Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) occurs when the median nerve, which runs through a narrow passage in your wrist called the carpal tunnel, becomes compressed or squeezed. This nerve controls feeling and movement in your thumb and first three fingers. **Key Facts:** - **Location:** Affects thumb, index, middle, and half of ring finger - **Cause:** Pressure on median nerve at the wrist - **Risk factors:** Repetitive hand movements, [diabetes](/condition/type-2-diabetes), pregnancy - **Treatment:** Often responds to conservative treatment; surgery if needed - **Prevention:** Ergonomic modifications, taking breaks **How It Differs from [Arthritis](/condition/arthritis):** - **Carpal tunnel:** Numbness/tingling in specific fingers, nerve compression - **[Arthritis](/condition/arthritis):** Joint pain/stiffness, affects all fingers equally - See our [carpal tunnel vs arthritis comparison](/compare/carpal-tunnel-vs-arthritis) **Related Conditions:** - [Arthritis](/condition/arthritis) — can occur alongside carpal tunnel - [Tendinitis](/condition/tendinitis) — inflammation of tendons in wrist/hand - [Type 2 diabetes](/condition/type-2-diabetes) — increases carpal tunnel risk - [Hypothyroidism](/condition/hypothyroidism) — associated with carpal tunnel - [Fibromyalgia](/condition/fibromyalgia) — chronic pain condition - [Pregnancy](/condition/pregnancy) — temporary carpal tunnel common **Warning Signs of Severe Cases:** - Constant numbness - Weakness making you drop things - Muscle wasting at base of thumb - Inability to feel hot/cold

**How Carpal Tunnel Syndrome Develops:** **The Carpal Tunnel:** The carpal tunnel is a narrow passageway in your wrist, about an inch wide. It's formed by small wrist bones (carpals) on the bottom and a tough ligament on top. Through this tunnel pass the median nerve and nine tendons. **1. Nerve Compression:** When anything causes swelling or narrowing of the tunnel, the median nerve gets squeezed. Even a small amount of pressure can cause symptoms because the tunnel has no room to expand. **2. Inflammation:** Repetitive movements can inflame the tendons, causing them to swell and press on the nerve. Conditions like [arthritis](/condition/arthritis) or [diabetes](/condition/type-2-diabetes) also contribute to inflammation. **3. Progressive Damage:** Without treatment, continued pressure can permanently damage the nerve, leading to constant numbness and muscle weakness. **Risk Factors:** - **Anatomy:** Women have smaller carpal tunnels - **Occupations:** Assembly line work, typing, sewing, cleaning - **Medical conditions:** [Diabetes](/condition/type-2-diabetes), [hypothyroidism](/condition/hypothyroidism), [rheumatoid arthritis](/condition/rheumatoid-arthritis) - **Pregnancy:** Fluid retention narrows the tunnel - **[Obesity](/condition/obesity):** Associated with higher risk - **Wrist position:** Extreme flexion or extension increases pressure

**Conservative Treatment (First 6-12 Weeks):** **Wrist Splinting (Most Important):** - Wear splint at night (prevents wrist bending) - May wear during aggravating activities - Keep wrist in neutral position **Activity Modification:** - Take frequent breaks from repetitive tasks - Modify workplace ergonomics - Avoid extreme wrist positions - Alternate hands when possible **Medications:** - NSAIDs for short-term relief - Limited evidence for long-term benefit **Corticosteroid Injection:** - Reduces inflammation in carpal tunnel - Relief lasts weeks to months - May delay or prevent need for surgery - Can be repeated if effective **Physical/Occupational Therapy:** - Nerve gliding exercises - Stretching and strengthening - Ergonomic training **Surgery (Carpal Tunnel Release):** **When Considered:** - Conservative treatment fails after 3-6 months - Severe or constant symptoms - Muscle wasting or weakness - EMG shows significant nerve damage **Procedure:** - Outpatient surgery (15-30 minutes) - Cut the ligament to release pressure - Open surgery or endoscopic - High success rate (85-90%) **Recovery:** - Grip strength returns in 2-3 months - Full recovery 6-12 months - Most can return to work in 1-6 weeks **Related Information:** - [Arthritis](/condition/arthritis) treatment - [Tendinitis](/condition/tendinitis) management