Carpal Tunnel Syndrome (CTS), also called wrist tunnel syndrome, is a condition that brings uncomfortable symptoms like numbness, tingling, and pain that extends from the palm to the fingertips. This happens when the median nerve gets compressed or trapped inside the carpal tunnel [3].
The carpal tunnel is basically a narrow passageway in the wrist. It’s formed by wrist bones at the bottom and covered by the transverse carpal ligament at the top. The median nerve runs through this tunnel, playing a key role in movement and sensation for the thumb and the three middle fingers.
CTS is actually one of the most common nerve compression disorders, affecting about 3–6% of adults. In the past few decades, cases have surged, mainly due to the increasing use of technology in daily life. Think about it—hours of typing, scrolling, and repetitive hand movements all add up, making CTS more common than ever [3].
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What Causes Carpal Tunnel Syndrome?
You’ve probably heard of Carpal Tunnel Syndrome, but what really causes it? While anyone can develop CTS, some people are more at risk than others. Research shows that white individuals and those between 40 and 60 years old are more likely to experience it. And here’s an interesting fact—women are about ten times more likely to develop CTS than men. Why? Their carpal tunnels tend to be smaller, and hormonal changes or fluid retention can add extra pressure on the median nerve [1].
But CTS isn’t always easy to pin down. Sometimes there’s no obvious reason why it pops up. Other times, it’s because there’s too much pressure on the median nerve, which can make your hand feel irritated, tingly, or sore. What causes this nerve to feel the squeeze? Here are a few usual suspects [1] [4]:
- Using your wrist too much – If you spend hours typing, writing, or using tools and machines without taking breaks, you can tire out your wrist. This can lead to swelling, which can press on the nerve.
- Your genes – Some people are born with a smaller-than-average carpal tunnel, which means they’re more likely to have problems with the nerve in their wrist.
- Autoimmune diseases – Illnesses like rheumatoid arthritis and lupus can cause swelling in the wrist, which adds pressure on the nerve.
- Being pregnant – When you’re pregnant, changes in your hormones and retaining more water can make the tissues in your wrist swell up. This can cause tingling and numbness, but usually only temporarily.
- Being overweight – If you’re carrying extra weight, you might have more tissue around your wrist, and that can press on the carpal tunnel.
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Secondary Causes of Carpal Tunnel Syndrome
We’ve talked about the usual suspects—repetitive wrist movements, genetics, and health conditions. But sometimes, there’s more to the story. In some cases, carpal tunnel syndrome develops due to physical changes or underlying conditions that mess with the carpal tunnel’s structure. When that happens, it’s called secondary CTS—basically, when something else is to blame for putting pressure on the median nerve.
So, what kind of things can throw your wrist out of balance? Here are some key culprits [2] [3] [4]:
- Structural abnormalities in the carpal tunnel – Some people are just born with a naturally tight tunnel, making it easier for the nerve to get pinched.
- Wrist dislocations or fractures – Breaking or dislocating your wrist isn’t just painful—it can shift things around in a way that puts extra strain on the nerve.
- Arthritis, especially gout-related arthritis – When inflammation flares up in the wrist, it can crowd the tunnel and leave less room for the nerve to function properly.
- Thickened tendon sheaths (Tenosynovial hypertrophy) – Basically, the protective coverings around the tendons swell up, taking up valuable space in the tunnel.
- Diabetes-related nerve damage – Over time, high blood sugar can weaken nerves, making them more vulnerable to pressure.
- Amyloidosis – A condition where protein builds up in the body’s tissues, and yes, it can affect the wrist too.
- Hypothyroidism – Low thyroid function can lead to fluid retention, swelling, and—yep—extra pressure on the nerve.
- Menopause – Hormonal shifts can cause fluid retention and inflammation, increasing the risk of CTS.
- Long-term dialysis – Over time, dialysis can lead to a buildup of substances that thicken wrist tissues.
- Enlarged arteries near the median nerve – More pressure in an already tight space spells trouble.
- Wrist tumors or cysts – Whether it’s a ganglion cyst or something else, extra growth inside the tunnel can push against the nerve.
- Bleeding inside the carpal tunnel – This can happen due to hemophilia, injury, or trauma, creating swelling that compresses the nerve.
- Frequent exposure to vibrations – If your job involves using vibrating tools (like drills or jackhammers), it can cause long-term stress on the wrist.
- Thickening of the transverse carpal ligament – This ligament acts as the “roof” of the carpal tunnel, and when it thickens, the space inside shrinks.
- Excessive alcohol consumption – Believe it or not, too much alcohol can mess with your nerves and contribute to swelling in the wrist.
