Carpal Tunnel Syndrome

Carpal tunnel syndrome is a common condition that affects the fingers, wrists and arms. If untreated, it can lead to permanent weakness and loss of sensation. If you have symptoms of carpal tunnel syndrome, a prompt diagnosis and treatment are critical to maintaining the health of your wrists and hands.

Man holding his wrist while consulting his doctor about Carpal Tunnel Syndrome.

What Is Carpal Tunnel Syndrome?

The carpal tunnel is a narrow passageway running from the forearm to the palm of the hand, housing tendons and the median nerve. The carpal bones are small wrist bones that form the bottom and sides of the passageway, while the top consists of a strong band of tissue called the transverse carpal ligament.

The carpal tunnel structure means that it is limited in its ability to stretch or expand. When the carpal tunnel narrows or tissue around the tendons swell, the median nerve becomes squeezed or compressed, reducing blood supply and causing these symptoms in the hand and forearm:

Numbness

Tingling

Pain

Loss of sensation

Weakness

The median nerve is a primary nerve that controls the muscles around the thumb and branches into the index, middle, and ring fingers. Therefore, pressure on the median nerve can negatively affect the entire hand.

What Causes Carpal Tunnel Syndrome?

Carpal tunnel syndrome is more common in women and older patients. It is often associated with multiple causes.

Heredity

Patients with a naturally smaller carpal tunnel are more likely to experience carpal tunnel syndrome.

A person using a mouse and keyboard sitting at a desk.

Repetitive Hand Use

When the hands and wrists move the same way over a prolonged period, the tendons can become aggravated. This leads to swelling that puts pressure on the median nerve.

Doctor holding a female patient's wrist.

Hand and Wrist Position

Extreme flexion or extension of the hand and wrist for a prolonged period of time applies abnormal pressure on the nerve.

Pregnancy

The hormonal changes during pregnancy may cause swelling that results in pressure on the nerve.

Health Conditions

Certain health conditions, such as diabetes, rheumatoid arthritis, and thyroid gland imbalance, may lead to inflammation associated with carpal tunnel syndrome.

Heredity

Patients with a naturally smaller carpal tunnel are more likely to experience carpal tunnel syndrome.

Repetitive Hand Use

When the hands and wrists move the same way over a prolonged period, the tendons can become aggravated. This leads to swelling that puts pressure on the median nerve.

Hand and Wrist Position

Extreme flexion or extension of the hand and wrist for a prolonged period of time applies abnormal pressure on the nerve.

Pregnancy

The hormonal changes during pregnancy may cause swelling that results in pressure on the nerve.

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doctor performing a nerve conduction study on a patients arm

How Do Doctors Check for Carpal Tunnel?

Diagnosing carpal tunnel syndrome is a multistep process. As the first step, Dr. Benmoshe will discuss your symptoms, medical history, and general health. He will perform physical tests to check for numbness, weakness, or tingling.

Dr. Benmoshe may also order a nerve conduction study (EMG/NCV) to measure the signals traveling in the nerves of the hand and arm. He may have you undergo electromyography to measure the electrical activity in the muscles.

Some patients may require further imaging studies such as x-rays or MRI of the wrist an ultrasound to identify signs of compression on the nerve.

How Can Carpal Tunnel Syndrome Be Treated?

Many patients can find symptom relief without surgery when they receive an early diagnosis and treatment for carpal tunnel syndrome. Non-surgical treatments for carpal tunnel syndrome include:

Wrist Splinting

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Corticosteroids

Activity and Lifestyle Changes

Nerve Gliding Exercises

In more severe cases of carpal tunnel syndrome, surgery may be recommended. Severe carpal tunnel is characterized by consistent numbness and atrophy of the thumb muscles or symptoms that don’t improve with other treatments.

Surgery for the syndrome is called carpal tunnel release. The surgery involves cutting the transverse carpal ligament at the roof of the tunnel to relieve pressure on the median nerve.