Updated from Sept. 27, 2017
Carpal tunnel syndrome is a common cause of wrist pain and weakness. This guide explains what triggers it and how you can find effective relief.
Carpal tunnel syndrome is one of the most common conditions affecting the wrist and hand, often leading to pain, numbness, and reduced function. Symptoms typically develop gradually and may eventually interfere with daily activities. Although carpal tunnel syndrome affects an estimated 1% to 5% of the population, it is highly treatable when diagnosed early.
By recognizing the early signs and learning about available treatments, you can take meaningful steps toward relieving symptoms and protecting long-term hand function.
What is carpal tunnel syndrome?
The carpal tunnel is a narrow passageway formed by the bones and ligaments of the wrist. The median nerve, which provides sensation to the thumb, index, middle, and part of the ring finger, runs through this space along with several flexor tendons.
Carpal tunnel syndrome occurs when the median nerve becomes compressed within this confined space. That pressure often leads to difficulty doing fine motor skills with your hands, such as buttoning a shirt, lifting a cup, or gripping an object.
What causes carpal tunnel syndrome?
The causes of carpal tunnel syndrome range from everyday work tasks to medical conditions. Here’s a rundown of possible carpal tunnel syndrome causes:
- Repetitive motions. Activities that require frequent wrist bending or gripping, such as hammering, assembly work, or repetitive hand tools, can place stress on the median nerve.
- Chronic conditions. Nerve damage linked to diabetes and inflammatory conditions such as rheumatoid arthritis can pressure the median nerve. Arthritis can alter the small bone structure of the wrist and also affect the median nerve.
- Anatomy. People with naturally smaller carpal tunnels are more prone to the condition.
- Pregnancy. Hormonal changes and fluid retention can temporarily increase pressure within the carpal tunnel.
- Fracture. A wrist fracture or sprain can narrow the carpal tunnel.
- Workplace factors. Certain jobs put more pressure on the wrist than others. Using vibrating machinery or performing repetitive, forceful hand motions can irritate the median nerve. In office settings, the issue is usually not typing itself but the way the wrists are positioned while typing. Whether you work at a desk or in a hands-on trade, improving wrist alignment and reducing repetitive strain can help lower your risk.
- Genetics. Smaller carpal tunnels or other anatomical traits may run in families.
Carpal tunnel syndrome symptoms
Carpal tunnel syndrome has a few tell-tale signs. You may notice:
- Numbness and tingling centered in the thumb, index, middle, and ring fingers (not the pinky)
- Pain in the hand, wrist and fingers that intensifies at night when at rest
- Pain that radiates up the forearm
- Weakness or a tendency to drop objects due to decreased grip strength
If these symptoms begin interfering with daily life or sleep, it’s best to see a medical professional. Waiting too long can lead to ongoing nerve irritation and even muscle loss.
How is carpal tunnel syndrome diagnosed?
To correctly diagnose carpal tunnel syndrome and rule out other possible causes, your doctor will assess your condition using the following diagnostic techniques:
- Health history. Knowing when symptoms started and frequency can help identify the condition.
- Physical exam. Bending the wrist and tapping on the nerve can often trigger symptoms.
- Imaging tests. X-rays may be ordered to determine if the wrist pain is due to arthritis or a fracture. An ultrasound provides a detailed image of the nerve.
- Nerve conduction test. A small electrical impulse checks how well the median nerve carries signals. Slow responses may indicate compression.
How to treat carpal tunnel syndrome
Most people improve with conservative care, especially when treatment starts early. A physical therapist or orthopedist may recommend:
Nighttime bracing to keep the wrist immobile while at sleep.
Medications, such as nonsteroidal anti-inflammatory drugs and steroid injections.
Lifestyle changes such as arranging your workstation in an ergonomic manner.
Refraining from any activity that strains the wrist.
Physical therapy to stretch and strengthen the muscles to reduce symptoms, such as wrist rotations.
Surgical Treatment
If conservative treatments don’t provide enough relief, carpal tunnel release surgery is a highly effective outpatient option.
It can be performed in two ways:
- Open surgery: A small incision in the palm.
- Endoscopic surgery: Two tiny incisions using a camera.
In both procedures, the surgeon releases the transverse carpal ligament, which relieves pressure on the median nerve. The ligament gradually heals but leaves more space for the nerve.
After surgery, you may be advised to:
- Use your hand but avoid strenuous movements
- Elevate your hand above your heart to reduce swelling
- Ice the area to reduce swelling
- Keep the surgical incision clear and dry
- Wear a splint if recommended
- Undergo physical therapy to improve wrist function
Recovery time varies, but most people feel significant improvement within weeks to a few months.
How to prevent carpal tunnel syndrome
Although not all cases can be prevented, several habits can help protect your wrists:
Change your workstation to ensure the proper wrist alignment:
- Keep wrists aligned with your forearms while typing.
- Maintain a 90-degree bend at the elbows.
- Adjust your chair to support good posture.
- Consider ergonomic keyboards, mice, or wrist rests.
- Avoid slouching, which strains nerves and tendons.
Build wrist-friendly habits:
- Take regular breaks from repetitive tasks.
- Stretch your hands and wrists before and after activity.
- Manage chronic conditions such as diabetes or rheumatoid arthritis.
Helpful stretches to try:
Wrist Flex & Extend
- Extend your arm with your palm down; gently bend your wrist downward, hold 15–30 seconds.
- Turn your palm up; gently pull your hand toward you, hold 15–30 seconds.
- Repeat 3–5 times per hand.
Wrist Curls
- Rest your forearm on a table, hand over the edge.
- Using a light weight or resistance band, curl your wrist upward and then lower it slowly.
- Do 10–15 repetitions and repeat with your palm facing down.
Get your wrist moving again
Carpal tunnel syndrome can be frustrating, but it doesn’t have to take over your life. Relieve your wrist and hand pain with therapy supervised by an orthopedist at New York Bone & Joint Specialists. Based on our years of experience treating carpal tunnel syndrome, we will develop a treatment plan to help you perform your tasks for work or fun without any restriction. Contact us today either online or by phone to learn more.
FAQs
What is the best treatment for carpal tunnel syndrome?
Conservative treatment with physical therapy, rest, medications, and nighttime splinting can reduce symptoms. You can also consider rearranging your workstation to take the strain off your wrist. If those don’t work, surgery is a viable option.
How do I get instant relief from carpal tunnel?
Carpal tunnel syndrome symptoms gradually diminish once you start conservative therapy. However, it may take a few weeks or more for a complete reversal of pressure on the median nerve.
Will the carpal tunnel heal on its own?
Possibly. But you’d have to avoid any repetitive wrist motions for a period of time, and that may be difficult if you work with your hands. It’s better to seek treatment than wait for carpal tunnel syndrome to dissipate on its own. Therapy promotes quicker healing and a faster return to full wrist function.
What’s the best exercise for carpal tunnel syndrome?
Exercises that stretch and strengthen the wrist can alleviate carpal tunnel syndrome symptoms. Try wrist curls to strengthen the wrist, and wrist flexes and extensions to increase range of motion.
What are the 4 symptoms of carpal tunnel?
The four distinct symptoms of carpal tunnel syndrome are:
- Numbness and tingling in the thumb, index, middle, and right finger, but not the pinky.
- Pain in the wrist, hand, and fingers that worsens at night and interrupts sleep.
- Pain radiating up the forearm.
- Inability to hold or use objects due to muscle weakness in the hand and fingers.
