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Know what to look for (and what to do if you have symptoms).

Your wrist is a complex part of your body. Knowing what tendons, joints and ligaments are impacted by carpal tunnel syndrome can help you pinpoint the source of your pain and decide whether it’s time to see a healthcare provider. 

The carpal tunnel is a narrow passageway of bones and ligaments in your wrist. Nine tendons and, most importantly, the median nerve travel through the carpal tunnel. The median nerve, which extends from your neck and shoulder into your palm, fingers and thumb, provides the sensation to your thumb, index, middle and ring fingers. The median nerve also provides the signals that control the movement of the thumb and some of the other small muscles in your hand. 

“Swelling or inflammation of the tendons and tissue traveling with the median nerve within the carpal tunnel can limit the space available for the nerve,” says C. Liam Dwyer, MD, a hand and upper extremity surgeon at Geisinger. “This causes the nerve to become compressed, limiting the ability of the nerve signal to pass to and from the hand.”

What typically starts as discomfort, numbness and tingling in your hand, wrist or arm can lead to a weaker grip and pain if left untreated.

Carpal tunnel syndrome symptoms include:

  • Numbness
  • Tingling
  • Weakness
  • Pain in your fingers, hand and wrist that can radiate up your arm 

Causes of carpal tunnel syndrome

"Common factors contributing to symptoms include your structural anatomy, associated medical conditions and repetitive activity,” explains Dr. Dwyer.

Traumatic, forceful or repetitive hand movements, hand-arm vibration or working for long periods in the same or awkward position can lead to the progression of the condition.

Carpal tunnel syndrome starts gradually with symptoms that come and go. That’s the best time to get a proper diagnosis, before what starts as a minor inconvenience becomes more troublesome — with possible symptoms like weakness in the hand or even permanent loss of sensation and control.

Two conditions misdiagnosed as carpal tunnel syndrome

When symptoms arise, it’s important to note that it may not always be carpal tunnel syndrome. Tendonitis and neuropathy share many of the same symptoms, but there are a few differences.

Tendonitis. Tendonitis is the swelling of tendons, which can lead to hand pain. However, tendonitis doesn’t usually cause a tingling sensation or numbness. 

Neuropathy.  An encompassing term for nerve degeneration, neuropathy that affects your hand will give you pain and tingling sensations like carpal tunnel syndrome. Because both conditions can affect the median nerve, it’s difficult to diagnose it properly. If you’re unsure what's causing your pain, schedule a consultation to see a doctor or hand specialist. 

Treatment for carpal tunnel syndrome

The type of treatment you’ll need will depend on the severity of your symptoms and how long you’ve had them.

To treat your carpal tunnel, your provider may suggest:

  • Taking frequent breaks to rest your hands
  • Avoiding activities that worsen symptoms
  • Using ice packs to reduce swelling
  • Taking ibuprofen for pain
  • Wearing a wrist splint at night

And, if necessary, surgery.

The two common types of surgical intervention include open surgery, where an incision on the palm is made to cut the ligament and free the median nerve, and endoscopic surgery, which involves smaller incisions used to insert a small camera and blade to relieve pressure on the median nerve.

What to do if you have symptoms of carpal tunnel syndrome?

If you have persistent symptoms of numbness, tingling, weakness and pain that interfere with your regular activities and sleep, contact your healthcare provider.

“If you have carpal tunnel symptoms, especially if you have them consistently, call your doctor for an evaluation. If left untreated, carpal tunnel can lead to permanent nerve and muscle damage,” Dr. Dwyer notes.

If you’re still not feeling better, your healthcare provider can work with you to create a treatment plan that gives you relief.

Next steps: 

Meet C. Liam Dwyer, MD
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