Carpal Tunnel Syndrome Symptoms and Causes

Carpal tunnel syndrome is a condition that occurs when the median nerve is compressed as it passes through an opening (carpal tunnel) from the wrist to the hand called the carpal tunnel. The carpal tunnel is formed by the carpal bones on the bottom of the wrist and the transverse carpal ligament across the top of the wrist. The median nerve runs through the carpal tunnel and connects with the thumb and fingers of the hand. Since the median nerve provides sensory and motor functions to the thumb and three middle fingers, many symptoms of carpal tunnel syndrome may result. Swelling or thickening from irritated tendons can increase pressure inside the tunnel and consequently compress the median nerve. Symptoms can include pain, weakness or numbness in the hand and wrist. Treatment options for carpal tunnel syndrome range from non-surgical treatments to carpal tunnel release surgery for the most severe cases.

Who is at Risk for Developing Carpal Tunnel?

According to the National Institutes of Health (NIH), carpal tunnel syndrome is the most common of the entrapment neuropathies, or conditions that happen when the body's peripheral nerves are compressed or traumatized. Women are three times more likely to develop carpal tunnel syndrome, possibly because the carpal tunnel is smaller in women than in men. People with metabolic disorders like diabetes are also at risk for carpal tunnel syndrome. This condition usually occurs in adults and is most common in patients 45 to 65 years of age, although it can occur at any age. It is also common in women during pregnancy.

Although carpal tunnel syndrome has long been associated with the repetitive motions of typing on a computer keyboard, the risk of developing the condition is not confined to people in a specific industry or job. In fact, carpal tunnel syndrome is three times more common in assembly-line workers in the manufacturing, sewing, cleaning and meat packing industries. The NIH further reports that a 2001 research study found that heavy computer use, even up to seven hours a day, did not increase a person's risk of developing carpal tunnel syndrome.

The multidisciplinary team of orthopaedic experts at North Shore-LIJ Orthopaedic Institute's Hand and Wrist Services in New York treats carpal tunnel syndrome as well as a broad range of conditions affecting the hand and wrist areas.

Carpal Tunnel Syndrome Symptoms

The following are the most common symptoms for carpal tunnel syndrome. However, each individual may experience symptoms differently. Symptoms may include:

  • Pain and/or numbness that is worse at night, interrupting sleep, or in the morning when awakening
  • Difficulty making a fist
  • Difficulty gripping objects with the hand(s)
  • Pain and/or numbness in the hand(s) at any time of the day or night
  • "Pins and needles" feeling in the fingers
  • Swollen feeling in the fingers
  • Burning or tingling in the fingers, especially the thumb and the index and middle fingers

The symptoms of carpal tunnel syndrome may suggest other medical conditions or problems. Always consult your physician for a diagnosis.

Carpal Tunnel Syndrome Causes

Carpal tunnel syndrome often results from a combination of factors which increase pressure on the median nerve and tendons in the carpal tunnel. Other contributing factors include:

  • Trauma, injury or mechanical problems in the wrist or joint
  • Joint or bone disease such as arthritis, osteoarthritis and rheumatoid arthritis
  • Hormonal or metabolic changes, including menopause, pregnancy and thyroid imbalance
  • Changes in blood-sugar levels – this may be seen with type 1 and type 2 diabetes
  • Frequent, repetitive, small movements with the hands
  • Frequent, repetitive, grasping movements with the hands such as with sports and certain physical activities
  • Overactivity of the pituitary gland
  • Fluid retention during pregnancy or menopause
  • Development of a cyst or tumor in the canal
  • Work stress

There is very little clinical data to prove whether or not repetitive movements of the hand and wrist relating to work or leisure activities can cause carpal tunnel syndrome. Repeated motions performed during normal activities have been known to result in other motion disorders such as bursitis, tendonitis and writer’s cramp.

For information about other orthopaedic conditions of the hand and wrist treated by the NSLIJ Orthopaedic Institute, please visit:

Trigger finger
Rheumatoid arthritis
Hand pain and problems
Cubital tunnel syndrome
Basal joint arthritis
Dupuytren’s disease

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