Could You Have Carpal Tunnel Syndrome?

Do you ever feel tingling, burning or numbness in your arm or hand? Perhaps waking you up at night or when you hold the steering wheel or a phone? If so, you might have carpal tunnel syndrome.

Carpal tunnel symptoms are common in adults ages 30 to 60.  Thankfully, the symptoms of carpal tunnel syndrome are treatable. It is important to seek care if you show the signs of carpal tunnel syndrome.

Knowing how to spot the symptoms and what to do about them can offer carpal tunnel relief faster and get you back to living your best life.

What Is Carpal Tunnel Syndrome?

Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm to the wrist, becomes squeezed or compressed. A group of small nerves in your neck connect to your arm. There, they come together to form 5 major peripheral nerves including the median nerve which is affected in carpal tunnel syndrome. This nerve continues through your upper arm to your elbow. Then, into your forearm and through your wrist. Finally, it passes through the carpal tunnel to reach your hand supplying sensation to the thumb, index, middle and ring fingers.

The carpal tunnel in your wrist is a narrow passage created by the bones of the wrist and a ligament across the top of the tunnel, giving this part of your body little flexibility. Tendons  pass through the carpal tunnel along with the median nerve. When these tendons become swollen or inflamed, or fluid is retained in this region, it can put pressure on the median nerve. Because this nerve connects to your fingers and thumb, this pressure can cause tingling, numbness, discomfort, and/or weakness that are signs of carpal tunnel syndrome.

Signs Of Carpal Tunnel Syndrome

Symptoms of carpal tunnel syndrome usually occur in the thumb, index, middle and ring fingers. When symptoms become more prominent, burning pain may also be experienced most typically in the hand and forearm, rarely with upper arm symptoms.

Signs of carpal tunnel syndrome may include:

• Numbness, tingling, burning, itching or pain in hand, including thumb, index, middle and ring fingers
• Shock-like sensations in the hand or arm
• Weakness in the fingers or hand
• Difficulty with fine motor movements like buttoning clothes
• Dropping objects or having a weak grip
• Difficulty perceiving hot and cold

Symptoms of carpal tunnel syndrome may feel mild at first and worsen over time. Some people report having these sensations at night, with symptoms increasing in severity and frequency. If symptoms become more noticeable and frequent, it may be time to get them checked out.

“The biggest thing is recognizing the symptoms,” said Andrew Hills, DO, an Indianapolis sports medicine specialist in the Franciscan Physician Network. “It’s definitely something you want to get ahead of sooner rather than later.”

Carpal Tunnel Syndrome Causes

Many factors can cause carpal tunnel syndrome, including:

• Inherited physical traits, such as a small carpal tunnel or other anatomical features that affect the wrist
• Repetitive movement of the wrist and hand through daily activities such as knitting, texting, typing or using tools
• Traumatic injury, such as wrist fracture or sprain
• Workplace activities that involve using vibrating tools or repeated, forceful hand movements.

Carpal Tunnel Syndrome Risk Factors

Having another health condition that affects the nerves or causes inflammation may increase your risk. These conditions include:

• Diabetes
• Rheumatoid arthritis
• Thyroid gland imbalances
• Pregnancy.

The American Academy of Orthopedic Surgeons says other common risk factors for carpal tunnel include:

• Heredity, as smaller carpal tunnels can run in families.
• Using your hands in the same way repetitively over time.
• Having hormonal changes, such as those during pregnancy.
• Being older.

Carpal Tunnel Syndrome Prevention

Good news! There are steps you can take to prevent carpal tunnel syndrome. Reducing repetitive movements of the wrist and hand can lower inflammation in the carpal tunnel. If you move your hand in the same way often, you can try:

• Changing your grip
• Reducing the pressure you use when typing
• Taking breaks
• Using an elevated keyboard or ergonomic chair
• Wearing padded gloves when holding tools
• Writing text messages with your index finger instead of your thumb.

“Posture and good ergonomics can go a long way,” said Dr. Hills. “Keeping the wrist in a position where it isn’t flexed or bent keeps you from increasing compression across the carpal tunnel.”

Carpal Tunnel Treatment

If you think you have carpal tunnel syndrome, talk to your doctor. While most cases are treatable, symptoms not related to pregnancy rarely go away on their own. Early detection and treatment can be an important step to ensuring symptom resolution.

Without carpal tunnel treatment, carpal tunnel syndrome can worsen and lead to permanent damage to the nerves and muscles in your arm.

“Nerves generally don’t have the greatest healing or regenerative properties,” said Dr. Hills. “You definitely want to seek treatment before the symptoms become more severe and start to affect the muscles.”

Your doctor can check for carpal tunnel syndrome by testing the feeling and strength of the muscles in your fingers and hand. They may obtain a complete history of symptoms and should perform:

• Physical examination including a wrist flexion test
• There may be role for obtaining Electrical tests (EMG, nerve conduction studies)

Braces Or Wrist Splints For Carpal Tunnel

Your doctor may ask you to wear a brace or splint at night as part of your treatment for carpal tunnel. These devices can help you keep your wrist in a position that reduces pressure on the carpal tunnel. Bracing your wrist at night may be helpful if carpal tunnel symptoms keep you awake. During the day, they can help make activities that aggravate your symptoms less noticeable.

Medicines And Steroid injections For Carpal Tunnel

Over-the-counter drugs such as ibuprofen can help alleviate symptoms if related to recent injury or swelling. Injectable anti-inflammatory agents may be indicated in certain patients to also provide temporary relief.

Nerve Gliding Exercises

Some patients may benefit from stretching and flexibility exercises for carpal tunnel syndrome. Nerve glides are a kind of physical therapy for carpal tunnel. These exercises help the median nerve move more freely within the carpal tunnel.

“We also call it neuro glide,” said Dr. Hills. “It’s a series of motions that teach you to put your arm and hand into different positions. Changing positions causes a stretch on the nerve. Moving through those positions can help those nerves glide back and forth through the areas of compression, which has shown to be somewhat beneficial, especially for the milder cases.”

Carpal Tunnel Release Surgery

If symptoms don’t go away with conservative treatment, carpal tunnel release surgery may be indicated. During carpal tunnel release surgery, a doctor will expand the carpal tunnel to lessen pressure on the tendons and median nerve.

Symptoms disappear after surgery in most cases, however some symptoms are severe and may persist if permanent nerve changes have occurred prior to onset of treatment.

“For this reason, it is extremely important to recognize symptoms of carpal tunnel and begin treatment early to reduce the risk of permanent nerve changes,” said Kelly Graner, MD, an independent orthopedic surgeon who chooses to practice at Franciscan Health.

Recovery time may vary. Carpal tunnel release surgery is an efficient, safe outpatient procedure for most patients.

Keep Your Joints and Bones Healthy

Looking for a doctor near you to check for carpal tunnel syndrome? Find out more about Franciscan Health’s orthopedic care and providers.