Sometimes, thickening from the lining of irritated tendons or other swelling narrows the tunnel and compresses the median nerve. The result may be numbness, weakness, or sometimes pain in the hand and wrist some people may feel pain in the forearm and arm. Symptoms usually start gradually, with frequent numbness or tingling in the fingers, especially the thumb and the index and middle fingers.
Some people with CTS say their fingers feel useless and swollen, even though little or no swelling is apparent. The symptoms often first appear in one or both hands during the night. The dominant hand is usually affected first and produces the most severe symptoms. As symptoms worsen, people might feel tingling during the day, especially with certain activities such as talking on the phone, reading a book or newspaper, or driving.
Hand weakness may make it difficult to grasp small objects or perform other manual tasks. Some people with very severe CTS cannot determine between hot and cold by touch, and may burn their fingertips without knowing it. Carpal tunnel syndrome is often the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself. Contributing factors include trauma or injury to the wrist that cause swelling, such as sprain or fracture; an overactive pituitary gland; an underactive thyroid gland; and rheumatoid arthritis.
Other factors that may contribute to the compression include mechanical problems in the wrist joint, repeated use of vibrating hand tools, fluid retention during pregnancy or menopause, or the development of a cyst or tumor in the canal. Often, no single cause can be identified. Women are three times more likely than men to develop carpal tunnel syndrome. Anything that squeezes or irritates the median nerve in the carpal tunnel space may lead to carpal tunnel syndrome.
A wrist fracture can narrow the carpal tunnel and irritate the nerve, as can the swelling and inflammation caused by rheumatoid arthritis. Many times, there is no single cause of carpal tunnel syndrome. It may be that a combination of risk factors contributes to the development of the condition. A number of factors have been associated with carpal tunnel syndrome.
Although they may not directly cause carpal tunnel syndrome, they may increase the risk of irritation or damage to the median nerve. These include:. Anatomic factors. A wrist fracture or dislocation, or arthritis that deforms the small bones in the wrist, can alter the space within the carpal tunnel and put pressure on the median nerve. Carpal tunnel syndrome is generally more common in women. This may be because the carpal tunnel area is relatively smaller in women than in men.
Women who have carpal tunnel syndrome may also have smaller carpal tunnels than women who don't have the condition. Workplace factors. Working with vibrating tools or on an assembly line that requires prolonged or repetitive flexing of the wrist may create harmful pressure on the median nerve or worsen existing nerve damage, especially if the work is done in a cold environment. However, the scientific evidence is conflicting and these factors haven't been established as direct causes of carpal tunnel syndrome.
Several studies have evaluated whether there is an association between computer use and carpal tunnel syndrome. Some evidence suggests that it is mouse use, and not the use of a keyboard, that may be the problem. However, there has not been enough quality and consistent evidence to support extensive computer use as a risk factor for carpal tunnel syndrome, although it may cause a different form of hand pain.
Your condition will continue to worsen if symptoms last too long and you may need carpal tunnel surgery in both hands. Your doctor may suggest surgery if any of this sounds like your situation:. Additional treatments — such as braces, corticosteroids and daily routine changes failed to help. Your pain, tingling or numbness do not go away or reduce in six months. It's harder to grasp, grasp, or pinch objects as you have once done.
When you decide to go for carpal tunnel surgery in both hands , definitely do not do both hands simultaneously except if you have a close proximately complete caregiver with whom you have a close personal connation and trust for several weeks of personal hygiene and intimate care. Without using either hand, life can be complicated.
A hand operated before it is fully cured may lead to serious potentially complicated complications and the generation of scar tissue. Carpal Tunnel can actually be made worse after operation than before the surgeon at the base of the hand by the formation of scar tissue. Soft tissue healing takes at least six weeks, and if complications with bacterial infection arise, can take up to 8 weeks or even 12 weeks.
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. 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:.
Carpal tunnel syndrome is one of the most common causes of absence from work. Things that put you at risk for carpal tunnel syndrome include:. Call or go to an emergency room immediately if you notice sudden loss of feeling in your arm. 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.
