically based on the characteristic pattern of numbness and tingling in the affected fingers, together with specific examination tests that reproduce symptoms.
• Nerve conduction studies, where available, can confirm the diagnosis and assess severity in less clear or more significant cases.

A wrist splint, worn particularly at night, helps keep the wrist in a neutral position and can significantly reduce symptoms for many people with mild to moderate carpal tunnel syndrome.

Modifying activities that trigger or worsen symptoms, along with regular breaks during repetitive hand tasks, can help reduce irritation of the nerve.

A corticosteroid injection into the carpal tunnel may be considered for more persistent symptoms not responding to splinting.

Surgery to relieve pressure on the nerve may be considered for severe or persistent symptoms, particularly with evidence of ongoing nerve damage or significant weakness, and is generally very effective.

• Take regular breaks during repetitive hand or wrist activities.
• Maintain good wrist posture during typing or other repetitive tasks.
• Use a wrist splint at night if experiencing early symptoms.
• Manage underlying conditions, such as diabetes or thyroid disease, which can contribute to risk.
• Seek early assessment for persistent numbness or tingling in the hand, since earlier treatment tends to have better outcomes.