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Carpal Tunnel Syndrome

If your fingertips feel tingly or numb, you might have carpal tunnel syndrome (CTS). CTS refers to the signs and symptoms of the median nerve not working well at your wrist. The tingling can sometimes become so intense that it is painful. You can wear a splint to help you sleep, but eventually, you’ll likely need surgery to avoid permanent loss of feeling. Some doctors might suggest steroid injections, but it's not clear how much they help.   

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What Is Carpal Tunnel Syndrome?  

One of the important nerves in your arm is called the median nerve. It travels from your neck to your fingertips.

This nerve helps you feel things with the tips of your thumb, index, middle, and part of your ring finger. It also helps you make specific thumb movements. The nerve travels through a tunnel in your wrist made by wrist bones – the carpal tunnel. There's a band forming the top of this tunnel.

The nerve can stop working well at this tunnel. The signs and symptoms of the nerve not working well is called carpal tunnel syndrome (CTS).

What causes carpal tunnel syndrome?

CTS is caused by a nerve in your wrist not working well. If you are born with a narrower tunnel, you have a higher chance of experiencing CTS.

What are risk factors for carpal tunnel syndrome?

Risk factors for carpal tunnel issues include:

  • Age — It's more common in adults.
  • Genetics — It can run in families.
  • Pregnancy – Pregnant people may get it, but it often goes away after giving birth.

How common is carpal tunnel syndrome? 

Problems in the median nerve are present in about a third of people by age 65, although levels of symptoms vary.  

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What Are the Signs and Symptoms of Carpal Tunnel Syndrome? 

Early signs include tingling in the fingertips, especially at night. Later signs include loss of feeling in the fingertips.

When you lose feeling, you may have difficulty handling buttons and small objects.

When should I see a doctor for my carpal tunnel symptoms?

If your symptoms only bother you at night, you can try wearing a splint to keep your wrist straight. If your hand goes numb regularly even with the splint on, it takes a while for the numbness to go away, or the numbness becomes constant, surgery is recommended.

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How Do You Diagnose Carpal Tunnel Syndrome?

Doctors diagnose problems with your nerve by talking to you and examining your hand. They might suggest a test called a nerve conduction study to determine how well your nerve is working. Some doctors also use ultrasound to look at your nerve.

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How Do You Treat Carpal Tunnel Syndrome?  

Without surgery

If you only experience symptoms at night, wearing a splint or brace can help you sleep. Some doctors may inject steroids into the carpal tunnel, but studies show this may only provide temporary relief.

With surgery

If your median nerve isn’t working well or if a brace no longer helps, surgery might be an option. During surgery, the surgeon will cut the band that is the top of the carpal tunnel. Your wrist and fingers will keep working normally afterward.

This procedure can be done in an office, surgery center, or hospital. Most people have local anesthesia, which provides pain relief directly at the surgical site, and don’t go to sleep for the surgery.

Recovery after surgery

Using a brace or having surgery can quickly relieve nighttime tingling. If you have constant numbness or weakness in your thumb, those changes could be permanent. Your nerve can continue to improve for two to three years after surgery.

Sometimes, tingling may get worse before it gets better. If your CTS was severe, the nerve might not fully recover, and you could still have some numbness or weakness. Talk about this possibility with your doctor.

It's important to keep using your hand for everyday activities right after surgery to prevent stiffness and speed up your recovery.

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Contact Us

UPMC Brachial Plexus and Peripheral Nerve Disorder Center
UPMC Mercy Professional Building
1350 Locust St., Suite G-103
Pittsburgh, PA 15219

412-232-5616


By UPMC Editorial Staff. Last reviewed on 2024-07-29 by Teun Teunis, MD, PhD.