Carpal Tunnel Syndrome

The median nerve travels through a short tunnel at the wrist called the carpal tunnel.  The median nerve is responsible for supplying sensation to the thumb, index and middle fingers.  The median nerve can get compressed within the carpal tunnel to cause numbness and tingling in the thumb, index and middle fingers.  This is called carpal tunnel syndrome.

What are the causes?

For most patients the exact cause is unknown.  Prolonged pressure to the nerve at the wrist can cause symptoms and so may relate to a patient’s occupation.  It is more common in women and is associated with pregnancy and medical conditions such as diabetes and thyroid problems.  Previous wrist trauma can also cause symptoms.  

What are the symptoms?

The main symptoms are of tingling and altered feeling in the thumb, index and middle fingers.  This is usually worse at night.  Gripping objects, such as a telephone or driving, can provoke symptoms. Weakness in the hand or a loss of coordination of the fingers can occur in more severe cases.

How is it diagnosed?

Your surgeon can usually make the diagnosis by asking about the symptoms you have and examining your hand.  Nerve conduction studies can be used to confirm the diagnosis.

How is it treated?

If symptoms are mild then avoidance of aggravating factors, night splints and steroid injections can be used.  If symptoms persist then surgery in the form of a carpal tunnel release can be performed.