Carpal Tunnel Syndrome

What it is

Overview

Carpal tunnel syndrome (CTS) is a common condition that happens when the median nerve, which runs from your forearm into your hand, gets squeezed or compressed in a narrow passageway in your wrist called the carpal tunnel. This tunnel is made of bones and ligaments, and when there’s too much pressure, it irritates the nerve. CTS can make everyday tasks like typing or holding objects uncomfortable.

When to see specialist

People with CTS often notice symptoms that start slowly and may worsen over time. Common signs include numbness or tingling in the thumb, index, middle, and part of the ring finger. This can happen while driving, reading, or at night, sometimes waking you up. You might also feel pain in your hand or wrist that shoots up your arm, or weakness that makes you drop things. These symptoms usually don’t affect the little finger. If ignored, they can become constant and lead to lasting nerve damage and weakness of the thumb muscles.

Causes & risk factor

CTS doesn’t always have one clear cause, but several factors can contribute by increasing pressure on the median nerve. Overuse from repetitive hand or wrist motions, like typing, assembly line work, or using vibrating tools can swell the tissues in the tunnel.

COMMON RISK FACTOR
  • Trauma, such as a wrist fracture or sprain, can narrow the tunnel or cause swelling that pinches the nerve.
  • Genetics may play a role too; some people inherit a smaller carpal tunnel or family traits that make them more prone.
  • Health conditions like diabetes can damage nerves and increase risk, while smoking reduces blood flow and may worsen inflammation.
  • Other factors include obesity, pregnancy (due to fluid buildup), thyroid problems, or rheumatoid arthritis, which causes joint swelling.

Treatment Options

Treatment starts with non-surgical options, especially for mild to moderate cases, and moves to surgery if needed. Success depends on severity, but early action often helps.

non-surgical

These aim to reduce pressure and ease symptoms without an operation.

Wearing a wrist splint at night keeps your wrist straight and relieves nighttime tingling—effective for about 50-70% of mild cases. Over-the-counter pain relievers like Ibuprofen can reduce swelling and pain. Corticosteroid injections into the wrist decrease inflammation, providing relief for several months in many people. 

  • Physical therapy, nerve gliding exercises
  • Avoiding flaring activities
  • Nightime splints that keep the wrist straight
  • Steroid injections
Success rate

Wearing a wrist splint at night keeps your wrist straight and relieves nighttime tingling—effective for about 50-70% of mild cases.

surgical

If symptoms persist or are severe

Carpal tunnel release surgery is common. It involves cutting the ligament pressing on the nerve, either through a small open incision in the palm or endoscopically with tiny cuts for faster recovery.

Success rate

This outpatient procedure has a high success rate of 95%, with most people experiencing lasting relief from numbness and pain, though full recovery may take weeks to months. Risks are low but include infection or scar tenderness.

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