Carpal tunnel syndrome (CTS) is a squeezing of the median nerve at the wrist. This nerve brings feeling to the thumb, index finger, middle fingers, and half the ring finger.

Carpal Tunnel Syndrome

Causes

This problem is caused by pressure in the carpal tunnel. This is the passage that the nerve uses as it goes from the wrist into the hand. The cause of this pressure is not always known. Other times it may be due to:

Injury to the wrist
Problems in the way the carpal tunnel, bones, tendons, muscles, or ligaments look or work
Blood vessel problems
Swelling
Tumors
Long-term health problems, such as obesity, heart failure, or osteoarthritis

Risk Factors

CTS is more common in women and adults over 50 years of age. Other things that may raise the risk are:

Obesity
Doing repetitive things with the hands, such as:
- Some sports
- Sewing
- Playing musical instruments
- Typing
- Assembly tasks
Menopause
Using workplace tools that vibrate, such as a jackhammer

Symptoms

The problem may be in one or both hands or wrists. These issues may get worse over time:

Numbness, tingling, or swelling
Pain that goes from the wrist to the shoulder
Pain that gets better with hand or wrist shaking
Loss of grip strength
Weakness

Diagnosis

The doctor will ask about your symptoms and past health. A physical exam will be done, looking closely at the arms, wrists, and hands. The doctor may ask about the tasks done at work.

An ultrasound may be done to help confirm the diagnosis. This will use sound waves to measure the nerve area.

Treatment

It is important to adjust what is causing CTS. Making simple changes at work and home may ease problems. Ask work for ergonomic details they may have to decrease stress on wrist.

Other options may be:

Initial Care

Care that may help includes:

Resting the wrist by keeping it straight and not doing things that worsen pain
Putting ice packs on the wrist
Raising the hand above the heart to ease swelling
Wearing a hand splint to ease pain, especially at night
Doing exercises to make the wrist stronger and help it to move better

Medications

Medicine may be given to ease pain. Steroids may also be injected into the carpal tunnel to ease swelling.

Surgery

Some people may need surgery if initial care does not help or symptoms are severe. Carpal tunnel release cuts the transverse carpal ligament and release pressure on the nerve. A splint can help ease pain after surgery.

Prevention

There are no known methods to lower the chance of CTS.

RESOURCES:

American Association of Neurological Surgeons
http://www.aans.org

Ortho Info—American Academy of Orthopaedic Surgeons
http://orthoinfo.aaos.org

CANADIAN RESOURCES:

Canadian Centre for Occupational Health and Safety
http://www.ccohs.ca

Canadian Physiotherapy Association
http://www.physiotherapy.ca

References:

American Academy of Orthopaedic Surgeons (AAOS). Clinical Practice Guideline on the Treatment of Carpal Tunnel Syndrome. AAOS 2016 Feb PDF.

Carpal tunnel syndrome. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/carpal-tunnel-syndrome. Accessed December 13, 2020.

Carpal tunnel syndrome fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Carpal-Tunnel-Syndrome-Fact-Sheet. Accessed December 13, 2020.

Last reviewed December 2020 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS
Last Updated: 8/14/2020

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