Carpal Tunnel

Pressure on the median nerve can stem from anything that reduces the space for it in the carpal tunnel.

Symptoms

Progressing from a vague ache in the wrist that may extend to the hand or forearm to tingling or numbness in the fingers or hand, especially the thumb, index, middle or ring fingers, but not the little finger.

About this Condition

Pressure on the median nerve can stem from anything that reduces the space for it in the carpal tunnel. Causes might include anything from bone spurs to the most common cause, which is swelling or thickening of the lining and lubricating layer (synovium) of the tendons in the carpal tunnel.

The nerve involved is the median nerve. The median nerve is a mixed nerve, meaning it has a sensory function and also provides nerve signals to move the muscles. The median nerve provides sensation to the thumb, index finger, middle finger and the middle-finger side of the ring finger.

The sensations associated with carpal tunnel syndrome often occur while driving a vehicle or holding a phone or a newspaper or upon awakening. Many people "shake out" their hands to relieve their symptoms. There may be pain radiating or extending from the wrist up the arm to the shoulder or down into the palm or fingers, especially after forceful or repetitive use. This usually occurs on palm side of the forearm. A sense of weakness in the hands and a tendency to drop objects as well a constant loss of feeling in some fingers can occur if the condition is advanced.

This content is for your general education only. See your doctor for a professional diagnosis and to discuss an appropriate treatment plan.

Conservative Treatments

Physical Therapy / Occupational Therapy for Carpal Tunnel

Physical and occupational therapy can play a vital role in treating your symptoms.

Physical therapy often includes hot and cold compresses and instructions not to sleep on your wrists. You may be fitted with a wrist splint to wear at night and possibly during the day.

Occupational therapy is focused on helping you make changes in the workplace, at home or wherever the repetitive stress is occurring. For example, you may need a special keyboard or mouse if typing is causing the swelling and pressure on your median nerve.

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Medications for Carpal Tunnel

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen are often used to treat carpal tunnel syndrome. Corticosteroids may be injected into the carpal tunnel area, providing relief for an extended period of time.

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Surgery

Carpal Tunnel Decompression

If the muscles in the hand and wrist are getting smaller because the nerve is being pinched, surgery will usually be done right away.

A carpal tunnel decompression divides the transverse carpal ligament that makes up part of the carpal tunnel. This makes more room for the median nerve and tendons that pass through the tunnel. Your surgeon may use an endoscope to perform this procedure in a minimally invasive way.