Signs & Symptoms of Carpal Tunnel Syndrome & How to Treat

Does this sound familiar? You’ve begun experiencing numbness and tingling in your fingers, a burning and itching sensation, particularly in your thumb, index, middle fingers and perhaps the palm of your hand. Your fingers feel swollen, though there is no evidence of swelling. You often feel the need to “shake out” your hand to wake it up. While you’ve tried to ignore these symptoms, they have worsened. Now you struggle to pick up small objects, manipulate buttons, open jars, and put pieces together.  

If you are suffering from any of the above mentioned symptoms, you could have carpal tunnel syndrome.

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a painful progressive condition caused by compression of a key nerve in the wrist—the median nerve. Our median nerve, which runs through the carpal tunnel from the forearm to the palm of the hand, controls sensations in the palm side of the thumb and fingers (excluding the little finger).  It also activates our nerves to move the muscles around the thumb and fingers.  When this nerve becomes compressed, it is unable to function properly.

Who is most likely to develop the syndrome?

  • Women are three times more likely than men to have carpal tunnel syndrome.  This is probably because the carpal tunnel is smaller in women than men.
  • Chronic illnesses, such as diabetes or other metabolic disorders and inflammatory conditions such as rheumatoid arthritis or infection, can increase the risk of nerve damage. 
  • Certain conditions that affect body fluids such as pregnancy and thyroid disorders can affect the median nerve in the carpal tunnel space. 

Contrary to popular belief, there is little scientific data to support whether repetitive and forceful movements of the hand and wrist during work or leisure activities can cause carpal tunnel syndrome.

What should I do if I suspect carpal tunnel?

It is important to seek medical attention early if symptoms persist in order to avoid permanent damage to the median nerve.  Be sure to give an accurate description of your symptoms.  Tell your doctor about the timing of symptoms (upon waking, gripping the steering wheel, grasping small items, etcetera).  There are a number of tests your doctor might perform to positively identify the diagnosis.  Your doctor will test the strength and sensation in your hand.  X-rays, nerve conduction studies, or electromyograms (measures electrical impulses of the muscle) may be ordered to assist with the diagnosis. 

What treatment is available?

There are a number of treatment options to help reduce the symptoms of carpal tunnel syndrome.  Non-surgical treatments include medication such as anti-inflammatories and cold packs to reduce the pain.  Splinting may be recommended for night positioning, or during the day to support the wrist when doing routine activities. Yoga is an alternative method which has been shown to reduce pain and increase hand function.  It is always important to consult your physician prior to beginning any treatment.

Exercise under the supervision of an occupational or physical therapist can be helpful to alleviate the symptoms associated with carpal tunnel syndrome.  Strengthening and stretching exercises are commonly prescribed.  Simulation of purposeful activities such as occupations and daily life tasks of self-care, cooking, cleaning, etcetera, may be helpful, not only in the healing process but in adapting to the condition as well.  Techniques may include how to hold your baby or bake a cake using adaptive methods to compensate for limited mobility. When conservative treatments are ineffective, surgery is often the best option.  This involves releasing the carpal ligament, enlarging the space and reducing the pressure on the nerve.   

Can carpal tunnel be prevented?

Although carpal tunnel syndrome cannot be prevented, you can reduce stress on the hands to minimize the pressure on the median nerve and reduce symptoms.  Make a habit of stretching and moving your hands and wrists and take breaks from repetitive motions and positioning. A night splint may help position the wrist to minimize compression on the nerve.  It is important to recognize and treat the symptoms of carpal tunnel syndrome early to reduce the long term effects caused by compression of the median nerve. If left untreated, the nerve can be damaged, causing permanent weakness, numbness, and tingling.