Carpal tunnel syndrome

Carpal tunnel syndrome, also known as carpal tunnel, is a condition that can cause pain, tingling, numbness, and sometimes a loss of dexterity in the fingers and hands. Symptoms develop when the median nerve is compressed or irritated as it passes through a bone structure in the wrist called the carpal tunnel.

Causes and triggers

Tendons required to move your hands and fingers also pass through the carpal tunnel. Frequent repetitive movements can irritate these tendons and cause them to swell. If the tendons become swollen, they can squash or pinch your median nerve, leading to carpal tunnel syndrome. Repetitive movements are often performed at work.

Other factors can increase the likelihood of developing carpal tunnel syndrome:

• Being a woman
• Being pregnant (symptoms often stop after childbirth)
• Being overweight
• Certain chronic conditions such as diabetes, rheumatoid arthritis, hypothyroidism
• Hormonal changes caused by oral contraceptives or menopause
• A wrist injury

However, in the majority of cases, the cause of carpal tunnel syndrome remains unknown.

Symptoms may be present in both hands, but not necessarily with the same intensity. They may be intermittent or constant, depending on the stage of the syndrome, and may worsen in certain situations: 

• At night (some people are woken by the pain)
• While driving
• When holding a phone
• When writing

For certain people, symptoms are not limited to the fingers and hand. They may also affect the forearm, though they rarely extend beyond the elbow. When severe, carpal tunnel syndrome can reduce hand strength and dexterity to the point where it becomes difficult to do simple tasks, such as unscrewing a bottle.

Treatment

Treatment varies according to the severity of the condition.

For a mild form of carpal tunnel syndrome, wearing a wrist brace may be helpful, especially if symptoms are nocturnal. The brace keeps your hand in a neutral position, which limits painful movements. It's particularly useful for women who develop carpal tunnel syndrome during pregnancy, as their symptoms are often temporary and improve after childbirth.

If the condition is severe, you may need injections to reduce the inflammation, or in some cases, surgery.

If the syndrome is caused by an external illness, such as rheumatoid arthritis or hypothyroidism, treating these other conditions can help resolve carpal tunnel symptoms. In addition, anti-inflammatory drugs such as ibuprofen (e.g., Advil, Motrin) can be taken to relieve the pain.

When should I see a health care professional?

If you think you have carpal tunnel syndrome, it's important to see a health care professional to receive a diagnosis and slow the progression of symptoms.