Carpal Tunnel Syndrome

Causes

Carpal tunnel syndrome (CTS) is by far the most common peripheral nerve compression syndrome in the body. It is caused pinching of the median nerve at the wrist. The median nerve travels through the middle of the forearm and passes through the carpal tunnel in the wrist ("carpal" literally means wrist) where it can be pinched. This pinching is what causes the symptoms experienced in CTS.

Symptoms

The median nerve normally supplies the first three digits of the hand (thumb, index/pointer, and middle fingers) with sensation. That is why when this nerve is pinched you will likely experience numbness and tingling in these fingers. Often times, the whole hand may even go numb.

Diagnosis

CTS is usually diagnosed with a nerve test called an EMG. The EMG includes nerve conduction studies (NCS or NCV) that test how well the median nerve is functioning. This test will show whether or not the nerve is being damaged and will also diagnose how severe it is. CTS can range from mild to moderate to severe.

Treatment

Mild cases are usually treated conservatively with a wrist splint that is worn at night. This helps prevent the nerve from being pinched at night while you sleep. CTS is often worse at night and may cause you to wake up shaking your hand out to get the feeling back. More moderate cases can be treated with steroid injections to help reduce the inflammation around the nerve and get your symptoms to improve. Severe cases usually require a surgical referral for carpal tunnel release surgery.