What Does Carpal Tunnel Feel Like?

Carpal Tunnel Syndrome

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Carpal tunnel syndrome is a condition where one of the nerves of the wrist is pinched, causing symptoms in the hand and fingers. There are many reasons why a person can develop carpal tunnel syndrome, but here are some of the most common signs and symptoms.

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Tingling & Numbness

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The most common symptoms of carpal tunnel are tingling and numbness. Typically the tingling and numbness corresponds to the precise area where the median nerve is located. Many patients report their entire hand feels numb, but when the pattern of numbness is tested, it is almost always limited to the thumb, index, long, and half the ring finger. The small finger should not go numb in patients with carpal tunnel syndrome. Often the symptoms are most bothersome at night and can cause people to awaken from sleep. Many patients find their symptoms are relieved by shaking their hands.

Pain

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Pain is a common complaint of people with carpal tunnel syndrome. While tingling and numbness are the more common symptoms, pain is also a common complaint. Many people have pain in the same location as their numbness, although some patients also complain of pain radiating up the forearm as well as down into the hand. Like the tingling, pain is often relieved by shaking out the hand.

Weakness & Atrophy

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Nerves have three primary functions: sending messages to the brain about pain and about sensations, and sending messages from the brain to contract muscles. When carpal tunnel syndrome is severe, messages sent from the brain to the small muscles in the palm of the hand can be interrupted, causing the muscle to atrophy (weaken). This is seen as a side-to-side difference in the size of the meaty part of the palm of the hand and is considered a late finding of the most severe cases of carpal tunnel syndrome. When muscle atrophy is present, recovery tends to be partial, even when surgical treatment is pursued.

Tinel's Test

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Tinel's test is performed by tapping the median nerve along its course in the wrist. Because the nerve is compressed and irritated, tapping the nerve can cause abnormal sensations in the fingers. A positive test is found when this causes worsening of the tingling in the fingers when the nerve is tapped.

Phalen's Test

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Phalen's test is done by pushing the back of your hands together for one minute. This compresses the carpal tunnel and is also positive when it causes the same symptoms you have been experiencing with your carpal tunnel syndrome.

Abnormal Nerve Tests

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Nerve function can be tested by performing a specialized test to determine if the nerve is functioning normally. The most common tests are called EMG and nerve conduction studies (NCS). The studies are able to determine the electrical activity in muscles (the EMG), and how quickly an electric impulse travels along a nerve (NCS).

The studies are performed by sending a small electrical impulse along the nerve and measuring how fast it travels. While this happens in fractions of a second, sensitive instruments can detect if the nerve is functioning normally or not. The speed of the electrical impulse can be assessed and compared to the opposite side and also compared to known normal rates. 

Most often a nerve test is performed before any surgical treatment is done. This is helpful for two reasons. First, it confirms the diagnosis and the location of the nerve compression. Most often this can be determined with a careful examination, but it is helpful to have confirmation. Second, if there are any problems with recovery or complications from surgery, a baseline test from before surgery can help assess recovery.

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