Carpal Tunnel Syndrome

Carpal tunnel syndrome is a common nerve disorder that may affect hand strength and sensation, causing reduced function. Carpal tunnel syndrome is more common among women and middle-aged or older people. It usually affects one hand but may occur in both. The median nerve passes through the carpal tunnel on the inner wrist. When the median nerve is squeezed, it slows or blocks nerve impulses, causing numbness and possibly weakness. Carpal tunnel syndrome may occur in people who are pregnant, overweight, or have diseases like arthritis or diabetes. Repetitive hand activity may worsen symptoms.

What Are the Signs/Symptoms?

Mild carpal tunnel syndrome causes periodic numbness, when severe there can be weakness. Symptoms often appear in the morning but may happen at other times. Symptoms may worsen with hand activities like driving, holding a book or grasping items. Tasks like buttoning a shirt become difficult, and people with carpal tunnel may often drop things. Patients may shake their hands to try to relieve pain, and sense swelling when none is present. Diagnosis requires a physical exam and possibly some specialized testing. The doctor may prick the skin to test for loss of sensation, bend the wrist at a 90-degree angle (Phalen test), tap it with a reflex hammer to cause electric sensation (Tinel sign) or do nerve conduction testing. Ultrasonography and magnetic resonance imaging (MRI) may show median nerve swelling, tunnel wall abnormalities, or show why the nerve is compressed.

What Are Common Treatments?

Treatments for pain relief include medications like acetaminophen (Tylenol), and nonsteroidal anti-inflammatory drugs like ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn). Cortisone injected into the carpal tunnel may relieve pain for weeks or months. If hypothyroidism or rheumatoid arthritis are causing carpal tunnel syndrome, treating those diseases may relieve symptoms. If other treatments do not provide symptom relief, surgery called carpal tunnel release can be performed to open the carpal tunnel and relieve pressure on the median nerve.

Living with Carpal Tunnel Syndrome

Carpal tunnel syndrome numbness and tingling may be mild at first, so people may not seek medical help or treatment. For mild disease, you can try wearing splints, available at drugstores. You can also try over-the-counter pain relief medications. If these do not help and the condition remains untreated, it may progress and cause muscle weakness and loss of function. This is why it is important to see your doctor if the splints and over-the-counter remedies do not work.

Updated February 2023 by Karmela Chan, MD, and reviewed by the American College of Rheumatology Committee on Communications and Marketing.

This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.