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What is carpal tunnel syndrome?

Carpal tunnel syndrome, also known as median nerve compression, is a condition which causes tingling, numbness or weakness in the hand. The median nerve is located on the palm side of your hand which is also known as the carpal tunnel. The median nerve is responsible for providing sensation to the thumb, the index finger, and parts of the ring finger. The nerve is responsible for the muscle going to the thumb. Carpal tunnel syndrome can occur in any or both of your hands.



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Anatomic factors such as fracture or dislocation of the wrist bones


Women have smaller carpal tunnel area than that in men


Chronic illness such as diabetes or damage to the median nerve




Medications such as Arimidex


Other medical conditions such as kidney disorders, thyroid, menopause


High blood pressure

Thyroid dysfunction

Fractures or trauma to the wrist



Fluid retention from pregnancy or menopause

Autoimmune disorders such as rheumatoid arthritis


Numbness, tingling, and pain in your thumb and the first three fingers of your hand

Pain and burning that travels up your arm

Weakness in the muscles of the hand

Wrist pain at night that interferes with sleep



A doctor can diagnose a carpal tunnel syndrome by doing a physical examination and tests called nerve conduction studies. The physical examination may include a thorough evaluation of your hand, shoulder, wrist, neck or any other parts that can cause pressure in the nerve. The doctor may also check if there are any tenderness or swelling in the wrist. The doctor may further check the sensation of the fingers and the strength of the muscles in your hand.


To relieve the symptoms of carpal tunnel syndrome, the doctor conducts a surgery called Carpal Tunnel Release surgery. During a carpal tunnel release or surgery, the surgeon cuts through the ligament that is pressing down on the carpal tunnel. This makes more room for the median nerve and tendons passing through the tunnel, and usually improves pain and function.

When does a person require a carpal tunnel release?

The doctor might suggest a carpal tunnel release when:

  • The nonsurgical interventions for carpal tunnel syndrome fail to provide relief from the pain.
  • The muscles of the hands or wrists are weak and actually getting smaller because of the severe pinching of the median nerve.
  • The symptoms of carpal tunnel syndrome have lasted 6 months or longer with no relief.
  • The doctor performs an electromyography test of the median nerve and determines that you have carpal tunnel syndrome.

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Frequently Asked Questions

What is the best treatment for CTS?

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Carpal Tunnel Syndrome is a condition in which pain, tingling and numbness occurs in the hands and arm. Carpal tunnel syndrome is a very common problem that affects the hands of people. This condition occurs when the media nerve - one of the major nerves - gets squeezed or compressed while passing through the wrist. The median nerve is responsible for providing sensation to th...

e thumb, index, and the middle fingers. This health condition was first identified in the mid 1800s.

There are 9 tendons which help in bending the fingers and the thumb. These tendons are known as flexor tendons.

Carpal tunnel syndrome occurs when the tunnel becomes narrow and the flexor tendons nearby swells up. This puts pressure on the median nerve leading to carpal tunnel syndrome.

Facts on Carpal tunnel syndrome:

  • Heredity is the most common factor leading to carpal tunnel syndrome. Small carpal tunnels may run in the heredity of a family. If your parents have carpal tunnel syndrome, you are likely to suffer from it too.

  • Medical conditions such as thyroid issues, rheumatoid arthritis, diabetes can also cause carpal tunnel syndrome.

  • Diagnosis of carpal tunnel syndrome is very important. If not treated on time, it can damage the muscles of the hand permanently.

  • Maintaining a healthy weight can reduce the risk of carpal tunnel syndrome.

