Carpal Tunnel Syndrome: Symptoms, Causes, Diagnosis & Treatment- By Dr. Balaraju Naidu, Robotic Orthopedic Surgeon, ONUS Robotic Hospitals
Carpal Tunnel Syndrome is a common nerve compression problem that affects the hand and wrist. It happens when the median nerve gets compressed inside the wrist, causing pain, tingling, numbness, burning sensation, or weakness in the hand.
The median nerve passes through a narrow passage in the wrist called the carpal tunnel. When this nerve is compressed, symptoms can affect the thumb, index finger, middle finger, and part of the ring finger. Mayo Clinic explains that carpal tunnel syndrome is caused by pressure on the median nerve in the carpal tunnel of the wrist.
In this video, Dr. Balaraju Naidu, Consultant Robotic Orthopedic Surgeon at ONUS Robotic Hospitals, explains the symptoms, causes, diagnosis, and treatment options for Carpal Tunnel Syndrome.
What Is Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome occurs when pressure builds up inside the wrist and compresses the median nerve. This nerve helps provide sensation to the thumb, index finger, middle finger, and part of the ring finger. It also helps control some muscles near the base of the thumb.
When the nerve is irritated or compressed, the hand may feel numb, weak, painful, or heavy.
Common Symptoms of Carpal Tunnel Syndrome
Many patients first notice tingling or numbness in the fingers, especially at night or early morning.
Common symptoms include:
- Numbness in the thumb, index, middle, and ring finger
- Tingling or pins-and-needles sensation
- Burning sensation in the hand
- Wrist pain
- Pain spreading to the forearm
- Weak grip
- Dropping objects frequently
- Difficulty holding mobile phone
- Difficulty typing or writing
- Night-time hand numbness
- Hand weakness in advanced cases
Night symptoms are common. Many patients wake up with numbness or tingling in the hand, and Mayo Clinic notes that this symptom is often controlled with a wrist brace at night.
Why Hand Numbness and Tingling Happen
Hand numbness and tingling happen because the median nerve is under pressure. When the nerve cannot function properly, sensation becomes abnormal.
Patients may feel:
- Electric shock-like sensation
- Pins and needles
- Burning pain
- Numbness
- Loss of finger sensation
- Weakness while gripping
The little finger is usually not affected because it is supplied by a different nerve.
Causes and Risk Factors
Carpal Tunnel Syndrome may not always have one clear cause. In many patients, multiple factors contribute to nerve compression.
Common causes and risk factors include:
- Repeated wrist movements
- Typing or computer work
- Mobile phone overuse
- Driving for long periods
- Wrist injury or fracture
- Diabetes
- Thyroid problems
- Rheumatoid arthritis
- Pregnancy-related fluid retention
- Obesity
- Kidney disease
- Inflammatory conditions
- Small carpal tunnel anatomy
Mayo Clinic lists wrist anatomy, health conditions, and repetitive hand motions as possible contributors, and also notes diabetes, inflammatory conditions, obesity, pregnancy, and thyroid disorders as risk factors.
When Wrist Pain Becomes Serious
Wrist pain should not be ignored when it is associated with numbness, tingling, weakness, or night symptoms.
Consult an orthopedic specialist if you have:
- Persistent hand numbness
- Tingling in fingers
- Night-time symptoms
- Weak grip
- Dropping objects
- Pain spreading to forearm
- Difficulty using mobile phone or keyboard
- Hand weakness
- Symptoms worsening over time
- Diabetes with hand numbness
- Pain after wrist injury
Early diagnosis and treatment are important because long-term nerve compression can lead to permanent nerve damage.
Diagnosis of Carpal Tunnel Syndrome
Diagnosis begins with clinical examination. The doctor may check hand sensation, grip strength, thumb muscle strength, wrist movement, and signs of nerve compression.
Diagnosis may include:
- Detailed symptom history
- Physical examination
- Tinelβs test
- Phalenβs test
- Grip strength assessment
- Nerve conduction study
- Electromyography in selected cases
- X-ray if wrist injury or arthritis is suspected
Role of Nerve Conduction Test
A nerve conduction test helps confirm whether the median nerve is compressed at the wrist. During the test, small electrical impulses are used to measure how well the nerve is working.
Mayo Clinic explains that a nerve conduction study passes a small shock through the median nerve to see whether electrical impulses are slowed in the carpal tunnel; this test can help diagnose the condition and rule out other problems.
Non-Surgical Treatment Options
Mild and early Carpal Tunnel Syndrome can often be managed without surgery.
Treatment may include:
- Night wrist splint
- Activity modification
- Avoiding repeated wrist strain
- Ergonomic correction
- Medicines for pain and inflammation
- Physiotherapy
- Nerve gliding exercises
- Steroid injection in selected cases
- Treatment of diabetes, thyroid, or inflammatory disease
- Regular follow-up
AAOS notes that wearing a brace or splint at night helps keep the wrist in a neutral position and reduces pressure on the nerve in the carpal tunnel.
Exercises and Physiotherapy
Exercises may help in selected patients, especially when combined with splinting, medicines, and activity changes. AAOS notes that specific exercises may help reduce pressure on the median nerve and can be included with bracing, medication, and activity modification.
Physiotherapy may include:
- Nerve gliding exercises
- Tendon gliding exercises
- Wrist mobility exercises
- Strengthening after pain reduces
- Posture correction
- Workstation advice
- Ergonomic training
Exercises should be done under medical guidance, especially if symptoms are severe.
When Surgery May Be Required
Surgery may be advised when symptoms are severe, long-standing, worsening, or not improving with non-surgical treatment.
Surgery may be considered if there is:
- Persistent numbness
- Severe night symptoms
- Weakness in the hand
- Thumb muscle wasting
- Failed splinting or medicines
- Abnormal nerve conduction test
- Difficulty with daily activities
- Progressive nerve compression
Carpal tunnel release surgery reduces pressure on the median nerve by releasing the tight ligament over the carpal tunnel.
Prevention Tips
Some daily habits can reduce wrist strain:
- Keep wrist in neutral position
- Avoid prolonged bending of the wrist
- Take breaks during typing
- Avoid tight gripping for long periods
- Use ergonomic keyboard and mouse
- Do hand and wrist stretches if advised
- Control diabetes and thyroid problems
- Avoid repeated mobile phone strain
- Do not ignore night numbness
Expert Hand & Wrist Pain Care at ONUS Robotic Hospitals
At ONUS Robotic Hospitals, patients with hand numbness, wrist pain, tingling hands, median nerve compression, hand weakness, and Carpal Tunnel Syndrome receive expert evaluation and personalized treatment.
For Appointments:
Dr. Balaraju Naidu, Robotic Orthopedic Surgeon
ONUS Robotic Hospitals β Hyderabad
π link: contact-us or book-appointment
Β