Symptoms of Carpal Tunnel Syndrome
Carpal Tunnel Syndrome symptoms can hit you like a ton of bricks, and once they start, they’re hard to ignore. They’re pretty distinctive, too. Here’s a breakdown of what you might feel [2]:
- Pain, numbness, and tingling – It starts in the palm and can radiate all the way up to your fingers, especially the thumb, index, and middle fingers.
- Pain gets worse at night – That’s when it’s most noticeable, and for some, it’s almost impossible to get any relief.
- Shaking or wriggling your hand – Trying to shake off that nagging pain? You’re not alone.
- Weak grip and dropping things – You might find yourself struggling to hold onto things, and objects slip right through your fingers.
- Pain resurfaces during wrist-heavy tasks – Activities like driving, reading the paper, knitting, or even writing can make it flare up.
- Dominant hand pain – For most people, the pain shows up in the hand they use the most (for right-handed folks, that means the right hand), though in rare cases, both hands can be affected.
- Hand swelling – Your hand may start to feel puffy, adding to the discomfort.
- Cold or hot sensations – You might notice your hand feeling unusually cold or hot, which can be pretty unsettling.
- Sensitivity to temperature changes – Exposure to cold can really make the pain and numbness worse.
Diagnosing Carpal Tunnel Syndrome
Diagnosing Carpal Tunnel Syndrome isn’t too complicated. Often, a doctor can figure it out simply by looking at your symptoms, checking your medical history, and doing a physical exam [3].
Now, the physical exam isn’t just about looking. The doctor might perform a few simple tests, or maneuvers, that help bring out the symptoms of CTS, confirming the diagnosis. One of the most common is Phalen’s maneuver. Here’s the deal: you place the backs of your hands together, with your wrists bent down so they’re touching. You hold that position for 30-60 seconds, and if it triggers the symptoms, it’s pretty much a solid indicator of CTS [3].
There’s another maneuver, called Durkan’s maneuver, where the doctor applies direct pressure to the median nerve. While pressing, they’ll ask you to bend your hand inwards slightly. This test helps pinpoint any nerve compression or irritation [3].
If the doctor still has doubts, they might go a step further with a nerve conduction study. This test measures how well your median nerve is sending signals, showing if there’s any electrical disruption caused by compression [3].
Now, most cases don’t need imaging. But, if the doctor suspects something else might be going on, like a tumor or another abnormality putting pressure on the carpal tunnel, they may recommend an MRI of your wrist [3].
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Treating Carpal Tunnel Syndrome
When it comes to treating Carpal Tunnel Syndrome, it all depends on how far along the condition is. Treatment usually starts with modifying wrist movements that trigger the symptoms of CTS. It’s also important to avoid repetitive wrist motions. Interestingly, exercising and losing weight might help alleviate some of the symptoms associated with CTS [4].
However, research shows that stretching, or massaging the wrist doesn’t provide much improvement for people with CTS [2].
In general, treatments for CTS fall into two main categories [2] [4]:
Conservative Treatment for Carpal Tunnel Syndrome
For mild to moderate cases, doctors typically go with conservative treatment, meaning surgery is not involved.
Here are a few common conservative treatment options for CTS:
- Wrist splints: These splints gently extend the wrist joint and are usually worn every night for 3-4 weeks.
- Physical therapy: Under the guidance of a physical therapist, this can help with movement and pain management.
- Steroid injections (Corticosteroids): Injecting steroids into the carpal tunnel helps reduce irritation and inflammation in the median nerve and wrist.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): These drugs can relieve CTS symptoms, especially when there’s tendon or muscle inflammation around the wrist. Some examples include:
- Diclofenac
- Naproxen
- Ibuprofen
- Indomethacin
- Anticonvulsants: For nerve pain relief, anticonvulsants like Pregabalin and Gabapentin can reduce numbness, tingling, and the pain that comes with CTS.
- Diuretics: In some cases, diuretics such as Hydrochlorothiazide may be prescribed, especially when there’s fluid retention involved.
Carpal Tunnel Syndrome Surgery
So, what happens when the usual treatments just aren’t cutting it anymore? That’s where surgery comes in. If conservative options like splints, physical therapy, or medications aren’t doing the trick, or if the Carpal Tunnel Syndrome (CTS) is really severe, surgery might be the answer. The decision to go under the knife depends on how bad the CTS is, and doctors usually figure that out with nerve conduction tests.
Now, when it comes to surgery, it’s generally pretty effective—over 90% of people see a positive outcome. The procedure can be done in two ways: endoscopic surgery (which is less invasive) or the more traditional open surgery (where they make an incision in the wrist). But here’s the catch: even after surgery, there’s a chance CTS could come back. About one in three patients might experience a relapse within five years.
