What is carpal tunnel syndrome?

Carpal tunnel syndrome is a condition that causes pain and numbness in the fingers and hands. It happens when a nerve in the wrist called the “median nerve” gets pinched or squeezed.

The median nerve goes through a tunnel in the wrist that is formed by the bones of the wrist and a tough band of tissue called a “ligament”.

The median nerve carries signals about sensation—it tells the brain what the hand is “feeling.” It gets input from the palmar part of the hand.

What are the symptoms of carpal tunnel syndrome?

The symptoms include pain and tingling in the thumb and the index, middle, and ring fingers. The symptoms can be on both hands but usually pain is worse in one hand. Symptoms are usually worst at night and can even wake you up from sleep. The symptoms can also flare up when you do things that involve bending and unbending your wrist. Examples of activities that can trigger carpal tunnel symptoms include:

• Driving
• Reading
• Typing
• Holding a phone

n many people, the symptoms come and go. But in some, the symptoms may be persistent. They can end up having trouble moving their fingers or controlling their grip.

Is there a test for carpal tunnel syndrome?

Yes. Electrical tests of the nerves can show if you have carpal tunnel syndrome, but these tests are not always necessary.

Your doctor will probably be able to tell if you have carpal tunnel syndrome by learning about your symptoms and doing an exam. During the exam, he or she might tap on or press on your wrist, or ask you to hold your hands in ways that are known to make symptoms worse.

Electrical nerve tests can prove if you really have carpal tunnel syndrome. Doctors usually order these tests for people who might need surgery to treat their condition.

• Nerve conduction studies – Nerve conduction studies can show whether the median nerve is carrying electrical signals the right way. In people with carpal tunnel syndrome, signals can be slow or weak.
• Electromyography – Electromyography, also called EMG, can show whether the muscles in the hand and wrist are responding the right way to electrical signals. This test is most useful in checking whether another condition besides carpal tunnel syndrome might be causing the symptoms.

How is carpal tunnel syndrome treated?

Treatments are often combined and can include:

• Wrist splints – Some people feel better if they wear splints at night that keep their hands in a “neutral position.” The neutral position is when the wrist is not bent forward or backward and the fingers are curled naturally toward the palm.  
• Steroid shots or pills – Steroids are a group of medicines that control inflammation and swelling. To treat carpal tunnel syndrome, doctors sometimes inject steroids into the carpal tunnel.
• Surgery – Doctors offer surgery to people who have severe symptoms and who do not get better with other treatments. Surgery for carpal tunnel syndrome involves cutting the ligament that stretches across the wrist to form the tunnel.

People sometimes try other treatments for carpal tunnel, such as special exercises called “nerve-gliding” exercises. Only the treatments listed above have been proven to work for carpal tunnel syndrome.