Ask Your Family Doctor

Developed by the College of Family Physicians of Canada

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a painful disorder of the wrist and hand. The carpal tunnel is a narrow tunnel formed by the bones and other tissues of your wrist. This tunnel normally protects your median nerve. The median nerve gives you feeling in your thumb, and index, middle and ring fingers. But when other tissues in the carpal tunnel, such as ligaments and tendons, get swollen or inflamed, they press against the median nerve. That pressure can make part of your hand hurt or feel numb.

What are the symptoms of carpal tunnel syndrome?

You may have symptoms in one or both of your hands, but the hand you use most will usually show the symptoms first. See below for a list of symptoms.

Symptoms of carpal tunnel syndrome

	Numbness or tingling in your hand and fingers. You may feel this the most in your thumb, and index and middle fingers.
	Pain in your wrist, palm or forearm.
	More numbness or pain at night than during the day. The pain may be so bad it wakes you up. You may shake or rub your hand to get relief.
	More pain as you use your hand or wrist more such as when driving.
	Trouble gripping objects.
	Weakness in your thumb.
	If you're a woman, more pain before your period, in the last few months of pregnancy or in the first few months after delivery. This is because you may retain fluids at these times. What leads to carpal tunnel syndrome? Making the same hand movements over and over can lead to carpal tunnel syndrome. It's most common in people whose jobs require pinching or gripping with the wrist held bent. People at risk include people who use computers, carpenters, grocery checkers, assembly-line workers, meat packers, violinists, mechanics, or anyone using vibrating machinery. Hobbies such as gardening, needlework, and golfing and canoeing can sometimes bring on the symptoms. Carpal tunnel syndrome is linked to other things too. It may be caused by an injury to the wrist, such as a fracture. Or it may be caused by a disease such as diabetes, rheumatoid arthritis or thyroid disease. Carpal tunnel syndrome can also occur during pregnancy. It is most common in women age 40 to 60. How is carpal tunnel syndrome diagnosed? Your doctor will probably ask you about your symptoms. He or she may examine you and ask you how you use your hands. Your doctor may also do these tests: Your doctor may tap the inside of your wrist. You may feel pain or a sensation like an electric shock. Your doctor may ask you to bend your writst down for one minute to see if this causes symptoms. Your doctor may order a nerve conduction study or an electromyography (EMG) test to see whether the nerves and muscles in your arm and hand show the effects that are typical of carpal tunnel syndrome. How serious is carpal tunnel syndrome? Carpal tunnel syndrome isn't usually serious. With treatment, the pain will usually go away and you'll have no lasting damage to your hand or wrist. How is carpal tunnel syndrome treated? If your carpal tunnel syndrome is caused by a medical problem, your doctor will probably first treat that problem. If you have thyroid disease, for example, carpal tunnel syndrome may go away when you start taking medicine for the thyroid problem. If your carpal tunnel syndrome isn't caused by another medical problem, your doctor may begin your treatment by asking you to rest your wrist or change how you use your hand. Your doctor may also ask you to wear a splint on your wrist. The splint keeps your wrist from moving but lets your hand do most of what it normally does. A splint can help ease the pain of carpal tunnel syndrome, especially at night. Putting ice on your wrist, massaging the area and doing stretching exercises of the wrist may help too. Tips on easing carpal tunnel syndrome Prop up your arm with pillows when you lie down. Avoid using your hand too much. Find a new way to use your hand by using a different tool. Try to use the other hand more often. Avoid bending your wrists down for long periods. What about medicine? Your doctor may also suggest you use a medicine such as ibuprofen or ASA to help ease the discomfort of carpal tunnel syndrome. Your doctor may give you a shot in your carpal tunnel with a drug such as cortisone. This may help stop the swelling and inflammation and ease the pain. But the relief may not last. If you get carpal tunnel syndrome while you're pregnant, your doctor may not treat it with medicine unless the pain gets very bad. Carpal tunnel syndrome that happens during pregnancy usually goes away with childbirth. What if these treatments don't work? In some cases, surgery is needed to make the symptoms go away. The surgery involves cutting the ligament that may be pressing on your median nerve. You'll usually get back the normal use of your wrist and hand within a few weeks to months after surgery. Doing the hand, wrist and finger exercises that your doctor asks you to do after surgery is important. This means you can play a big part in how well your surgery turns out. Can I prevent carpal tunnel syndrome? Yes. By watching your health and the way you use your hands, you can lower your risk of getting carpal tunnel syndrome. Many products you can buy - such as wrist rests - are supposed to ease symptoms of carpal tunnel syndrome. Some people may have less pain and numbness after using these products. For others, symptoms may get worse. No one has proved that these products really prevent wrist problems. Things that may help prevent carpal tunnel syndrome Lose weight if you're overweight. Cut down on alcohol use and smoking. Get treatment for any disease you have that may cause carpal tunnel syndrome. If you do the same tasks with your hands over and over, try not to bend, extend or twist your hands for long periods. Don't work with your arms too close or too far from your body. Don't rest your wrists on hard surfaces for long periods. Switch your hands during work tasks. Hold objects instead of pinching them. Make sure your tools aren't too big for your hands. Use tools that don't vibrate too much. Take regular breaks from repeated hand movements to give your hands and wrists time to rest. Don't sit or stand in the same position all day. If you often use a computer or type a lot, adjust the height of your chair so that your forearms are level with your keyboard and you don't have to flex your wrist to type. PDF Version Revised 2007 The College of Family Physicians of Canada This information provides a general overview on this topic and may not apply to everyone. To find out if this information applies to you and to get more information on this subject, talk to your family doctor. This health education material has been favorably reviewed by the Patient Education Review Committee of the College of Family Physicians of Canada: Dr Cathy MacLean, Halifax, NS (Scientific Editor) Dr C. Richard Fischer, Pickering, ON Dr Patrice Laplante, Fleurimont, QC Dr Richard Moffatt, Red Deer, AB Dr David Nunn, Kentville, NS Dr Cornelius Woelk, Winkler, MB The College of Family Physicians of Canada, one of the nation's largest medical groups, is committed to promoting and maintaining high standards for family physicians - the doctors who provide ongoing, comprehensive care for people of all ages. This patient education information was developed by The College of Family Physicians of Canada in cooperation with the American Academy of Family Physicians. Support for this program has been provided by an educational grant to the Research and Education Foundation by Scotiabank. Copyright © 2009  Privacy Policy  | Last updated: 06/09/2008