Carpal tunnel syndrome is a painful disorder caused by compression of a nerve in the wrist. The main treatments involve avoiding movements that cause pain, anti-inflammatories, wearing a splint at night, and occasionally surgery.
What is carpal tunnel syndrome?
Carpal tunnel syndrome is caused by compression of a nerve when it passes through the wrist.
The nerve affected is the median nerve, which carries the sense of touch to the thumb and most of the first three fingers, and controls movement for some of the hand muscles.
This nerve runs from the spinal cord down the arm then through the carpal tunnel – a narrow passageway in the wrist with just enough room for the tendons and nerves that pass through it. Swollen or thickened tendons mean there is less space for the median nerve, and it can become compressed.
Carpal tunnel syndrome can be caused by anything that makes the nerves or tendons larger, or makes the tunnel that they run through smaller. Common causes include overuse of the wrist, injuries to the wrist, arthritis and pregnancy.
Symptoms can include nerve pain in your hand or wrist, tingling and numbness in the fingers and palm, or a sense of weakness in the hand.
Treatments for carpal tunnel syndrome include splinting your wrist, anti-inflammatory medicines and avoiding troublesome activities. Surgery may be needed for some people.
What causes carpal tunnel syndrome?
Carpal tunnel syndrome can be caused by anything that makes the nerves or tendons larger, or makes the tunnel that they run through smaller, such as:
- a wrist or arm injury, such as a sprain or fracture
- activities that involve repetitive use (overuse) of the wrist and hand, including using vibrating tools
- rheumatoid arthritis and other joint disorders or connective tissue disorders
- tendonitis
- fluid retention during pregnancy or menopause
- a cyst or tumour in the carpal tunnel
- diabetes
- hypothyroidism
- abnormal growth of the hands (acromegaly)
- kidney disease with dialysis.Sometimes, carpal tunnel syndrome just happens without any obvious cause.
Symptoms
The most common symptoms of carpal tunnel syndrome are:
- tingling or numbness in your fingers or the palm of your hand
- nerve pain in your wrist or hand, which can spread up your arm or down to your fingers
- weakness in your hands
- swollen fingers.
Symptoms are usually worse in the hand you use the most (your dominant hand), but it can affect both hands.
Over time, people with carpal tunnel syndrome might find that they slowly lose strength and movement in their hand and wrist. So it’s important to see your doctor if you think you may have carpal tunnel syndrome.
Carpal tunnel syndrome treatments
Treatment for carpal tunnel syndrome depends on its cause.
Your clinician will ask about your symptoms, such as wrist pain or tingling in your fingers, and will perform a physical examination.
You may have further tests such as a nerve conduction study (to test the speed the median nerve transmits impulses through the carpal tunnel) and blood tests to rule out associated conditions, such as rheumatoid arthritis. They may also request x-rays, particularly if you have injured or broken your wrist or have bone changes.
Treatment options can include:
- treating a related medical condition that could be causing the symptoms
- wearing a wrist brace (also called a splint) to keep the wrist straight, especially at night
- anti-inflammatory medicines to ease pain
- avoiding activities that cause symptoms
- physiotherapy
- corticosteroid injections into the wrist
- carpal tunnel surgery.
