Carpal tunnel syndrome

Carpal tunnel syndrome happens when the median nerve is squeezed as it passes through a narrow passageway in the wrist called the carpal tunnel. It is a common cause of numbness and tingling in the hand.

• Numbness, tingling, or burning in the thumb, index, middle, and part of the ring finger
• Symptoms that wake you at night or are worse in the morning
• Shaking the hand to "wake it up"
• Dropping objects or clumsiness
• Weakness of the thumb and, in long-standing cases, shrinking of the muscles at the base of the thumb

Diagnosis is based on symptoms and an examination. Nerve conduction studies and electromyography (EMG) may be used to confirm the diagnosis and measure severity.

Non-operative treatment includes a wrist splint worn at night, changes to activities that bring on symptoms, and sometimes a steroid injection into the carpal tunnel.

When symptoms persist or the nerve is significantly compressed, carpal tunnel release may be recommended. The surgeon divides the ligament that forms the roof of the tunnel to make more room for the nerve. It is an outpatient procedure, performed through a small open incision or endoscopically.