Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is a squeezing of the median nerve at the wrist. This nerve brings feeling to the thumb, index finger, middle fingers, and half the ring finger.
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This problem is caused by pressure in the carpal tunnel. This is the passage that the nerve uses as it goes from the wrist into the hand. The cause of this pressure is not always known. Other times it may be due to:
- Injury to the wrist
- Problems in the way the carpal tunnel, bones, tendons, muscles, or ligaments look or work
- Blood vessel problems
- Long-term health problems, such as obesity, heart failure, or osteoarthritis
CTS is more common in women and adults over 50 years of age. Other things that may raise the risk are:
The problem may be in one or both hands or wrists. These issues may get worse over time:
- Numbness, tingling, or swelling
- Pain that goes from the wrist to the shoulder
- Pain that gets better with hand or wrist shaking
- Loss of grip strength
The doctor will ask about your symptoms and past health. A physical exam will be done, looking closely at the arms, wrists, and hands. The doctor may ask about the tasks done at work.
An ultrasound may be done to help confirm the diagnosis. This will use sound waves to measure the nerve area.
It is important to adjust what is causing CTS. Making simple changes at work and home may ease problems. Ask work for ergonomic details they may have to decrease stress on wrist.
Other options may be:
Care that may help includes:
- Resting the wrist by keeping it straight and not doing things that worsen pain
- Putting ice packs on the wrist
- Raising the hand above the heart to ease swelling
- Wearing a hand splint to ease pain, especially at night
- Doing exercises to make the wrist stronger and help it to move better
Medicine may be given to ease pain. Steroids may also be injected into the carpal tunnel to ease swelling.
Some people may need surgery if initial care does not help or symptoms are severe. Carpal tunnel release cuts the transverse carpal ligament and release pressure on the nerve. A splint can help ease pain after surgery.
There are no known methods to lower the chance of CTS.
American Association of Neurological Surgeons
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Centre for Occupational Health and Safety
Canadian Physiotherapy Association
American Academy of Orthopaedic Surgeons (AAOS). Clinical Practice Guideline on the Treatment of Carpal Tunnel Syndrome. AAOS 2016 Feb PDF.
Carpal tunnel syndrome. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/carpal-tunnel-syndrome. Accessed December 13, 2020.
Carpal tunnel syndrome fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Carpal-Tunnel-Syndrome-Fact-Sheet. Accessed December 13, 2020.
Last reviewed December 2020 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS Last Updated: 8/14/2020