Carpal Tunnel Syndrome

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a painful condition caused by compression of a key nerve in the wrist. It occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist. Symptoms usually start gradually, with pain, weakness, or numbness in the hand and wrist, radiating up the arm. As symptoms worsen, people might feel tingling during the day, and decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In some cases no direct cause of the syndrome can be identified. Most likely the disorder is due to a congenital predisposition – the carpal tunnel is simply smaller in some people than in others. The risk of developing carpal tunnel syndrome is especially common in those who preform repetitive work tasks, such as assembly line work. Carpal tunnel syndrome is also associated with pregnancy and diseases such as diabetes, thyroid disease, or rheumatoid arthritis.

Is there any treatment?

Initial treatment generally involves resting the affected hand and wrist for at least 2 weeks, avoiding activities that may worsen symptoms, and immobilizing the wrist in a splint to avoid further damage from twisting or bending. Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, other nonprescription pain relievers, and oral steroids (prednisone) may ease pain. Steroid injections can also be used to alleviate the swelling and pressure on the median nerve. For more severe cases of carpal tunnel syndrome, open carpal tunnel release surgery or endoscopic carpal tunnel release may be recommended.

What is the prognosis?

In general, carpal tunnel syndrome responds well to treatment, with the majority of patients recovering completely. To prevent workplace-related carpal tunnel syndrome, workers can do on-the-job conditioning, perform stretching exercises, take frequent rest breaks, wear splints to keep wrists straight, and use correct posture and wrist position. Wearing fingerless gloves can help keep hands warm and flexible.

What research is being done?

The National Institute of Neurological Disorders and Stroke (NINDS) conducts stroke research and clinical trials at its laboratories and clinics at the National Institutes of Health (NIH), and through grants to major medical institutions across the country. Currently, NINDS researchers are studying the mechanisms of stroke risk factors and the process of brain damage that results from stroke. Basic research has also focused on the genetics of stroke and stroke risk factors. Scientists are working to develop new and better ways to help the brain repair itself to restore important functions.  New advances in imaging and rehabilitation have shown that the brain can compensate for function lost as a result of stroke.

Conditions