Carpal Tunnel Syndrome at a Glance

Learn More about Carpal Tunnel Syndrome

Carpal tunnel syndrome is characterized by aching pain in the wrist and forearm, with pain often radiating down into the fingers. Symptoms of carpal tunnel syndrome often increase gradually and might initially occur only at night. It can happen in one or both wrists, and a dull, aching pain may spread into all digits except the little finger.

Tingling or burning sensations may be experienced in the hand and fingers and can radiate all the way up the arm into the shoulder.

Weakness in the hands and fingers might also occur. To diagnose carpal tunnel, a few tests can be performed to reproduce symptoms.

Phalen’s sign is performed by pushing the back of the hands together to bend the wrists and holding the hands in this position for 60 seconds. If the patient experiences tingling in the thumb, index and fourth finger then the test is positive.

Tinel’s test is performed by tapping the front side of the wrist with two fingers. If the patient experiences tingling or other symptoms, it may be a sign of carpal tunnel. MRI scans, ultrasound imaging, nerve conduction study or electromyography can also confirm a diagnosis.

Carpal tunnel symptoms occur due to a compressed median nerve in the wrist. This nerve, along with the muscle tendons of the forearm, passes through a small channel called the carpal tunnel. If this tunnel narrows due to a variety of reasons, including injury, repetitive strain, fluid retention, or use of vibrating machinery, it compresses the nerve.

Women are much more likely to suffer from carpal tunnel because they tend to have narrower carpal tunnels. The condition usually occurs in the dominant hand first and may develop in the other hand as well.

If possible, non-invasive treatments should first be attempted, and surgery should only be considered if these treatments are not successful after a few weeks:


Cease or limit activities that aggravate the pain. Not resting the painful wrist prevents the inflammation from reducing and the soft tissue from healing. Activities such as typing on the keyboard or participating in racket sports may be the culprit of the pain.

Wrist splint

Wearing a carpal tunnel wrist splint will prevent movement of the wrist joint. This gives the wrist a chance to rest while permitting some hand function. The splint is made from durable material with a metal support along the wrist to immobilize the joint.

Ice or cold therapy

Apply ice or a cold wrap to the joint for 10 minutes every hour to reduce swelling. As symptoms decrease, the ice or wrap may be applied less frequently.


Anti-inflammatory medications such as ibuprofen can reduce inflammation and alleviate the pain. If fluid retention is causing symptoms, diuretics may also be suggested.


After the joint has been given a chance to rest, stretching and strengthening exercises are recommended to help prevent the symptoms from recurring.

If pain occurs in the wrist during these exercises, continue resting until it is no longer painful to perform the exercises. Gently stretch the joint at first to restore full range of motion. After this, begin static exercises that do not require movement of the wrist. Once these are comfortable to perform without pain, continue on to dynamic exercises with movement and resistance bands or weights to restore normal strength. If there is no improvement, corticosteroids or lidocaine injections may be an option.


If symptoms do not let up, then surgery may be required. Carpal tunnel release is very common and is usually an outpatient procedure. The surgery involves relieving pressure on the median nerve by cutting the carpal ligament. The operation may be arthroscopic or an open release with a small incision.

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