What You Need to Know About Carpal Tunnel Syndrome: Causes, Symptoms, and Solutions

Carpal tunnel syndrome (CTS) is one of the most common peripheral nerve entrapment syndromes, affecting the median nerve as it passes through the carpal tunnel, a narrow passageway in the wrist formed by the wrist bones and the transverse carpal ligament. The median nerve provides sensation to the thumb, index finger, middle finger, and part of the ring finger while helping control several muscles at the base of the thumb. When pressure builds inside the carpal tunnel, the nerve becomes compressed, leading to pain, numbness, tingling, weakness, and difficulty performing everyday activities.

Carpal tunnel syndrome develops when increased pressure within the carpal tunnel reduces the normal function of the median nerve. Repetitive hand movements, wrist injuries, arthritis, diabetes, hypothyroidism, pregnancy, menopause, obesity, and natural differences in wrist anatomy can all increase the risk of developing the condition. Women are affected more often than men, and symptoms commonly develop in the dominant hand first. Because similar symptoms may also result from cervical radiculopathy, cubital tunnel syndrome, pronator syndrome, or peripheral neuropathy, an accurate diagnosis is essential before treatment begins.

Symptoms often develop gradually and may become more noticeable at night or during activities such as typing, gripping tools, driving, using a computer mouse, or holding a phone. Many people wake up with their hand “asleep,” shake it to temporarily relieve the tingling, or notice themselves dropping objects because of reduced grip strength. As the condition progresses, weakness, decreased thumb strength, difficulty performing fine motor tasks, and muscle wasting of the thenar muscles at the base of the thumb may occur. Early diagnosis and treatment are important because prolonged compression of the median nerve can lead to permanent nerve damage and lasting loss of hand function.

A comprehensive evaluation may include a physical examination with tests such as the Phalen test and Tinel sign. When additional confirmation is needed, nerve conduction studies (NCS) or electromyography (EMG) may be recommended to confirm the diagnosis, assess the severity of nerve compression, and rule out other conditions.