Carpal Tunnel Syndrome

Carpal tunnel syndrome, also called median nerve compression, is a condition that causes numbness, tingling, or weakness in your hand.
It happens because of pressure on your median nerve, which runs the length of your arm, goes through a passage in your wrist called the carpal tunnel, and ends in your hand. The median controls the movement and feeling of your thumb and the movement of all your fingers except your pinky.
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Symtoms

For many people with tingling, pain, or numbness in their fingers, carpal tunnel syndrome is the first thing to come to mind. It’s a common condition, but it’s not the only one that causes problems in your hands and wrists. It helps to know what to look for so you can get the right care. Early treatment can make a make a big difference in how long it takes to get better.
Carpal tunnel syndrome is caused by pressure on your median nerve. This nerve gives you feeling in your thumb and all your fingers except your pinky. When it goes through your wrist, it passes through the carpal tunnel — a narrow path that’s made of bone and ligament. If you get any swelling in your wrist, this tunnel gets squeezed and pinches your median nerve, which causes your symptoms.

What Are the Early Signs?

Typically, the symptoms start out slowly, with burning, numbness, tingling, or pain. You might feel it in your thumb and any of your fingers, but not your pinkie. The strange feeling may also travel up your forearm.
Often, symptoms start at night. That’s because most people sleep with their wrists bent, which causes pressure on the median nerve. You might wake up feeling like you need to shake your hands out.
As your condition gets worse, you may notice symptoms during the day, as well. This often happens when you’re doing something where your wrist is bent up or down for a long time, like driving a car, reading a newspaper, or holding your phone.
At first, symptoms tend to come and go. But over time, they occur more often and become worse.
You might also notice other symptoms:
Over time, carpal tunnel can also affect your grip and ability to pinch. Here are some things that could be happening:

Diagnosis

How Do I Know if I Have Carpal Tunnel Syndrome?

Carpal Tunnel Tests

Tinel’s Sign The doctor will tap or press on the median nerve in your wrist with a reflex hammer. If your fingers tingle or if you feel an electric-shock-like sensation, the test is positive. You may have carpal tunnel syndrome.

Phalen’s Maneuver
This is also known as the wrist-flexion test. The doctor will tell you to press the backs of your hands and fingers together with your wrists flexed and your fingers pointed down. You’ll stay that way for a minute or two. If your fingers tingle or get numb, you have carpal tunnel syndrome.

Two-Point Discrimination Test This means you can tell if two objects touching your skin are two distinct points instead of just one. The doctor may use a gadget called a 2-point disk-criminator, a small, flat, eight-sided tool with needle-like prongs sticking out from all sides.
They might do the test several times on each finger. They’ll start with two points touching your skin a few centimeters apart and move them closer together until you feel just one point of pressure.
The distance at which you can feel only one point will help them figure out nerve function and compression — two important components of carpal tunnel syndrome.

Nerve Conduction Velocity Test

This test provides some of the strongest evidence of carpal tunnel syndrome. It measures how fast an electrical signal can travel along a nerve or from the nerve to a muscle.
The doctor places a small electrode on your skin near your elbow. It sends a mild electrical current down your median nerve. The more time it takes for the current to travel from your elbow to your fingers, the more damage to your median nerve.

Electromyogram

This works like the second part of the nerve conduction velocity test. It measures how well the muscle around your median nerve works. The doctor places a small needle electrode into muscles in your hand and arm that get impulses from the median nerve. The needle sends electric impulses into the muscle. You relax and flex your hand several times. The doctor can tell if your median nerve is damaged or being squeezed.
The needles might hurt a little, but it should stop once the doctor takes them out. You may feel twitches or spasms from the electrical current. You could have some bruising where the electrode went in, but that should go away within a few days.

Ultrasound, X-ray, and MRI

Your doctor may order one of these tests to rule out other causes of wrist and hand pain. An X-ray can show arthritis or a broken bone. An ultrasound or MRI will show a swollen or compressed median nerve. They’ll also tell the doctor why it is being squeezed, whether it’s arthritis, carpal tunnel syndrome, or another reason.
They might also order lab tests, like blood work, to look for diseases like diabetes that can damage your nerves.

Other Physical Examination

Your doctor will also ask you about any patterns with your symptoms. For example, if you have tingling or numbness in your little finger, it may not be carpal tunnel syndrome since the median nerve doesn’t provide feeling to that finger. The doctor may also ask if you have a history of symptoms:

Treatment

From yoga to surgery, you have a lot of options when it comes to treating carpal tunnel syndrome. Just remember that what helps your friend or neighbor may not work for you. You may need to try out different approaches to get the relief you need.
Carpal tunnel syndrome tends to come on slowly and get worse with time. But if you treat it early on, you can slow it down or stop it in its tracks. Early treatment can also make for a shorter recovery time.
Typically, you start with basic remedies, like wrist braces. For more severe cases, though, you might need surgery.

Self-Care

To help ease the symptoms of carpal tunnel syndrome, you may want to put ice on your wrist or soak it in an ice bath. Try it for 10 to 15 minutes, once or twice an hour.
You can also gently shake your wrist or hang it over the side of your bed for pain that wakes you up at night.

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