People assigned female at birth are more likely to develop carpal tunnel syndrome. Your risk for this condition also goes up as you get older.
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What is carpal tunnel syndrome?
Carpal tunnel syndrome is a nerve condition that affects your ability to feel your fingers and move your thumb. Pressure on the median nerve that runs from your forearm to your hand causes this condition. This pinched nerve can lead to numbness, tingling, and pain in the fingers or hand. An estimated 10 million Americans have this condition.
Mass General Brigham orthopedic specialists provide comprehensive care for carpal tunnel syndrome. Should you need surgery, our orthopedic surgeons are experts in hand and wrist surgeries.
At Mass General Brigham Orthopedics, you’ll have access to a dedicated team of hand and arm orthopedic specialists who are committed to helping you manage hand and wrist arthritis. You’ll benefit from a collaborative approach that brings together fellowship-trained orthopedic surgeons, experienced rheumatologists, and skilled rehabilitation specialists. Together, they tailor a treatment plan to help you stay active and control your symptoms.
Call 857-282-3300 to schedule a consultation or find a hand specialist.
What is the carpal tunnel?
The carpal tunnel is a narrow corridor inside your wrist. Bones and ligaments surround this tunnel. The median nerve travels through the carpal tunnel. This nerve helps you sense and move your thumb, index finger, and middle finger.
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Symptoms of carpal tunnel syndrome
Symptoms of carpal tunnel syndrome tend to come on gradually and worsen over time. Pain, numbness, and tingling are often more severe at night and during activities where the wrist is bent for a long time. You should see your doctor if symptoms don’t go away or get worse and affect your ability to sleep, complete daily tasks, drive, work, or hold items.
Signs of carpal tunnel syndrome include:
- Difficulty with fine motor movements like buttoning a shirt
- Feeling like your fingers are swollen when they’re not
- Numbness or tingling in your thumb, index, middle, and ring fingers
- Pain or tingling that travels from your forearm to your shoulder
- Tingling, pain, or weakness with activities like holding your phone or a steering wheel
- Weak hand grip, which may cause you to drop items and appear clumsy
Causes of carpal tunnel syndrome
Carpal tunnel syndrome happens when there is too much pressure on the median nerve, which runs through a narrow passage in your wrist called the carpal tunnel. This pressure may occur when something irritates the tissue that forms the “roof” of this tunnel (the transverse carpal ligament), causing it to swell and push against the nerve.
Potential carpal tunnel syndrome causes include:
- Inherited small or narrow carpal tunnel
- Pregnancy
- Repetitive wrist movements (repetitive strain injury)
- Rheumatoid arthritis
- Wrist fractures
Preventing carpal tunnel syndrome
You may be able to alleviate symptoms of carpal tunnel syndrome by protecting your wrists and hands from repetitive strain. Simple steps include:
- Using a straight wrist splint when sleeping at night.
- Take frequent breaks when working with your hands.
- Use wrist rests and proper form while working on a computer.
Diagnosis of carpal tunnel syndrome
Your healthcare provider will conduct a physical exam, perform tests, and review your symptoms and medical history.
Carpal tunnel syndrome tests
Your provider may perform carpal tunnel syndrome tests during your physical exam. These tests include:
- Phalen’s test: to check for numbness, weakness, or tingling when you move your hands and wrists into different positions
- Tinel’s sign test: to check for a tingling sensation when your provider taps the area above your median nerve
Diagnostic tests for carpal tunnel syndrome
Your provider may order certain tests to rule out other conditions and diagnose carpal tunnel syndrome. These tests include:
- Electromyography (EMG) and nerve conduction study (NCS): to see how well your median nerve is working
- Ultrasound: to look for signs of nerve compression
- X-rays: to check for arthritis and fractures
If you’re experiencing symptoms of carpal tunnel syndrome, call 857-282-3300 to schedule a consultation or find a hand specialist.
Treatment for carpal tunnel syndrome
We always recommend starting with less invasive, nonsurgical treatments. These treatments can ease carpal tunnel syndrome symptoms and keep the condition from getting worse. Depending on the severity of the condition, it can take weeks or months for symptoms to improve.
Your provider may recommend:
- Modifying activities, such as changing your arm and hand position while working on a computer
- Taking nonsteroidal anti-inflammatory drugs (NSAIDs) or getting corticosteroid injections to ease inflammation and swelling
- Wearing a wrist brace or splint to take pressure off the median nerve, especially during the night
Carpal tunnel syndrome surgery
Your provider may recommend surgery if nonsurgical treatments don’t help. The goal of carpal tunnel surgery is to reduce pressure on the median nerve by cutting the ligament that forms the roof of the carpal tunnel. As the tissue heals, it leaves more space for the nerve, which can ease pain and improve function.
Types of carpal tunnel surgery include:
- Endoscopic surgery: A surgeon inserts a scope device with a camera into small incisions in your hand or wrist. Images from the camera help guide the surgeon while they cut the ligament.
- Open surgery: A surgeon makes a longer incision in the palm of your hand to access the carpal tunnel and cut the ligament.
Recovering from carpal tunnel syndrome surgery
It’s normal to still have some numbness and tingling after surgery. It may be several weeks or months before you notice a significant improvement. Regaining full strength in your hand may take a year or longer.
After surgery, you may:
- Take over-the-counter medications to ease pain and swelling
- Elevate your arm while you sit or sleep to prevent swelling
- Take time off from activities that require pressure on the palm or heavy lifting
FAQs about carpal tunnel syndrome
Arthritis and tendonitis are two conditions that are often misdiagnosed as carpal tunnel syndrome. The conditions cause similar symptoms, including pain and weakness in your wrists and hands.
Pain from carpal tunnel syndrome affects everyone differently. You may have pain in your:
- Thumb, index, middle, and ring fingers
- Palm of your hand (often radiating to or from the base of your thumb)
- Wrist
If you have carpal tunnel syndrome, you should avoid actions that make symptoms worse, such as:
- Gripping or holding objects for a prolonged time or too tightly
- Bending your wrist for prolonged periods
- Repetitive hand and wrist motions that aggravate symptoms
- Typing at an uncomfortable angle
Carpal tunnel syndrome and cubital tunnel syndrome cause similar symptoms, but the affected nerves are different. A pinched ulnar nerve in your elbow causes cubital tunnel syndrome. This syndrome causes symptoms when you bend and straighten your arm, or put pressure on your elbow.
