Overview of Carpal Tunnel Syndrome from Colorado Clinic

Carpal tunnel syndrome (CTS) is caused by compression of the median nerve in the wrist. It can affect the hand and arm, which causes tingling, numbness, and inability to grip or hold on to things at times. The carpal tunnel is a narrow passageway located on the palm side of the wrist, which is formed by bones and ligaments. The tunnel protects a main nerve to the hand and the nine tendons that bend the fingers. If this nerve is compressed, it causes the carpal tunnel syndrome.


How common is carpal tunnel syndrome?


Carpal tunnel syndrome affects around 4.7% of the general adult population, and it is the most common type of entrapment neuropathy. Bilateral symptoms occur in around 50% of cases, and the annual crude incidence appears to be around 329 per 100,000 population.


What are the risk factors for CTS?


Certain things may contribute to carpal tunnel syndrome. Risk factors are:


  • Repetitive motions of the hands
  • Underlying health problems
  • Anatomy of the wrist
  • Pregnancy/weight gain


What causes carpal tunnel syndrome?


A number of possible causes of carpel tunnel syndrome exists. These include:


  • Nerve damage. Chronic illnesses such as diabetes may increase your risk of nerve damage, including damage to the median nerve.


  • Anatomic factors. A fracture to the wrist, or a dislocation, may affect the space within the carpel tunnel and cause pressure on the median nerve.


  • Sex. Women more commonly have carpel tunnel syndrome than men do. The reason may be as simple as women having smaller wrist.


  • Extra bodily fluids. Retaining fluid, commonly in pregnancy or menopause, may increase pressure within the carpal tunnel. It usually resolves on its own after pregnancy or menopause is over.


  • Inflammation. Rheumatoid arthritis is an inflammatory condition which can cause inflammation to occur and affect the tendons of the wrist.


  • Repetitive workouts. Working repeatedly with the hands can cause carpet tunnel syndrome.


  • Medical conditions. Thyroid disorders, weight gain, kidney failure all are linked to increased risk of this condition.


What symptoms are associated with CTS?


Symptoms of carpal tunnel syndrome usually starts with a gradual numbness and/or tingling in the thumb, index finger, and middle fingers. The pain comes and goes, and is associated with:


  • Weakness. If weakness is experienced in your hand and may or may not tend to drop objects, you could have carpel tunnel syndrome. The weakness may be due to the nerve compression.


  • Numbness/tingling. Another symptom is numbness and/or tingling in the hand. You may notice if you shake your hands loosely at the wrist, you may regain some of the feeling. This also affects your thumb, index finger, and middle fingers. You may wake from sleep wanting to shake the feeling back in your hands.


How is carpal tunnel syndrome treated?


There are several ways to treat Carpal Tunnel Syndrome. Here are a few choices:


  • Corticosteroids. Pain may be relieved by a corticosteroid injection to the carpal tunnel, or the doctor may order you a short-course of oral steroids pills.


  • Nonsteroidal anti-inflammatory drugs (NSAIDs). Ibuprofen (Motrin, Advil, and more), ketoprofen, or naproxen (Aleve) may help relieve pain from this condition, but should not be taken long-term.


  • Open surgery. This procedure involves the surgeon makes an incision in the palm of your hand directly over the carpel tunnel to cuts through the ligament to free the nerve.


  • Endoscopic surgery. This procedure is done by use of a telescope-like device, which has a tiny camera attached (called an endoscope). The scope helps the surgeon to see inside the carpel tunnel to cut the ligament, and the scope is inserted through one or a couple small incisions either in the wrist or hand.




LeBlanc KE & Cestia W (2011). Carpal Tunnel Syndrome. Am Fam Phys, 83(8), 952-958.