Symptoms of Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a condition in which one of the nerves of the wrist is pinched, causing symptoms in the hand and fingers. You may feel numbness, tingling, pain, and weakness that develops gradually and may worsen. Learn the most common signs and symptoms and when to see your doctor.

carpal tunnel syndrome symptoms
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Frequent Symptoms

The symptoms of carpal tunnel syndrome will often develop gradually and can affect your dominant hand first.

Changes in Sensation

The most common symptoms of carpal tunnel are tingling and numbness. Some people also experience a sensation like an electric shock.

Typically, these altered sensations correspond to the precise area the median nerve serves. This is the nerve that passes through the carpal tunnel in your wrist to your palm, thumb, and each of your fingers except your pinky.

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 finger, middle finger, and half of the ring finger.

The small finger should not go numb in people with carpal tunnel syndrome.

You may feel the tingling or shock sensation traveling up from your wrist to your arm, along the path of the median nerve. You may find your symptoms are relieved by shaking out your hands.

Over time, you may lose your ability to tell hot from cold in the areas that feel numb.

Pain

Many people have pain in the same location as their numbness, although some 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.

Feeling of Swelling

You may also feel as if your fingers are swollen and find it difficult to use them. However, there isn't any evidence of swelling. For example, your rings still fit as usual.

Pattern of Symptoms

Often the symptoms are most bothersome at night and can cause you to awaken from sleep. While symptoms may start only at night or when awakening, your daytime activities such as driving, holding your phone, reading a book or newspaper, or buttoning your clothes may be affected. Symptoms can progress until you feel them often or constantly.

Weakness and Atrophy

As your symptoms progress, you may discover you don't have as much grip strength and it becomes difficult to hold objects and do tasks where you need manual dexterity. You may find yourself dropping things. You may feel you are becoming clumsy; while this may be due to weakness and numbness, it is also because the nerves can't maintain a sense of where your hand is in space, which is known as proprioception.

Nerves have three primary functions: sending messages to the brain about pain and 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 muscles at the base of the thumb to atrophy (weaken). You can see this shrinkage in the muscle when you compare the meaty part of your palm on one hand with that on the other hand. It 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.

When to See a Doctor

You should see a doctor if your symptoms have been continuing for two weeks or more. At first, the symptoms may come and go. Once they are persistent, waking you up at night, or interfering with everyday tasks, you should seek care. If the symptoms are due to CTS, allowing them to go on for too long increases the risk of muscle atrophy and permanent nerve damage.

Early treatment can also help avoid the need for surgery.

Visit your primary care provider for an assessment and general health check. If you don't have a primary care provider, you can see an internal medicine physician or an occupational medicine specialist. You may be referred to an orthopedic surgeon, neurologist, hand surgeon, rheumatologist, or physiatrist for further testing or treatment.

Carpal Tunnel Syndrome Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Man

Your doctor will consider other possible causes of the symptoms, including other nerve conditions and arthritis. In addition, carpal tunnel syndrome is seen more frequently in people with underlying conditions such as ​hypothyroidism, diabetes, and rheumatoid arthritis which you may not be aware that you have. Seeing your doctor will allow you to get a diagnosis and appropriate treatment for both carpal tunnel and any other conditions.

If you have a sudden loss of feeling in your arm, you should go to an emergency room. This is a sign of a more serious condition rather than carpal tunnel syndrome.

Frequently Asked Questions

What does carpal tunnel syndrome feel like?

Symptoms of carpal tunnel syndrome can include:

  • Changes in sensation, like tingling and numbness, or an electric shock sensation
  • Shooting or tingling pain that may radiate into your wrist or forearm, and that may be relieved when the hands are shaken out
  • Feeling like your fingers are swollen, even when they aren't
  • Symptoms that set in mostly at night, at least at first
  • Hand weakness, especially a weak grip

The symptoms of carpal tunnel tend to be felt throughout most of your hand, including your palm, thumb, and fingers—except for your pinky, which is not connected to the median nerve, the nerve affected by carpal tunnel.

What causes carpal tunnel syndrome?

Carpal tunnel syndrome occurs when one of the nerves in the wrist (the median nerve) becomes pinched due to pressure placed on the nerve as it passes through the narrow carpal tunnel. Certain wrist positions (such as sleeping with your wrists flexed) and repetitive activities can cause this pressure to increase. Other causes may include:

  • A wrist injury, like a sprain or fracture
  • Structural issues in the wrist
  • An underactive thyroid
  • Rheumatoid arthritis
  • Fluid retention during pregnancy or menopause

Does using a keyboard or a mouse cause carpal tunnel syndrome?

No, most studies have not shown that typing on a keyboard or using a mouse is directly linked to causing carpal tunnel. However, spending long hours doing an activity that keeps your wrist in a flexed position, like holding a pen or using some forms of machinery, has been shown to increase the pressure on the median nerve.

What helps relieve pain from a carpal tunnel flare?

Try an ice pack on your wrist to reduce swelling, and take frequent breaks from activities that seem to make your pain worse. In most cases, wearing a wrist brace at night or while you're performing your daily activities can help keep your wrist in the ideal position to prevent pressure buildup in the carpal tunnel. Wrist stretches and exercises, as well as yoga and acupuncture, also can help relieve inflammation and reduce pain.

How is carpal tunnel syndrome treated?

Treatment of carpal tunnel syndrome depends on the severity of your symptoms. In mild cases, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin can help relieve pain. Corticosteroid injections or oral prednisone may be helpful if your pain is more intense. A surgical procedure known as carpal tunnel release surgery is also an option if medication and home remedies aren't helping, though, like any surgical procedure, it's not without risks.

What happens if carpal tunnel syndrome is left untreated?

If left untreated, carpal tunnel syndrome may progress, causing you to lose feeling in your fingers and hand and lose grip strength. In severe cases, untreated carpal tunnel syndrome can result in atrophy (weakness and deterioration) of the muscles at the base of the thumb. When atrophy is present, even surgery cannot fully recover hand function, so prevention and early treatment are essential.

How can I prevent carpal tunnel?

Prevention is based on keeping your wrists in a neutral position when performing daily activities or job functions and avoiding repetitive strain. Specialized work training programs can be helpful to ensure correct posture, and regular breaks and wrist stretches can help, too. Wearing fingerless gloves can help ensure hands and wrists stay warm in cold workplaces, promoting circulation and flexibility.

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Article Sources
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