Carpal tunnel syndrome is usually diagnosed using:. If your symptoms are severe, if nonsurgical treatment has not improved symptoms, or if your symptoms aren't clearly caused by carpal tunnel syndrome, your doctor may recommend:. The goal of treatment for carpal tunnel syndrome is to allow you to return to your normal function and activities and to prevent nerve damage and loss of muscle strength in your fingers and hand.
Treatment for carpal tunnel syndrome is based on the seriousness of the condition, whether there is any nerve damage, and whether other treatment has helped. If your symptoms are mild, 1 to 2 weeks of home treatment are likely to relieve your symptoms. If you feel that certain work activities are causing finger, hand, or wrist numbness or pain, talk to your human resources department. Ask about different ways of doing your job, changes in your equipment, other job assignments, or the possibility of an ergonomics evaluation of your work space and procedures.
For more information, see the topic Office Ergonomics. In daily routines at home 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. If you have mild symptoms, such as occasional tingling, numbness, weakness, or pain in your fingers or hand, follow these steps to reduce inflammation :. When your pain is gone, begin exercises for flexibility and strength for your arm and wrist.
Learn the best positions and posture for hand and wrist movements. Medicine may relieve swelling, inflammation, and pain in the wrist or hand related to carpal tunnel syndrome.
Reducing swelling in the wrist will relieve pressure on the median nerve in the carpal tunnel and relieve your symptoms. Nonsteroidal anti-inflammatory drugs NSAIDs may relieve pain and inflammation and are available with or without a prescription. They work best if your tendon is inflamed. Corticosteroids may be a treatment option when NSAIDs don't effectively relieve pain and inflammation.
But these are powerful anti-inflammatory medicines. They have side effects that should be considered. Corticosteroids can be taken in pill form or injected into the wrist by a doctor. Medicine should be used with other measures such as ice, rest, and splints to reduce pain and inflammation. Most people with carpal tunnel syndrome are treated without surgery. Surgery is considered only when:.
The most common surgery for relieving carpal tunnel symptoms involves cutting the transverse carpal ligament to relieve pressure on the median nerve in the wrist. Two approaches for this surgery are:. Some surgeons are now doing small- or mini-open release surgery. This requires a smaller incision than standard open carpal tunnel release surgery. It may reduce healing time and scarring. But it also allows the surgeon to view the ligament directly during the surgery to minimize danger to the nerve itself.
This procedure may be promising. But there are few studies comparing it to the open carpal tunnel or endoscopic procedures at this time. Nerve tests nerve conduction velocity test and electromyogram are often completed before surgery is done.
Surgery is more likely to be successful if the results from nerve testing point to carpal tunnel syndrome. Your decision about whether to use open or endoscopic surgery depends on your doctor's experience with the procedures. Endoscopic carpal tunnel surgery uses very technical equipment and is most successful when the doctor has done the procedure many times. After surgery, it is important to avoid any activities that may have caused carpal tunnel syndrome.
Or you can change the way you do them. Other treatments for carpal tunnel syndrome include:. Some people try complementary medicine to help with the symptoms of tingling, numbness, weakness, or pain felt in the fingers or hand. There is not strong evidence that they help. Talk with your doctor about any complementary health practice that you would like to try or are already using. Your doctor can help you manage your health better if he or she knows about all of your health practices. Author: Healthwise Staff.
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Your use of this information means that you agree to the Terms of Use and Privacy Policy. Learn how we develop our content. To learn more about Healthwise, visit Healthwise. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Skip to main content. Health Information Library. Carpal Tunnel Syndrome. Topic Overview What is carpal tunnel syndrome? What causes carpal tunnel syndrome? Many things can cause this swelling, including: Illnesses such as hypothyroidism , rheumatoid arthritis , and diabetes.
Making the same hand movements over and over, especially if the wrist is bent down your hands lower than your wrists , or making the same wrist movements over and over. What are the symptoms?
How is carpal tunnel syndrome diagnosed? How is it treated? You can: Stop activities that cause numbness and pain.
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