Carpal tunnel syndrome (CTS) occurs when the median nerve that runs from the forearm to your hand becomes compressed at the narrow passageway (carpal tunnel) in your wrist, leading to tingling, numbness and discomfort in your hand and fingers.
It’s important to know about carpal tunnel syndrome symptoms and their potential causes, so you know what to look out for and when to seek advice. In this blog we discuss carpel tunnel syndrome causes and its symptoms, as well as how to get a diagnosis and the treatment options for CTS.
Signs & Symptoms of Carpal Tunnel Syndrome
Most people with CTS experience a gradual onset of symptoms that may come and go. They usually worsen at night and can interrupt your sleep.
Carpal tunnel syndrome symptoms include:
- Numbness, tingling, or ‘pins and needles’ in your hand, fingers, or thumb.
- Weakness in your hand, fingers, or thumb, making it more difficult to grip or hold things, such as a phone or pen.
- Pain or discomfort in your hand, fingers, or thumbs.
- Pain radiating up your arm into the elbow, shoulder, and neck.
Carpal tunnel symptoms may be similar to other medical conditions. It’s advisable to see your doctor if you are experiencing them.
What causes carpal tunnel syndrome?
There are multiple carpal tunnel syndrome causes and often a combination of factors can increase your risk of developing the condition.
Repetitive movements
Any strenuous, repetitive movement involving the hand, wrist or fingers may increase your risk of developing CTS.
Actions such as repeatedly scrolling on your phone, writing, typing, gripping tools, or holding a game console could potentially lead to an increased risk of CTS over time.
Wrist anatomy
The anatomy of your wrist can affect the pressure on your median nerve in your carpal tunnel.
If you have arthritis or a wrist sprain, fracture or dislocation, the space in your carpal tunnel may change. This can cause more pressure on your median nerve and may increase your susceptibility to developing carpal tunnel syndrome.
You may be born with a smaller carpal tunnel which can also increase your risk of developing CTS.
Medical condition
Some medical conditions can cause swelling and inflammation in your wrist and hand, which can compress the median nerve in your carpal tunnel.
The most frequent medical conditions associated with CTS include:
- Diabetes - high blood sugar levels can cause inflammation and prevent your tendons from moving properly. It also increases the risk of nerve damage, including the median nerve.
- Rheumatoid arthritis - this autoimmune disease can cause inflammation in your joints, including the wrist.
- Thyroid gland imbalance - an imbalance in thyroid hormones can cause swelling of the synovial membrane around the tendons in your carpal tunnel.
- Fractures or trauma to the wrist - can narrow your carpal tunnel and irritate the nerve.
- Fluid retention from pregnancy or menopause - can lead to swelling in your hands and wrists which can compress your median nerve.
- High blood pressure – can contribute to swelling in your wrist.
Hormonal changes
Hormonal changes in your body, such as those that occur during pregnancy or menopause, may lead to increased fluid retention. If fluid builds up in your wrist, this can lead to swelling, which may compress the median nerve, resulting in CTS.
Common risk factors for carpal tunnel syndrome
There are a number of factors that increase your risk of carpal tunnels syndrome. They include:
Occupation
Certain jobs may require you to move your hand in a repetitive motion which may increase your susceptibility to developing carpal tunnel syndrome.
For example, those working in offices may repeatedly use their mouse and keyboard, which if positioned incorrectly, may lead to gradual compression of the median nerve, resulting in CTS.
Or, those working in construction and manufacturing may also be more prone to developing CTS because of repeated forceful hand movements and the use of hand-held vibrating tools.
Family history
Some people may be predisposed to developing CTS if they have a parent or sibling with the condition.
Being born female
Carpal tunnel syndrome is generally more common in women. This may be due to the carpal tunnel area being relatively smaller in women compared to men or hormones affecting tendon lining in the carpal tunnel.
Previous injury
If you’ve previously injured your wrist, either through a sprain, fracture, or dislocation, this may increase your risk of developing CTS.
How to prevent carpal tunnel syndrome
Of course, you’re wondering how can you prevent carpal tunnel. Unfortunately, there are no proven strategies to help with carpal tunnel prevention. However, if you have one or more risk factors, it’s useful to understand the measures you can take to minimise stress on your hands and wrist, which could reduce your chances of acquiring the condition.
Here are our tips to help with carpal tunnel prevention.
Relax your grip
Often people use more force than is needed to perform small tasks. For example, if your work involves typing then hit the keys softly. If you write a lot, then choose a big pen with a soft grip and free flowing ink and apply only light pressure to the paper.
Take regular breaks to stretch your hands
If you are working on repetitive wrist motions you should periodically, for example every hour, take a break. It’s also worth alternating repetitive tasks if possible and rotating them with colleagues if possible. If you use vibrating equipment or perform tasks that require a lot of force, it’s particularly important to rest and alternate to prevent CTS.
Performing simple hand, wrist and finger exercises for four to five minutes every hour may be helpful in preventing CTS. This will help relax and also strengthen the muscles in your wrists and hands and improve blood flow to these areas.
You can try gently stretching and shaking exercises for your hand, wrist and fingers including: wrist bends (forward and back), wrist lifts, wrist flexes, finger bends, wrist stretches with weights, and hand squeezes.
Improve your posture
Avoid bending your wrist all the way up or down. Keeping your wrist in a relaxed middle position is best.
You should also take care when positioning your keyboard and keep it at elbow height or slightly lower.
