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Carpal tunnel syndrome is numbness, tingling, weakness, pain, and other problems in your hand that are caused by pressure on the median nerve in your wrist.
The median nerve and several tendons run from your forearm to your hand. They pass through a small space in your wrist called the carpal tunnel. The median nerve controls movement and feeling in your thumb and first three fingers. It doesn't control movement of your little finger.
Pressure on the median nerve causes carpal tunnel syndrome. Activities that cause repeated movements and vibration can cause this pressure. Sometimes the cause isn't known. Thyroid problems, diabetes, and pregnancy are some of the things that make carpal tunnel syndrome more likely.
Carpal tunnel syndrome can cause tingling, numbness, weakness, or pain in the palm side of the fingers and hand. Some people may have pain in their arm between the hand and the elbow. Symptoms most often occur in the thumb, index finger, middle finger, and half of the ring finger.
To diagnose this syndrome, your doctor will ask about health problems that could cause the condition. The doctor will ask about your routine and any recent activities that could have hurt your wrist, arm, or neck. You will get a physical exam, including comparing the strength of both hands. You may need nerve tests.
You can treat mild symptoms of carpal tunnel syndrome with home care. This includes wearing a wrist splint, icing your wrist, and avoiding activities that cause the problem. Corticosteroids taken by mouth or by injection are a treatment option. Surgery may be needed when you have severe symptoms and when other treatments haven't helped.
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Carpal tunnel syndrome occurs when a combination of health conditions and activities puts pressure on the median nerve. The median nerve passes through the carpal tunnel in your wrist. This pressure leads to symptoms.
Anything that decreases the amount of space in the carpal tunnel or increases the amount of tissue in the tunnel can lead to carpal tunnel syndrome. So can anything that makes the median nerve more sensitive.
Things that help cause carpal tunnel syndrome include:
Carpal tunnel syndrome is a common work-related condition. It can be caused by work that requires:
Carpal tunnel syndrome is even more likely if you have these work-related issues along with other health conditions.
In some cases the cause of carpal tunnel syndrome can't be found.
Things that put you at risk for carpal tunnel syndrome include:
In daily routines at home, at work, or while doing hobbies, think about changing activities in which you make repeated finger, hand, or wrist movements. Train yourself to use other positions or techniques that won't stress your hand or wrist.
This includes staying at a healthy weight, not smoking, and getting regular exercise.
Avoid activities that bend or twist the wrists for long periods of time. Use hand and wrist movements that spread the pressure and motion evenly throughout your hand and wrist.
Avoid gripping with only the thumb and index finger. This can stress your wrist.
If your symptoms improve when you stop, resume that activity gradually.
A splint can keep your wrist in a neutral position and reduce the stress on your fingers, hand, or wrist.
Mild carpal tunnel symptoms most often affect the hand and sometimes the forearm, but they can spread up to the shoulder. Symptoms include:
With moderate or severe carpal tunnel symptoms, you may have numbness or reduced strength and grip in your fingers, thumb, or hand. It may be hard to:
Symptoms most often occur in parts of the hand supplied by the median nerve. These are the thumb, the index finger, the middle finger, and half of the ring finger. The median nerve doesn't affect your little finger. So if your little finger is affected, you may not have carpal tunnel syndrome.
Symptoms often occur in both hands, but they are usually worse in one hand than the other. You may first notice symptoms at night. People with carpal tunnel syndrome can usually fall asleep, but pain or numbness may wake them up.
Not all pain in the wrist or hand is caused by carpal tunnel syndrome. There are many other conditions with similar symptoms, such as:
The symptoms of carpal tunnel syndrome usually develop gradually. Symptoms often improve if you stop or change an activity that is helping to cause the condition.
Most mild cases of carpal tunnel syndrome get better with treatment. Usually there is no permanent damage to the median nerve. Your symptoms may improve by themselves when:
Long-term carpal tunnel syndrome can cause:
Call 911 or go to an emergency room immediately if you notice sudden loss of feeling in your arm.
Call your doctor if you:
You can treat mild symptoms of wrist and hand pain or numbness at home. You may try home treatment for 1 to 2 weeks before calling your doctor.
To diagnose carpal tunnel syndrome, your doctor will ask if you have any health problems, such as arthritis, hypothyroidism, or diabetes. The doctor may ask if you are pregnant. The doctor will ask if you recently hurt your wrist, arm, or neck. Your doctor will want to know about your daily routine and any recent activities that could have hurt your wrist.
During the exam, your doctor will check the feeling, strength, and appearance of your neck, shoulders, arms, wrists, and hands. The doctor may suggest having tests, such as:
Treatment for carpal tunnel syndrome is based on how serious it is, if there is any nerve damage, and if other treatment has helped.
If your symptoms are mild, home treatment for 1 to 2 weeks is likely to relieve your symptoms. Try these tips.
Corticosteroids may treat the swelling of the nerve and your pain. They can be taken in pill form or injected into the wrist by a doctor. Physiotherapy or occupational therapy is sometimes used.
Surgery is an option. But it's mostly used only when symptoms are so bad that you can't work or do other things even after several weeks to months of other treatment.
The sooner you start treatment, the better your chances are to stop symptoms and prevent long-term damage to the nerve.
Home treatment for carpal tunnel syndrome can ease pain and prevent further or permanent damage to your median nerve. Home treatment may completely relieve your symptoms if you start treatment when symptoms first occur.
If you have mild symptoms, such as occasional tingling, numbness, weakness, or pain in your fingers or hand, try the following steps to reduce inflammation.
When your symptoms improve, resume the activity gradually. As you do, keep your wrists straight or only slightly bent.
Ice it for 10 to 15 minutes at a time.
These medicines can help relieve pain and reduce swelling. Studies haven't shown NSAIDs to be effective for carpal tunnel syndrome, but they may help relieve your symptoms. Be safe with medicines. Read and follow all instructions on the label.
A splint keeps your wrist in a neutral position and relieves pressure on your median nerve. A splint might give you temporary relief.
Talk to your doctor about starting exercises for flexibility and strength for your arm and wrist. Also, learn the best positions and posture for hand and wrist movements.
Medicine may relieve swelling, inflammation, and pain in the wrist or hand caused by carpal tunnel syndrome. Reducing swelling in the wrist will relieve pressure on the median nerve in the carpal tunnel. This helps relieve your symptoms.
Medicine choices include:
Medicine should be used with other treatments (such as ice, rest, and splints) to reduce pain and inflammation.
Surgery may be an option when other treatment hasn't helped, if you've had carpal tunnel syndrome for a long time, or if there's nerve damage or the risk of nerve damage.
The most common surgery for relieving carpal tunnel symptoms involves cutting the transverse carpal ligament. This helps relieve pressure on the median nerve in the wrist. Two approaches for this surgery may be used. They are:
Some surgeons are now doing small- or mini-open release surgery. This requires a smaller incision than standard open release surgery. It may reduce healing time and scarring. It also allows the surgeon to view the ligament directly during the surgery. This helps to minimize danger to the nerve.
Your decision about whether to use open or endoscopic surgery may depend on your doctor's experience with the procedures. Endoscopic carpal tunnel surgery uses special equipment. It's most successful when the doctor has done the procedure many times.
Adaptation Date: 2/8/2023
Adapted By: Alberta Health Services
Adaptation Reviewed By: Alberta Health Services
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