Carpal Tunnel Syndrome

Carpal tunnel syndrome is a painful condition of the wrist and arm. It is caused by pressure on the median nerve.

The median nerve is one of the nerves that give feeling and movement to the hand. It passes through a tunnel in the wrist called the carpal tunnel. This tunnel is made up of bones and ligaments. Narrowing of this tunnel or swelling of the tissues inside the tunnel puts pressure on the median nerve. This causes numbness, pins and needles, or electric shooting pains in your hand and forearm. Often the pain is worse at night and may wake you when you are asleep.

Carpal tunnel syndrome may occur during pregnancy and with use of birth control pills. It is more common in workers who must often bend their wrists. It is also common in people who work with power tools that cause strong vibrations.

Home care

• Rest the painful wrist. Avoid repeated bending of the wrist back and forth. This puts pressure on the median nerve. Avoid using power tools with strong vibrations.
• If you were given a splint, wear it at night while you sleep. You may also wear it during the day for comfort.
• Move your fingers and wrists often to avoid stiffness.
• Elevate your arms on pillows when you lie down.
• Try using the unaffected hand more.
• Try not to hold your wrists in a bent, downward position.
• Sometimes changes in the work place may ease symptoms. If you type most of the day, it may help to change the position of your keyboard or add a wrist support. Your wrist should be in a neutral position and not bent back when typing.
• You may use over-the-counter pain medicine to treat pain and inflammation, unless another medicine was prescribed. 
• Anti-inflammatory pain medicines, such as ibuprofen or naproxen may be more effective than acetaminophen (Tylenol), which treats pain, but not inflammation. 
• If you have chronic liver or kidney disease or ever had a stomach ulcer or GI bleeding, talk with your doctor before using these medicines.
• Opioid pain medicine will only give temporary relief and does not treat the problem. If pain continues, you may need a shot of a steroid drug into your wrist.
• If the above methods fail, you may need surgery. This will open the carpal tunnel and release the pressure on the trapped nerve.

Follow-up care

Follow up with your healthcare provider, or as advised, if the pain does not begin to improve within the next week.

If X-rays were taken, you will be notified of any new findings that may affect your care.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

• Pain not improving with the above treatment
• Fingers or hand become cold, blue, numb, or tingly
• Your whole arm becomes swollen or weak
• Little or no feeling in your fingers or hands or have decreased use of your hands