Carpal Tunnel Syndrome

Causes

• Repetitive hand movements - Especially activities involving extreme flexion or extension of the wrist, like typing, using a mouse, or manual labor.
• Anatomical factors - Naturally narrow carpal tunnel or wrist fracture/dislocation that alters the space.
• Sex - Women are three times more likely to develop CTS, possibly due to naturally smaller carpal tunnels.
• Heredity - Family history can play a role in susceptibility to CTS.
• Pregnancy - Hormonal changes and fluid retention can cause swelling in the carpal tunnel.
• Inflammatory conditions - Rheumatoid arthritis and other inflammatory conditions can affect the tendons in the wrist.
• Obesity - Higher body mass index is associated with increased risk.
• Diabetes - Can affect the nerves, making them more susceptible to compression.
• Thyroid disorders - Both hypothyroidism and hyperthyroidism can contribute to CTS.
• Renal (kidney) failure - Can lead to fluid retention and nerve pressure.
• Menopause - Hormonal changes may play a role.
• Workplace factors - Vibrating tools, cold environments, and awkward wrist positions increase risk.
• Previous wrist injuries - Sprains, strains, or fractures can alter wrist anatomy.

Signs and Symptoms

• Numbness, tingling, or "pins and needles" sensation in the thumb, index, middle, and half of the ring finger.
• Pain or burning in the hand and wrist that may radiate up the arm to the shoulder.
• Weakened grip strength and difficulty with fine motor tasks like buttoning clothes or picking up small objects.
• Tendency to drop objects due to numbness or weakness.
• Symptoms that worsen at night or early morning, often waking the person from sleep.
• Discomfort that may be relieved temporarily by "shaking out" the hand.
• Symptoms that worsen with activities that involve flexing the wrist, like driving, reading a book, or typing.
• Sensation of swelling in fingers, even without visible swelling.
• In advanced cases, atrophy (wasting) of the thenar muscles at the base of the thumb.
• Dry skin, swelling, or color changes in the hand due to autonomic symptoms.
• Symptoms typically begin gradually and worsen over time without treatment.
• In some cases, symptoms may initially come and go but eventually become more constant.
• Little finger remains unaffected (an important diagnostic clue, as the median nerve doesn't supply this finger).

Diagnosis

Treatment Options

Home Remedies

Preventive Care

• Take frequent breaks from repetitive activities to rest your hands and wrists.
• Maintain proper posture and wrist position when using a computer or performing hand-intensive tasks.
• Keep wrists in a neutral (straight) position when working, not bent up or down.
• Use ergonomic tools designed to reduce strain, such as split keyboards or vertical computer mice.
• Adjust your workstation to optimize wrist position (chair height, desk height, keyboard position).
• Rotate tasks to avoid performing the same hand and wrist motions for extended periods.
• Stretch and strengthen hand and wrist muscles regularly with appropriate exercises.
• Keep hands warm while working, as cold environments can worsen symptoms and increase stiffness.
• Address underlying health conditions that may contribute to CTS, such as diabetes or arthritis.
• Maintain a healthy weight, as obesity is a risk factor for carpal tunnel syndrome.
• Use proper form when performing activities requiring wrist movements, especially during exercise.
• Reduce force and pressure when performing hand tasks; hold tools and objects gently.
• Wear wrist splints during activities that tend to aggravate symptoms.
• Consider preventive splinting at night if you have early symptoms or high-risk occupations.

Surgical Options