Holding someone’s hand, typing up a quick email, and using a power drill to hang a picture: all of these movements require pain-free grip and a steady hand. But Carpal Tunnel syndrome can make each one of these movements nearly impossible. If your work or life puts you at risk for carpal tunnel syndrome, there are clear symptoms to watch for. The good news? If your carpal tunnel symptoms lead to a diagnosis, there are many treatments that can help you get your life back.

What causes carpal tunnel syndrome?

Carpal tunnel syndrome is a pain condition that occurs when pressure is placed on the median nerve. This nerve innervates the hand with sensation and movement and originates just inside the elbow. It runs through the carpal tunnel in the wrist, underneath the palm. This narrow, bony tunnel is also surrounded by ligaments. When pressure is placed on the median nerve, carpal tunnel syndrome can develop.

The major cause of carpal tunnel syndrome is repetitive motion, especially if it is done in a way that places stress on the nerve. Typing on a computer all day long – especially when the keyboard is at an incorrect angle – is one example of repetitive motion that can cause carpal tunnel syndrome.

Other causes of or risk factors for carpal tunnel syndrome include:

• Injury: A wrist fracture or sprain that causes inflammation puts you at risk for carpal tunnel syndrome
• Anatomy: The smaller the carpal tunnel, the higher the risk of nerve compression
• Nerve damage: Those with diabetes or other chronic conditions that damage nerves are at increased risk
• Inflammatory conditions: Arthritis increases the risk of joint inflammation and nerve compression
• Pregnancy: Fluid retention during pregnancy increases the risk (which is generally resolved after childbirth)
• Occupational hazards: Those who use vibrating machinery risk irritation of the median nerve

There is no definitive cause of carpal tunnel syndrome, but the conditions above increase your risk.

What can be mistaken for carpal tunnel?

Carpal tunnel symptoms overlap with other conditions. Two nerve conditions that have similar symptoms are cubital tunnel syndrome and radial tunnel syndrome. The cubital tunnel is located just inside the elbow (near the “funny bone”), and the radial tunnel is closer to the bones and muscles of the forearm.

Other conditions with similar symptoms include:

• Arthritis
• Tendonitis in the wrist
• Repetitive strain injury (RSI)
• Thoracic outlet syndrome

What types of jobs can cause carpal tunnel?

According to the U.S. Centers for Disease Control (CDC), the industries with the highest rates of carpal tunnel syndrome include:

• Textile, fabric finishing, and coating mills (44.9%)
• Apparel accessories and other apparel manufacturing (43.1%)
• Animal slaughtering and processing (39.8%)
• Any industry that requires repetitive pulling, twisting, or pushing movements has a higher risk of carpal tunnel syndrome for its workers.
• Although carpal tunnel syndrome can occur in office settings, it is much more prevalent in non-office work.

Eight carpal tunnel symptoms to watch for

People with carpal tunnel symptoms may report pain most often, but there are eight other symptoms to be on the lookout for.

• Pins and needles in the fingers
• Weak grip
• Burning sensation in the hand or fingers
• Pain or numbness at night
• Sensations that travel up the arms
• Radiating feeling of a shock in the thumb and index, middle, or ring fingers
• Swollen feeling in the hands
• Poor sleep due to symptoms

1. Pins and needles in the fingers

Pins and needles – that tingly feeling you get when an arm or leg falls asleep – is one of the first carpal tunnel symptoms to appear. This sensation occurs in the hand or any of the fingers (except for the pinky finger, generally).

2. Weak grip

As your carpal tunnel syndrome worsens, your grip gets weaker. This can impact fine motor skills like pinching an object to pick it up. This weakness may also affect your ability to close your hand completely.

3. Burning sensation in the hand or fingers

A burning sensation in the hand or fingers is not painful so much as it is an uncomfortable feeling of warmth. The intensity of the sensation varies and can border on pain at times.

4. Pain or numbness at night

Pain or numbness may intensify at night, especially if you sleep with your wrists bent. This increases pressure on the median nerve in the wrist and can also increase the severity of symptoms.

5. Sensations that travel up the arms

While carpal tunnel symptoms might begin in the wrist and hand, as the condition progresses, you might feel them travel up your arm. Pain, numbness, and weakness can all make their way towards your shoulder and, in severe cases, the upper back.

6. Radiating feeling of a shock in the thumb and index, middle, or ring fingers

For many, symptoms are constant, but some people experience intermittent feelings of shock that radiate into the thumb; hand; and index, middle, or ring fingers.

7. Swollen feeling in the hands

After a day of work or stress on your hands and wrists, you may experience a swollen feeling. There may be slight visible swelling, too, especially in the case of fluid retention.

8. Poor sleep due to symptoms

Even if your symptoms are mild during the day, carpal tunnel symptoms at night can be intensified due to the lack of distractions. It may be that the symptoms are challenging during the day, too, but you are just too busy to notice.

Do I have carpal tunnel syndrome?

Carpal tunnel syndrome is diagnosed starting with a medical history that also includes talking about your work and activities. In some cases, the symptoms combined with work or potentially risky activities is enough to make an accurate diagnosis.