Like any surgery, there are some risks, although they’re rare. These can include:
- Benign growths on the nerve branch that affects the palm’s skin.
- Loss of sensation in the palm, especially if multiple surgeries are needed.
- Stiffness in the wrist joint.
- Post-surgical wound infections.
- Scarring where the incision was made.
Complications of Carpal Tunnel Syndrome
Carpal Tunnel Syndrome isn’t something to brush off. If it’s not dealt with, it can get worse over time and harm the median nerve for good. This nerve is super important for feeling and moving your hand, and it can get damaged if it’s squished for too long. If that happens, your hand might not be able to grip things or do things that used to be easy [4].
As Carpal Tunnel Syndrome gets worse, the problems it causes become more serious. These problems can include [4]:
- Permanent damage to the median nerve, leads to lasting weakness and an inability to properly function the hand.
- Muscle weakness and wasting, particularly noticeable at the base of the thumb.
- Chronic pain that affects both the wrist and hand, often leading to daily discomfort.
Like many other health issues, Carpal Tunnel Syndrome won’t just get better by itself. The sooner you catch it, the better your chances are of avoiding permanent damage. If you don’t do anything about it, the long-term effects can really mess with your ability to use your hand.
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Finding Relief from Carpal Tunnel Syndrome
Carpal Tunnel Syndrome can really interfere with your daily routine. The pain, numbness, and tingling that usually go along with this condition can turn even the easiest tasks into a real struggle. The bright side, though, is that there are products and remedies out there to help you deal with and ease the discomfort. Let’s explore a few helpful possibilities:
Carpal Tunnel Wrist Brace
Wrist braces are a popular fix for carpal tunnel syndrome (CTS). They work by holding your wrist straight, which eases the pressure on the median nerve.
Slipping on a wrist brace, particularly when you hit the hay, can be super helpful because it stops your wrist from bending in your sleep, lessening the chances of your symptoms getting worse. Most are made to be comfy, let your skin breathe, and can be adjusted to fit your wrist just right. By using it consistently, you’re giving your wrist the support it needs to get better and ease any pain.
Ergonomic Keyboard
If you’re spending a lot of time typing, you could be accidentally putting stress on your wrists. An ergonomic keyboard might really help you out.
These keyboards are made to let your hands rest in a more natural position, which can help lessen wrist strain. Their divided layout and adjustable parts help you type in a more relaxed way. You might notice that your wrists feel less tight and tired, particularly after long hours of work. Also, many ergonomic keyboards have wrist rests built right in, giving you even more comfort.
Carpal Tunnel Compression Gloves
Carpal tunnel symptoms can be effectively managed with something as simple as compression gloves.
Compression gloves work by applying a gentle pressure to your hands and wrists, which helps to bring down swelling and boost blood circulation. Designed to be lightweight, breathable, and flexible, you can comfortably wear them all day long while you’re typing, driving, or just going about your usual routine. Lots of people find them particularly useful when they need some extra support during activities that involve using their wrists for longer stretches.
Vertical Mouse
When you’re facing carpal tunnel syndrome, it’s not just about your wrist but also how you interact with your mouse. Using a traditional mouse can put your wrist in uncomfortable positions, leading to more strain. On the other hand, a vertical mouse promotes a more natural grip, letting your hand stay in a more relaxed position. This change can help ease the pressure on your wrist and forearm, making it less likely you’ll feel pain or discomfort down the line. If you spend long hours at the computer, a vertical mouse could make a big difference.
Carpal Tunnel Wrist Splint (Day Use)
Nighttime wrist braces are definitely useful, but there are also wrist splints made just for wearing during the day. These daytime splints keep your wrist steady while you go about your daily tasks, offering the support you need to keep from overstraining it.
Whether you’re at the computer, behind the wheel, or tackling chores around the house, slipping on a wrist splint can help you steer clear of those motions that might cause you pain. And some are so subtle, you can comfortably wear them under your clothes, so you can keep getting things done without feeling uncomfortable.
References
- Aroori, S., & Spence, R. A. (2008). Carpal tunnel syndrome. The Ulster medical journal, 77(1), 6–17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2397020/
- Ashworth, N. (n.d.). Carpal Tunnel Syndrome. Medscape; WebMD. https://emedicine.medscape.com/article/327330-overview
- Joshi, A., Patel, K., Mohamed, A., Oak, S., Zhang, M. H., Hsiung, H., Zhang, A., & Patel, U. K. (2022). Carpal Tunnel Syndrome: Pathophysiology and Comprehensive Guidelines for Clinical Evaluation and Treatment. Cureus, 14(7), e27053. https://doi.org/10.7759/cureus.27053
- Sevy JO, Varacallo M. Carpal Tunnel Syndrome. [Updated 2022 Sep 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK448179/