Posture is a very important and if incorrect it can cause your shoulders to slump which aggravates your neck and shoulder muscles, and may causes problems in your arms, hands and wrists. Proper posture and exercise programs designed to strengthen fingers, hands, wrists, forearms, shoulders, and neck may help prevent CTS.
Keep your hands warm
A cold environment is always associated with stiff joints. Your hands are more likely to develop pain and stiffness in cold temperatures. Try fingerless gloves if you can’t control the temperature as these will keep your hands and wrists warm but allow you to work effectively and flexibly.
Use ergonomic equipment
Workstations, tools and tasks can be redesigned to allow you to maintain a natural wrist position whilst working.
An ergonomic keyboard is ideal for maintaining a more natural position for your hands. A computer mouse that is well positioned and not causing strain on your wrist may be beneficial too.
You may also try moving your mouse to the other side and using your less dominant hand. Eventually you’ll get used to using your other hand and it’s an excellent preventative measure.
How is carpal tunnel syndrome diagnosed?
If you have carpal tunnels syndrome symptoms, you will be wondering how to find out if you have carpal tunnel or if it’s something else. The only sure way to know is to see a healthcare specialist.
At Ramsay, we have hand and wrists specialists with convenient appointments who can assess your carpal tunnels symptoms and refer you for any required tests with the aim of giving you a diagnosis.
Your healthcare professional will ask you questions and may need to perform some tests. These may include:
- History of carpal tunnel symptoms – finding out when your symptoms occur can help with a diagnosis, such as while holding your phone, typing on a keyboard, at night awaking you from sleep or when you awake in the morning.
- Physical exam – to test the feeling in your fingers, the strength of your hand muscles, and whether symptoms are triggered through bending your wrist or tapping/pressing your median nerve.
- X-ray – can help exclude other causes of wrist pain, such as arthritis or fracture.
- Ultrasound - gives a picture of your tendons and nerves and can show if your nerve is being compressed.
- Electromyography - measures tiny electrical discharges produced in your muscles. It helps identify damage in your muscles that are controlled by the median nerve and may rule out other conditions.
Treatment of carpal tunnel syndrome
Treatment of CTS will be based on a number of factors. These include your age, your health and medical history, the extent of your carpal tunnel symptoms, how the condition is expected to progress, your toleration of treatments, and your preferences.
Carpal tunnel treatments may include:
- Hand splinting – to help prevent your wrist from moving and ease nerve compression.
- Anti-inflammatory medication - oral or steroid injections to reduce swelling.
- Reduce doing things that may be causing it – including anything where you frequently bend your wrist or grip hard.
- Hand and wrist exercises – to stretch and strengthen your muscles and tendons in this area. A physiotherapist will be able to advise on the best exercise for your CTS.
- Ergonomic worksite changes – such as altering the position of your office work station.
- Surgery – to relieve nerve compression in the carpal tunnel.
Carpal tunnel syndrome surgery
Carpal tunnel surgery usually cures CTS. If your symptoms are severe or have lasted a long time, tests show you have nerve damage or muscle wastage, and other treatments have not been successful in relieving your symptoms, then your healthcare specialist will discuss this option with you.
CTS surgery usually takes about 20 minutes. It is performed under a local anaesthetic. Your hand and wrist surgeon will make a small cut in the palm of your hand and cut the ligament to relieve pressure on your nerve. You should be able to go home the same day.
Read more here about what to expect after CTS surgery.
Carpal tunnel treatment with Ramsay Health Care
If you are experiencing symptoms of carpal tunnel syndrome, Ramsay Health Care can help.
We offer rapid access to appointments so that you can receive a prompt diagnosis and expert advice from our team of skilled specialists and medical professionals on the most appropriate course of treatment for you.
Should you require surgery, you’ll be looked after by our team of experienced orthopaedic surgeons.
Contact us today to learn more about the carpal tunnel treatment options available at your nearest Ramsay hospital.
Carpal tunnel syndrome FAQS
Does carpal tunnel syndrome cause shoulder pain?
Patients may ask ‘can carpal tunnel syndrome cause shoulder pain?’ and the answer is yes. Carpal tunnel syndrome can cause shoulder pain. It is known as a referred pain as the compression of the median nerve in your wrist can cause pain to spread up your arm and to your shoulder.
What happens if the carpal tunnel is left untreated?
If you have severe carpal tunnel syndrome symptoms and leave them untreated it can lead to irreversible nerve damage. This could result in permanent numbness, pain, weakness or clumsiness.
Does stress cause carpal tunnel?
It is thought that stress can contribute to the cause of carpal tunnel syndrome (CTS). This can be due to stress and anxiety causing poor posture. Slouching over or tensing your upper body muscles disrupts your body’s natural anatomy and transmits unbalanced forces and pressure to your wrist.
Stress can also cause hormone production that can lead to inflammation and swelling and pressure on your median nerve.
What makes carpal tunnel worse?
Factors that make carpal tunnel worse include:
- Repetitive hand and wrist movements – such as when typing, knitting, painting, or playing sports and can cause inflammation and swelling.
- Holding and gripping objects - including a phone, book, or steering wheel.
- Cold environments - can increase pressure on your median nerve.
- Underlying medical conditions – can increase risk of developing carpal tunnel syndrome. These include diabetes, thyroid problems, and rheumatoid arthritis.
- Fluid retention - during pregnancy or menopause can increase pressure on your median nerve.
What is the best way to fix a carpal tunnel?
There are a number of treatments for CTS. Typically, non-surgical treatments are recommended first. These can include hand splinting, anti-inflammatory medications, hand exercises and changes to your workplace. If these are not successful, your healthcare specialist may recommend carpal tunnel surgery.