Even when risks are revealed by a medical history and symptoms are confirmed by a physical exam, your doctor may choose to conduct electromyography. Electromyography uses tiny electrodes inserted into the muscles to evaluate how well the muscles and the nerves in your hand and arm are working. If the signals are weak, it is possible that the median nerve is being compressed.

A nerve conduction study also uses electricity to see if the median nerve is compromised. If an electrical signal delivered by two electrodes at the forearm slow on their way through the carpal tunnel, chances are good there is compression.

An MRI or an ultrasound cannot diagnose carpal tunnel syndrome, but they can be used to rule out other conditions.

Finally, your doctor may suggest an X-ray. X-rays are not used to diagnose carpal tunnel syndrome. Rather, they are used to rule out a fracture in the wrist or other damage to the mechanical structures that might be causing your symptoms.

Carpal tunnel treatments that can help

Once you have a proper diagnosis, carpal tunnel treatments can relieve pain and help restore hand and wrist mobility and function.

Here are 11 possible carpal tunnel treatment options.

1. Carpal tunnel braces

Since we usually can’t take excessive time off from using our hands, adding support to your wrists at work can help as you explore other treatments. Carpal tunnel braces hold your wrists in correct alignment to keep the pressure off the median nerve.

2. Change your mouse

There has been some research that suggests that the mouse on your computer (or the awkward way you use your touch pad) is a bigger contributor to carpal tunnel syndrome pain than anything else. Invest in an ergonomic mouse to ease symptoms.

3. Correct your angle of work

Speaking of ergonomics, does your job fit your body, or have you had to make your body fit your job? Ergonomics is the practice of adjusting your workspace – chair, desk, computer – so that it serves you better and is easier on your body.

This might mean swapping out your chair, moving your computer monitor, or raising or lowering your desk to keep your wrists even and level.

4. Take breaks and stretch

Many people who suffer from carpal tunnel pain and symptoms find relief by periodically shaking their wrists. This is just one carpal tunnel exercise that can be done no matter where you are.
Prevention is key, so take frequent short breaks, too. Stretching after the damage is done is akin to closing the barn door after the horse.

5. Try acupuncture

Acupuncture for carpal tunnel is gaining support in research. This traditional Chinese medical practice uses hair-thin needles inserted into specific points on the body. Chinese medical practitioners use these needles (referred to as pins) to free blocked energy channels in the body.

Modern research has found that acupuncture triggers a healing response in the brain. For people suffering from carpal tunnel syndrome, acupuncture can increase grip strength, decrease symptoms, and improve function.

6. Use over-the-counter medications

Non-steroidal anti-inflammatory drugs (NSAIDs) are a safe, effective, first-line treatment for pain and inflammation. It’s important to use as directed, though, as extended or improper use can lead to gastrointestinal complaints.

Topical pain creams may also help relieve pain and soreness associated with carpal tunnel syndrome. Menthol gel is a cooling carpal tunnel treatment that can be used as needed.

7. Physical therapy

For some people with carpal tunnel syndrome, pain and mobility issues can lead to other complaints in the body. When this happens, a physical therapist can lead you through stretches and exercises to ease soreness and improve range of motion wherever it’s compromised.

Physical therapy exercises might include strengthening the muscles of the arms and retraining the wrist and fingers. Many of these exercises can be completed at home between appointments for best results.

8. Chiropractic care

Chiropractors may deal with aligning the spine, but the skeleton is an inter-connected system. If your carpal tunnel syndrome is caused by a misalignment in the spine that is causing you to work out of alignment, a chiropractic adjustment can help.

9. Prescription medications

Prescription medications can include not only prescription-strength non-steroidal anti-inflammatory drugs but also other medications.

For acute pain and inflammation, your doctor may suggest a short course of oral corticosteroids. Common names of these medications are prednisone, prednisolone, and triamcinolone. These medications reduce swelling but can come with side effects when used for long periods of time.

10. Injections

For relief of inflammation and pain delivered on the spot, an injection may help. Sometimes referred to as cortisone shots, these injections consist of a steroid and an anesthetic. The steroid reduces inflammation, and the anesthetic relieves pain.

In some cases, there is a brief increase in pain levels directly after the shot, but this subsides within 48 hours. Many people experience profound relief from pain that can last for months at a time.

Injections are not generally a first-line treatment. When more conservative measures are not successful, or when pain and inflammation make other treatments impossible, an injection can relieve symptoms enough for other treatments to begin.

11. Surgery

If your symptoms do not respond to any other treatments, surgery is possible. There are two types of surgery for carpal tunnel syndrome pain.

• Endoscopic surgery: This surgery uses a thin telescope-like instrument to enter the carpal tunnel and cut ligaments that might be swollen
• Open surgery: A more traditional surgery that uses a scalpel to enter through the palm and release the ligament trapping the median nerve

Endoscopic surgery may result in less pain directly after surgery. Talk to your doctor about which procedure is best for you.

Get help for your pain

Carpal tunnel symptoms can make everything you do a literal pain. At Pain Doctor, we want to help you find a solution. As pain management doctors, we can help you understand all of your treatment options. You don’t have to suffer from carpal tunnel pain.

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