Carpal Tunnel Syndrome Overview

The carpal tunnel is a narrow passageway in the wrist that is formed by a ligament and the small wrist bones. The median nerve and several tendons run from the forearm to the hand through the carpal tunnel. In carpal tunnel syndrome, swelling in the carpal tunnel puts pressure on the median nerve, which controls sensation in the palm side of the thumb and fingers, except for the little finger, and movement of the fingers and thumb.

Several factors can lead to increased pressure on the median nerve and tendons within the carpal tunnel, and are listed below in this patient education guide:

  • Injury to the wrist that causes swelling (e.g. sprain or fracture)
  • Repetitive activities using the hand or wrist
  • Obesity
  • Overactivity of the pituitary gland
  • Hypothyroidism
  • Rheumatoid arthritis
  • Diabetes and other metabolic disorders that affect the nerves
  • Mechanical problems in the wrist joint
  • Work stress
  • Use of vibrating hand tools
  • Fluid retention during pregnancy or menopause
  • A cyst or tumor in the tunnel

Symptoms typically start off mild and gradually worsen over time. They often first appear in the night and eventually become bothersome during the day. Symptoms include:

  • Pain, weakness, or numbness in the hand and wrist that may radiate up the arm
  • Burning, tingling, or itching numbness in the palm of the hand and the fingers
  • Decrease in grip strength that results in difficulty making a fist, grasping small objects, or performing other manual tasks

Carpal tunnel syndrome is three times more common in women than in men, three times more common among assembly line workers than data-entry personnel, and overall more common in people with diabetes or other meta­bolic disorders that affect the nerves.


Written by Laurie LaRusso, MS, ELS

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