CARPAL TUNNEL SYNDROME

Carpal tunnel syndrome (CTS) is a condition caused by compression of the median nerve as it passes through a narrow passage in the wrist called the carpal tunnel.

Carpal Tunnel Syndrome

The median nerve provides sensation to parts of the thumb, index finger, middle finger, and part of the ring finger, and helps control some thumb muscles.

Causes of Carpal Tunnel Syndrome

Repetitive Hand and Wrist Activities

Repeated movements can irritate tissues within the carpal tunnel, including:

Typing
Mouse use
Assembly-line work
Tool use
Repetitive gripping

However, repetitive activity alone does not always cause CTS and is often one of several contributing factors.

Wrist Position

Frequent or prolonged:

Wrist bending (flexion)
Wrist extension (bending backward) can increase pressure within the carpal tunnel.

Swelling Within the Tunnel

Anything that reduces the available space can compress the median nerve.

Examples include:

Tendon inflammation
Fluid retention
Wrist injuries

Medical Conditions

CTS is more common in people with:

Type 2 Diabetes
Type 1 Diabetes
Hypothyroidism
Rheumatoid arthritis
Obesity

Pregnancy

Fluid retention during pregnancy can increase pressure in the carpal tunnel and cause temporary symptoms.

Wrist Injury

Fractures
Dislocations
Previous wrist trauma may alter the tunnel's structure and increase nerve compression.

Symptoms of Carpal Tunnel Syndrome

Numbness and Tingling

The most common symptoms are:

Tingling ("pins and needles")
Numbness usually affecting:
Thumb
Index finger
Middle finger
Half of the ring finger

The little finger is usually not affected.

Night Symptoms

Many people notice:

Waking with numb or painful hands
Symptoms worse at night
Needing to shake the hand for relief

This is one of the classic signs of CTS.

Hand Pain

Pain may occur:

In the wrist
In the palm
In the fingers

Sometimes it radiates into the forearm.

Weakness

As CTS progresses, people may notice:

Reduced grip strength
Difficulty opening jars
Difficulty holding objects
Frequent dropping of items

Thumb Weakness

The muscles at the base of the thumb can become weak.

In severe cases:

Visible thinning of the thumb muscles may occur

Common Activities That Trigger Symptoms

Symptoms may worsen during:

Driving
Holding a phone
Reading a book
Typing
Using tools
Sleeping with bent wrists

Early vs. Advanced Symptoms

Early CTS

Intermittent tingling
Night-time symptoms
Symptoms relieved by shaking the hand

Advanced CTS

Persistent numbness
Weakness
Reduced dexterity
Muscle wasting at the base of the thumb

Conditions That Can Mimic Carpal Tunnel Syndrome

Other conditions can produce similar symptoms, including:

Neck nerve compression (cervical radiculopathy)
Pronator syndrome (median nerve compression in the forearm)
Peripheral neuropathy
Ulnar nerve entrapment
Tendon disorders of the wrist

When to Seek Medical Assessment

Consider medical evaluation if:

Symptoms persist for several weeks
Night symptoms are frequent
You develop weakness
You are dropping objects
Numbness becomes constant

Typical Treatment Approaches

Depending on severity, treatment may include:

Wrist splinting (especially at night)
Activity modification
Ergonomic adjustments
Nerve-gliding exercises
Physical or occupational therapy
Corticosteroid injections in selected cases
Surgery for severe or persistent nerve compression

Early treatment often leads to better outcomes because prolonged nerve compression can sometimes cause permanent nerve damage.

Carpal Tunnel Syndrome Treatment