Orthopedics Hand & Wrist Carpal Tunnel Syndrome Carpal Tunnel Syndrome Guide Carpal Tunnel Syndrome Guide Overview Symptoms Diagnosis Prevention Symptoms of Carpal Tunnel Syndrome By Jonathan Cluett, MD Updated on November 19, 2023 Medically reviewed by Oluseun Olufade, MD Print The carpal tunnel is a narrow passageway between the forearm bones and ligaments. Tendons and the median nerve run through it. Carpal tunnel syndrome (CTS) develops when inflammation narrows the tunnel and compresses the nerve. This can cause numbness, tingling, pain, and weakness in your hands. Carpal tunnel syndrome is a repetitive stress injury, which means it develops gradually. This article will teach you the most common signs and symptoms and when to see your healthcare provider. Verywell Symptoms The symptoms of carpal tunnel syndrome often affect your dominant hand first. Without treatment, they tend to get worse over time. That's especially true if you continue the activity that caused it. Symptoms are often most bothersome at night and may even wake you up. Activities that involve repetitive hand motions can also worsen symptoms. Some of these activities include: DrivingHolding your phoneHolding a book or newspaperGripping a penButtoning your clothes Symptoms can progress until you feel them often or all the time. Changes in Sensation The most common symptoms of carpal tunnel are tingling and numbness. Some people also experience electric-shock sensations. You may feel the tingling or shock sensation traveling up from your wrist to your arm. You're most likely to have these feelings along the median nerve. This nerve passes through the carpal tunnel in your wrist. It then runs through your palm and into your ring, middle, and index fingers plus the thumb. With carpal tunnel, the little finger shouldn't go numb. Many people with carpal tunnel say their entire hand feels numb. When a healthcare provider tests it, however, the numbness is almost always absent in the little finger and half of the ring finger. Symptoms are sometimes relieved by shaking your hands. Over time, you may lose the ability to tell hot from cold in the numb areas. Why Body Parts Tingle and Fall Asleep Pain Many people have pain in the same location as their numbness. Others have pain radiating up the forearm as well as down into the hand. Like the tingling, pain is often relieved by shaking out the hand. Swollen Feeling You may feel like your fingers are swollen and have a hard time using them. However, there's usually no evidence of swelling. For example, your rings will still fit as usual. Weakness and Atrophy As symptoms progress, you may discover you don't have as much grip strength. It can become hard to hold objects and perform tasks that require manual dexterity. You may find yourself dropping things. It can feel like you're clumsy, but it's from the weakness and numbness. It's also because the nerves can't maintain a sense of where your hand is in space (proprioception). Nerves have three primary functions:Sending messages to the brain about pain and sensationsProcessing sensory information Sending messages from the brain to contract muscles When CTS is severe, messages from the brain to the small muscles in the palm of the hand can be interrupted. That can cause atrophy (weakening) in muscles at the base of the thumb. In severe cases, the meaty part of the affected palm can look significantly smaller than in the other hand. Muscle atrophy makes treatment and recovery less effective, even after surgery. Recap Symptoms of carpal tunnel include numbness, tingling, pain, feeling like your fingers are swollen and clumsy, nighttime pain, trouble with daily tasks, weakness, and muscle atrophy. When to See a Healthcare Provider You should see a healthcare provider if you have possible CTS symptoms for two weeks or longer. At first, the symptoms may come and go. See your provider if they're: ConstantWaking you up at nightInterfering with everyday tasks Allowing CTS symptoms to go on for too long increases the risk of muscle atrophy and permanent nerve damage. Early treatment can also help you avoid surgery. Visit your primary care provider for an assessment and general health check. If you don't have a primary care provider, you can see an internal medicine physician or an occupational medicine specialist. You may be referred to an orthopedic surgeon, neurologist, hand surgeon, rheumatologist, or physiatrist for further testing or treatment. Carpal Tunnel Syndrome Healthcare Provider Discussion Guide Get our printable guide for your next healthcare provider's appointment to help you ask the right questions. Download PDF Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Email Address Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. To diagnose CTS, your healthcare provider will consider other possible causes of your symptoms. That includes other nerve conditions and arthritis. CTS is more common in people with underlying conditions such as: Hypothyroidism Diabetes Rheumatoid arthritis It's possible that you have one of these conditions without knowing it. Seeing your healthcare provider will allow you to get a diagnosis and appropriate treatment for both CTS and other conditions. If you have a sudden loss of feeling in your arm, go to an emergency