OHSU

About Carpal Tunnel Syndrome

In carpal tunnel syndrome, the median nerve is compressed as it passes through the carpal tunnel. The carpal tunnel is a narrow space in your wrist. 

Since the median nerve provides sensation and movement functions to your thumb and three middle fingers, compression might cause many symptoms.

Symptoms

Symptoms may include:

  • Difficulty making a fist
  • Difficulty gripping objects with one or both hands
  • Hand pain, hand numbness or both
  • Tingling fingers ("pins and needles" feeling)
  • Swollen feeling in your fingers
  • Burning feeling in your fingers, especially your thumb, index (second) and middle (third) fingers

Diagnosis

OHSU's Nerve Center offers a wide range of neurodiagnostic (nerve diagnosis) services to evaluate your anatomy (structure of your body) and see if your brain, spinal cord, muscles, nerves and blood flow are functioning properly.

Our goal is to offer reliable and complete testing to help diagnose, manage and track your health condition. Learn more about diagnostic procedures

Causes

Carpal tunnel syndrome often has no specific cause. However, some conditions or activities can make it more likely. These include:

  • Frequent, repeated small movements with your hands, such as typing or using a keyboard
  • Frequent, repeated grasping movements with your hands, such as with sports, work activities and other activities 
  • Joint or bone disease, such as arthritis, osteoarthritis or rheumatoid arthritis
  • Hormonal or metabolism changes from menopause, pregnancy or thyroid imbalance
  • Changes in blood sugar levels (people with diabetes may develop carpal tunnel syndrome)
  • Other wrist conditions or injuries, such as a strain, sprain, dislocation or broken or swollen wrist

Treatment

Your doctor determines the best treatment for your carpal tunnel syndrome based on:

  • Your age, general health and medical history
  • Extent of your condition
  • How well certain medications, procedures or treatments work for you
  • How your doctor expects the condition to progress (get worse or better)
  • Your opinion or preference

Non-surgical treatment

Non-surgical treatment options include:

  • Wearing a splint to help prevent wrist movement and decrease the compression of the nerves inside the carpal tunnel.
  • Injecting anti-inflammatory medication into the carpal tunnel, or taking anti-inflammatory medication by mouth to reduce swelling.
  • Physical therapy
  • Occupational therapy ((such as changing the position of your computer keyboard, or making other changes to activities done with your hands, arms or elbows)

Surgical treatment

Your doctor might suggest surgery to relieve compression on the nerves in your carpal tunnel.

Surgery for carpal tunnel syndrome usually is performed in an outpatient location under local anesthesia and sedation (numbing medication and medicine to make you relax and minimize discomfort) or general anesthesia (you're asleep and don't remember the procedure when you wake up).

During carpal tunnel surgery, your doctor makes an incision (cut) in your wrist area. Next, he or she cuts the tissue that is pressing on your nerve. This reduces pressure.

After surgery, your wrist is wrapped and placed in a splint to keep it from moving. You usually wear a splint continuously for the first two weeks after surgery. After that, you wear it part of the time for about a month.

You usually have a moderate amount of pain (you notice pain, but it is not unbearable) in your hand after surgery. Most often, you can control pain by taking pain medication by mouth. Your surgeon also may have you keep your affected hand elevated (raised) while sleeping at night.

The length of recovery varies for each person. If your  nerve has been compressed for a long time, recovery might take longer. A few days after surgery, we encourage you to move your fingers and wrist to help prevent stiffness.

Prognosis

Cubital tunnel surgery may be right for you if:

  • Your doctor believes you are a suitable patient (would benefit from surgery)
  • Have an accurate diagnosis
  • Have surgery by an experienced surgeon

It is important to know that many people still have some symptoms after cubital tunnel surgery. Ask your OHSU Nerve Center doctor about the best treatment options for you.

Facts about Carpal Tunnel Syndrome

  • According to the National Institute of Neurological Disorders and Stroke (NINDS), carpal tunnel surgery is one of the most common surgical procedures performed in the US.
  • Carpal tunnel syndrome accounts for the highest average number of days lost at work compared to all other major work-related injuries or illnesses.
  • About 1 percent of people with carpal tunnel syndrome may develop permanent injury to the affected hand.
  • Although it is rare, symptoms of carpal tunnel syndrome may return after surgery in approximately 5 percent of patients.