Signs and symptoms of CTS:

The symptoms are always in connection with the nerve path and the compression of the median nerve. When the hand loses all senses, the hand is considered to 'fall asleep'. Other symptoms include:

  • Pain and burning sensation that travels from wrist to the arm

  • Wrist pain the increases when the person is asleep

  • Weakness in the muscles of the hand

  • Numbness and tingling in the thumb and the middle fingers

  • A person with CTS may feel the need to shake out the hand

Causes of CTS:

The pain of the carpal tunnel is due to excess pressure on the median nerve. The most common cause of CTS is often an underlying condition that leads to swelling of the wrist. Sometimes, even obstructed blood flow can cause the pain. Other causes include:

  • Diabetes

  • Thyroid retention

  • High blood pressure

  • Autoimmune disorders such as rheumatoid arthritis

  • Fractures or trauma to the wrist

  • Fluid retention from pregnancy or menopause

CTS may also be the result of :

  • Constant positioning of your wrists of the mouse or keyboard for long hours

  • Exposure to vibrations from using power tools

  • Repeated movement that overextends your wrist

Who is at risk for CTS?

People who are related to activities or jobs that involve repetitive finger use are at higher risk of CTS.

Other risk factors include:

  • Heredity (smaller carpal tunnels can run in families)

  • Alcoholism

  • Pregnancy

  • Hemodialysis (a process where the blood is filtered)

  • Arthritic diseases such as rheumatoid arthritis and gout

  • Thyroid gland hormone imbalance (hypothyroidism)

  • Wrist fracture and dislocation

  • Hand or wrist deformity

  • Diabetes

  • A mass (tumor) in the carpal tunnel

  • Older age

  • Amyloid deposits (an abnormal protein)


The problem of CTS is diagnosed by an orthopedic doctor. The doctor examines the hands, shoulders, arms, and the neck to find out the underlying cause of the pain. The doctor may rule out other conditions too that mimic CTS. He or she would further diagnose the hand for any tenderness, swelling or dislocation.

The doctor may recommend you to undergo X-rays and other imaging tests to reveal if there is any fracture or arthritis which can damage the nerve.

The doctor may ask you to do an ultrasound to see if there is any abnormal size of the median nerve. To check the anatomy of the wrist, you might be recommended to do a magnetic resonance imaging (MRI). In electromyography, a fine needle is inserted into a muscle and the electrical activity viewed on a screen can determine the severity of damage to the median nerve.


Non-surgical treatments

  • Splinting - A splint is worn at night for initial treatment.

  • Avoiding activities that may provoke pressure - Avoid prolonged hours of activities which put pressure on the hand and provoke the symptoms. Give your hand some rest.

  • Icing - If the swelling is visible and the hand is red, try applying ice packs.

  • OTC drugs - Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and other nonprescription pain relievers, may provide short-term relief from the pain in the wrist and hand.

  • Therapies - Therapies such as acupuncture and chiropractic have benefited many people from the pain. But, this relief is temporary and not long lastin


There are two major types of surgeries done to release carpal tunnel syndrome:

Open surgery - This is the traditional process of surgery. The orthopedic surgeon in this method, makes an incision up to 2 inches in the wrist. After that, the surgeon cuts the carpal ligament to enlarge the tunnel. The doctor generally uses local anesthesia to carry out the process and the surgery is done on an outpatient basis.

Endoscopic surgery - The surgeon makes minute incisions on the palm and the wrist. Through the incisions, a camera is inserted which is attached to a tube. Through the camera, the surgeon observes the ligament, and tendons on the monitor. Factors such as age of the patient, duration of the symptoms and severity of the injury determines the success or failure of the surgery.


  • People at the workplace can perform stretching exercises in between work or take short breaks and give the hand some rest.

  • Wearing fingerless gloves can help the hand stay flexible.

  • Workstations can be redesigned to support rest to the wrists of the employees.

Ayurvedic tips for CTS:

  • Apply Mahanarayana taila (herbal oil) on the wrist and palm.

  • Do gentle wrist movements after applying the oil.

  • Practice heat therapy

  • You can take salt heat therapy. Tie salt in a cloth, heat it on a pan and apply in your hand.

  • Health and lifestyle management

  • Do not smoke or consume too much alcohol

  • Take care of basic health

  • Eat balanced diet

  • Do regular exercises to keep the body fit and flexible

  • Keep a check on your diabetes and arthritis

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