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.

Frequent Symptoms

carpal tunnel syndrome symptoms
© Verywell, 2018

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 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.

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.

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