Carpal Tunnel Syndrome

The carpal tunnel is a narrow area located on the palm side of your wrist. The tunnel is formed by the wrist bones and ligaments. Nerves, blood vessels, and tendons pass through the carpal tunnel. Repeated wrist motion or certain diseases may cause swelling within the tunnel. This swelling pinches the main nerve in the wrist (median nerve) and causes the painful hand and arm condition called carpal tunnel syndrome.

CAUSES

  • Repeated wrist motions.

  • Wrist injuries.

  • Certain diseases like arthritis, diabetes, alcoholism, hyperthyroidism, and kidney failure.

  • Obesity.

  • Pregnancy.

SYMPTOMS

  • A "pins and needles" feeling in your fingers or hand.

  • Tingling or numbness in your fingers or hand.

  • An aching feeling in your entire arm.

  • Wrist pain that goes up your arm to your shoulder.

  • Pain that goes down into your palm or fingers.

  • A weak feeling in your hands.

DIAGNOSIS

Your caregiver will take your history and perform a physical exam. An electromyography test may be needed. This test measures electrical signals sent out by the muscles. The electrical signals are usually slowed by carpal tunnel syndrome. You may also need X-rays.

TREATMENT

Carpal tunnel syndrome may clear up by itself. Your caregiver may recommend a wrist splint or medicine such as a nonsteroidal anti-inflammatory medicine. Cortisone injections may help. Sometimes, surgery may be needed to free the pinched nerve.

HOME CARE INSTRUCTIONS

  • Take all medicine as directed by your caregiver. Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • If you were given a splint to keep your wrist from bending, wear it as directed. It is important to wear the splint at night. Wear the splint for as long as you have pain or numbness in your hand, arm, or wrist. This may take 1 to 2 months.

  • Rest your wrist from any activity that may be causing your pain. If your symptoms are work-related, you may need to talk to your employer about changing to a job that does not require using your wrist.

  • Put ice on your wrist after long periods of wrist activity.

  • Put ice in a plastic bag.

  • Place a towel between your skin and the bag.

  • Leave the ice on for 15 to 20 minutes, 3 to 4 times a day.

  • Keep all follow-up visits as directed by your caregiver. This includes any orthopedic referrals, physical therapy, and rehabilitation. Any delay in getting necessary care could result in a delay or failure of your condition to heal.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have new, unexplained symptoms.

  • Your symptoms get worse and are not helped or controlled with medicines.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.