Carpal Tunnel Symptoms and How to Treat It

Whether you work on a computer all day, swing a hammer, operate heavy equipment, drive a truck, do your part on an assembly line, or do other work that requires repetitive use of your hand, you’re at risk of joining the four to 10 million Americans suffering from carpal tunnel syndrome (CTS).

Frequently experienced as numbness and tingling in the thumb, index, middle finger and the thumb-side of the ring finger, carpal tunnel syndrome is caused by compression, or a squeezing, of the median nerve located in the wrist. In addition to providing feeling to the thumb, index, middle and part of the ring finger, this nerve also sends signals to the muscles around the base of the thumb. Symptoms of CTS are typically worse at night or while doing activities that require bending your wrist or grasping an object for long stretches of time (think gripping a steering wheel or holding a book).

In addition to the numbness and tingling, other symptoms of CTS may include: weakness, especially when pinching and gripping; and dropping things.

An important aspect of CTS is this: Once a person has numbness that is there all day, it is unlikely to resolve on its own without taking any action.

Left untreated, it can progress to more persistent numbness and burning. In severe cases, loss of muscle mass occurs at the base of the thumb on the palm side of the hand and the loss of sensation in the hand can be present all of the time which can make daily activities, such as buttoning a shirt or eating, difficult.

If you’re experiencing any symptoms of CTS—no matter how infrequent—see your doctor.

Diagnosing CTS is not complicated. Based on your own account and description of symptoms, your doctor may be able to determine if you have CTS.  If the diagnosis is not clear, a non-invasive test can confirm whether you have CTS and how severe it is.

Early treatment for mild CTS involves wearing a wrist brace at night to keep you from bending your wrist while you sleep. In some cases, day use may also be recommended based on the type of activities you engage in.

For moderate or severe CTS, surgery is typically recommended. One effective option is often referred to as ‘mini-open carpal tunnel release.’ A 5-minute outpatient procedure, the surgery requires a small incision at the base of the palm through which the ligament is cut to relieve the pressure on the median nerve, resolving the pain and tingling of CTS. Thanks to the small incision, the amount of scarring and discomfort is minimal, and risk of infection is low.

If you're experiencing symptoms of CTS, see your primary care doctor and ask if a referral to an orthopedic hand surgeon is needed to improve your symptoms to keep you on the job and enjoying life to the fullest.

David Veltre, MD, is a hand and upper extremity specialist at SVMC Orthopedics, which has offices in Bennington, VT and Williamstown, MA.