Carpal tunnel syndrome is a condition in which there is excessive pressure on the median nerve at the wrist. This is the nerve that allows feeling and movement to parts of the hand. Carpal tunnel syndrome can lead to pain, numbness, tingling, weakness, or muscle damage in the hand and fingers.
Median nerve dysfunction; Median nerve entrapment; Median neuropathy
The median nerve typically provides feeling and movement to the thumb side of the hand. This includes the palm, thumb, index finger, middle finger, and thumb side of the ring finger.
The area in your wrist where the nerve enters the hand is called the carpal tunnel. This tunnel is normally narrow. A thick ligament (tissue) just under your skin (the carpal ligament) makes up the top of this tunnel. Any swelling can pinch the nerve and cause pain, numbness, tingling, or weakness. This is called carpal tunnel syndrome.
Some people who develop carpal tunnel syndrome were born with a small carpal tunnel.
Carpal tunnel syndrome can also be caused by making the same hand and wrist motion over and over. Using hand tools that vibrate may also lead to carpal tunnel syndrome.
Studies have not proved that carpal tunnel is caused by typing on a computer, using a mouse, or repeating movements while working, playing a musical instrument, or playing sports. But, these activities may cause tendinitis or bursitis in the hand, which can narrow the carpal tunnel and lead to symptoms.
Carpal tunnel syndrome occurs most often in people ages 30 to 60. It is more common in women than men.
Other factors that may lead to carpal tunnel syndrome include:
Symptoms may include any of the following:
During a physical exam, your health care provider may find:
Tests that may be ordered include:
Your provider may suggest that you:
Changes you can make in your workplace to reduce the stress on your wrist include:
Medicines used to treat carpal tunnel syndrome include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen. Corticosteroid injections can be given into the carpal tunnel area to relieve symptoms.
Carpal tunnel release is a surgical procedure that cuts into the ligament that is pressing on the nerve. Surgery is successful most of the time but depends on how long you've had the nerve compression and its severity.
Symptoms often improve without surgery. But more than one half of cases eventually need surgery. Even if surgery is successful, full healing can take months.
If the condition is treated properly, there are usually no complications. If untreated, the nerve can be damaged, causing permanent weakness, numbness, and tingling.
Contact your provider for an appointment if:
Use tools and equipment that are properly designed to reduce the risk for wrist injury.
Ergonomic aids, such as split keyboards, keyboard trays, typing pads, and wrist braces, may be used to improve wrist posture during typing. Take frequent breaks when typing and always stop if you feel tingling or pain.
Weller WJ, Calandruccio JH, Jobe MT. Compressive neuropathies of the hand, forearm, and elbow. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 77.
Zhao M, Burke DT. Median neuropathy (carpal tunnel syndrome). In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 36.
Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.