room. This is a sign of a more serious condition, not CTS. How CTS Is Diagnosed Recap See your healthcare provider if you have CTS symptoms that last for two weeks, have become constant, wake you up, or interfere with basic activities. Early diagnosis and treatment leads to better outcomes. Summary Compression of the median nerve in the carpal tunnel can cause pain, numbness, tingling, weakness, and other symptoms. If symptoms impact your sleep or activities, get medical help. Letting it go for too long can lead to permanent nerve damage and makes surgery more likely. A Word From Verywell Because early CTS symptoms come and go, you might think nothing serious is wrong. Remember that the sooner you have it diagnosed, the faster and easier your recovery is likely to be. If you do need surgery, don't panic. It's a simple, routine surgery that helps many people get back full function in their hands. Frequently Asked Questions What does carpal tunnel syndrome feel like? Symptoms of carpal tunnel syndrome can include:Tingling, numbness, and/or electric shock sensationsShooting or tingling pain that radiates into your wrist or forearmFingers that feel swollen when they aren'tSymptoms that set in mostly at night, at least at firstHand weakness, especially a weak gripThe symptoms of CTS tend to be felt throughout most of your hand, including your palm, thumb, and fingers—except for the pinky. Learn More CTS Massage Techniques What causes carpal tunnel syndrome? Carpal tunnel syndrome is caused by compression of the median nerve in the wrist. This happens when inflammation narrows the carpal tunnel and puts pressure on the nerve.Certain wrist positions (e.g., sleeping with flexed wrists) and repetitive activities can increase pressure. Other causes include:A wrist injury, like a sprain or fractureStructural issues in the wristAn underactive thyroidRheumatoid arthritisFluid retention during pregnancy or menopause Does using a keyboard or a mouse cause carpal tunnel syndrome? No, most studies have not shown that typing or using a mouse directly cause CTS. However, long hours of any activity that keeps your wrist in a flexed position—like holding a pen or using some types of machinery—can increase pressure on the median nerve. What helps relieve pain from a carpal tunnel flare? You can relieve CTS pain by:Icing your risk to reduce swellingTaking frequent breaks from activities that make your pain worseWearing a wrist brace at night or while you're performing activities that aggravate the nerveDoing wrist stretches and exercises or yogaGetting acupuncture How is carpal tunnel syndrome treated? Carpal tunnel syndrome treatments depend on the severity of your symptoms. In mild cases, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin can help.Corticosteroid injections or oral prednisone may help with more intense pain. Carpal tunnel release surgery is an option if other treatments fail. Like any surgical procedure, it comes with some risks. What happens if carpal tunnel syndrome is left untreated? Untreated carpal tunnel syndrome progresses. You may lose grip strength and feeling in your fingers and hand. Severe CTS can lead to atrophy (weakness and deterioration) of the muscles at the base of the thumb.Once the muscles have atrophied, even surgery cannot fully recover hand function. Prevention and early treatment are essential. How can I prevent carpal tunnel? Prevention is based on keeping your wrists in a neutral position during activities and avoiding repetitive strain. Specialized work training programs can help you learn correct posture.Regular breaks and wrist stretches can help, too. Wearing fingerless gloves can keep hands and wrists warm plus promote circulation and flexibility. 7 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Chammas M, Boretto J, Burmann LM, Ramos RM, dos Santos Neto FC, Silva JB. Carpal tunnel syndrome – part I (anatomy, physiology, etiology and diagnosis). Revista Brasileira de Ortopedia. 2014;49(5):429-436. doi:10.1016/j.rboe.2014.08.001 Johns Hopkins Medicine. Carpal tunnel syndrome. American Academy of Orthopaedic Surgeons: OrthoInfo. Carpal tunnel syndrome. Fernandes CH, Meirelles LM, Raduan neto J, Nakachima LR, Dos santos JB, Faloppa F. Carpal tunnel syndrome with thenar atrophy: evaluation of the pinch and grip strength in patients undergoing surgical treatment. Hand (N Y). 2013;8(1):60-3. doi:10.1007/s11552-012-9471-8 Karne SS, Bhalerao NS. Carpal tunnel syndrome in hypothyroidism. J Clin Diagn Res. 2016;10(2):OC36-8. doi:10.7860/JCDR/2016/16464.7316 American Stroke Association. Stroke symptoms. Kozak A, Schedlbauer G, Wirth T, Euler U, Westermann C, Nienhaus A. Association between work-related biomechanical risk factors and the occurrence of carpal tunnel syndrome: an overview of systematic reviews and a meta-analysis of current research. BMC Musculoskelet Disord. 2015;16(1):1-9. doi:10.1186/s12891-015-0685-0 Additional Reading National Institutes of Health, National Institute of Neurological Disorders and Stroke. Carpal tunnel syndrome fact sheet. By Jonathan Cluett, MD Dr. Cluett is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the U.S. national soccer teams. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? 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