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 and the tiny blood vessels that bring oxygen to the nerve. This causes numbness, pins and needles, or electric shooting pains in your hand and forearm. Often the pain is worse at night. It may wake you when you are asleep.

Carpal tunnel syndrome may occur during pregnancy and with use of birth control pills. It's more common in workers who must often bend their wrists. It's also common in people who work with power tools that cause strong vibrations. Other people who are more likely to have this include people with diabetes, people who are overweight, and those who smoke.

Home care

  • Rest the painful wrist. Don't bend your wrist back and forth repeatedly. This puts pressure on the median nerve. Don't use power tools with strong vibrations.

  • Stop smoking, if needed.

  • If you have diabetes, make sure your condition is under control.

  • 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 prevent 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 workplace 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, which treats pain but not inflammation. If you have chronic liver or kidney disease or ever had a stomach ulcer or gastrointestinal bleeding, talk with your healthcare provider before using these medicines.

  • Opioid pain medicine will give only short-term (temporary) relief. It doesn't treat the problem. If pain continues, you may need a shot of a steroid medicine 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.

  • Low-level laser therapy has no proven benefit for carpal tunnel syndrome.

Follow-up care

Follow up with your healthcare provider, or as advised. If X-rays were taken, you'll be told of any new findings that may affect your care.

When to get medical advice

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

  • Pain doesn't improve with the above treatment.

  • Your fingers or hand become cold, blue, numb, or tingly.

  • Your whole arm becomes swollen or weak.

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