Carpal tunnel syndrome is a common condition in which there is compression of an important nerve across the wrist called the “median nerve.” Compression or pressure on this nerve can cause discomfort in the hand, leading to problems with sensation and weakness of the fingers. Patients frequently describe numbness and tingling when they wake up in the morning. Risk factors include female gender, pregnancy, and possibly repetitive hand use. Early diagnosis and treatment may greatly help symptoms of carpal tunnel syndrome.
Common Symptoms
- Hand and fingers numbness, particularly the thumb, index, and middle fingers, worse at night and early morning upon awakening
- Hand weakness or clumsiness
- Hand pain
Diagnostics
Carpal tunnel syndrome may be diagnosed at the bedside with a detailed neurological examination. Your doctor may also order a nerve conduction study and electromyography (EMG) test to confirm the diagnosis and grade its severity. An EMG involves giving the hand tiny electrical shocks to test the health of the nerves.
Treatment
Mild cases of carpal tunnel syndrome may be treated with wearing nightly wrist braces. More severe cases may require steroid injections into the carpal tunnel. In some instances, patients are referred to a hand or orthopedic surgeon for surgical release of the nerve, an ambulatory surgery during which the band over the median nerve called flexor retinaculum is transected to relieve pressure on the nerve.
Patients may also be advised to take frequent breaks from using their hands, to avoid sleeping in a position with bending of the wrist, and improving ergonomics at work.