Carpal Tunnel

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What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a common wrist condition that causes persistent pain, tingling and numbness in the palm, fingers and thumb.

Your carpal tunnel is a narrow passageway at the base of the hand near your wrist. In carpal tunnel syndrome, the median nerve (which runs from your forearm down into the palm of your hand) is compressed or squeezed as it passes through the carpal tunnel.

There are treatments for carpal tunnel syndrome, including simple self-care measures, medicines, splinting and surgery. In up to a third of people, it gets better on its own without treatment.

What are the Symptoms of Carpal Tunnel Syndrome?

Symptoms of carpal tunnel syndrome can include:

  • Tingling and numbness in the fingers and palm of your hand that feels like ‘pins and needles’. Some people experience a sensation that the fingers are swollen, even if they look normal in size.
  • Pain in your wrist or hand, which can radiate up the arm to your elbow or down to your fingers. Pain can vary from a dull, aching sensation, through to a burning feeling, or a sharp, piercing or shooting pain, like a very bad cramp.
  • Weakness in your hands or a loss of grip strength, which can make it difficult for you to hold small objects, clench your fist, or carry out your usual tasks.

The pain and discomfort can often be relieved by shaking out the hands (like you are flicking water off your hands).

Symptoms usually come on slowly and get progressively worse over time. The symptoms may be worse at night, particularly if you tend to sleep with your wrists flexed, with your palm bent down towards the front of your forearm.

For most people, their dominant hand is the first to develop symptoms, although both hands can be affected.

If left untreated, the excess pressure on the median nerve can cause the muscles near the base of the thumb to waste away.

What causes Carpal Tunnel Syndrome?

The carpal tunnel is a narrow, stiff passageway at the base of your hand that is made up of bones and ligaments. The median nerve and tendons pass through the carpal tunnel into your hand.

The median nerve is a large nerve that controls sensations to the palm side of the thumb and your first 3 fingers (but not the little finger). It also supplies movement to some of the small muscles in the hand that allow you to move your thumb and fingers.

So if the carpal tunnel narrows for any reason – or if the tendons within the tunnel become thickened or swollen – there is less space in the tunnel for the median nerve. As a result, the median nerve becomes compressed (squeezed), and the extra pressure on the nerve can lead to pain, tingling, numbness, itching and burning sensations.

Treatment for carpal tunnel syndrome

Up to 1 in 3 people with carpal tunnel syndrome get better without any specific medical treatment. In people with an underlying cause (such as diabetes or an underactive thyroid gland), carpal tunnel syndrome may get better when the underlying cause is treated.

If you are experiencing troublesome symptoms, there are a number of treatments, including:

  • Rest. You should avoid any activities or movements that aggravate your symptoms for at least 2 weeks.
  • A cool pack can help provide relief if there is any swelling of your hand or wrist.
  • Splinting. Splinting the wrist or wearing a hand brace may be part of the initial treatment. These devices are usually worn at night to start with, to help prevent the wrist from being bent during sleep.
  • Elevating the hand and forearm on a pillow during sleep can help relieve symptoms.
  • Corticosteroids. If initial treatments don’t control symptoms, your doctor may recommend corticosteroids to reduce inflammation in the carpal tunnel. Corticosteroids can be given as an injection directly into the wrist.

Surgery is often recommended if symptoms continue despite these treatments.


A procedure called a carpal tunnel release may be recommended to treat severe or ongoing carpal tunnel syndrome that is not responding to other treatments. During this procedure, the transverse carpal ligament (which forms the roof of the carpal tunnel) is cut. This makes more space in the carpal tunnel and releases the pressure on the median nerve.

Dr David Ward performs carpal tunnel release procedures at Albany Health Campus, Albany Day Hospital and also in the rooms at SRMG.

Many people get relief from their symptoms within a week of carpal tunnel surgery, but full recovery may take several months to a year.