Carpal Tunnel Syndrome


Carpal tunnel syndrome (sometimes referred to as carpal tunnel) is characterized by a variety of symptoms, such as weakness, numbness, tingling, and more, which occur in the hand and arm due to pressure on the median nerve in the wrist. The carpal tunnel is a narrow passageway on the palm side of the wrist that contains the median nerve and several tendons that run from the forearm to the hand. The median nerve controls the movement and sensation in the thumb and your first three fingers, excluding the little finger.

If left untreated, carpal tunnel syndrome can lead to permanent nerve damage and loss of hand function. Early diagnosis and treatment can help prevent these complications.

It is the most common nerve compression syndrome and affects about 5% of people in the United States, with a higher prevalence in women and older individuals. Carpal tunnel syndrome is more common in women than men and tends to occur more frequently in older adults. While carpal tunnel syndrome is a common condition, it is often preventable by practicing good hand and wrist posture, taking frequent breaks from repetitive activities, and maintaining good overall health.


Various factors can lead to carpal tunnel syndrome, including repeated use of the hand or wrist in a lowered position, medical conditions like diabetes and hypothyroidism, pregnancy, obesity, and genetic predisposition. Since carpal tunnel syndrome is caused by pressure on the median nerve that passes through the carpal tunnel, the pressure can be caused by a variety of factors, including:

  • Repetitive hand or wrist movements: Jobs or activities that have repetitive hand or wrist movements, such as typing, sewing, or using vibrating tools, can cause inflammation and swelling that compresses the median nerve.
  • Anatomic factors: Some people may be born with a smaller carpal tunnel, which can increase the likelihood of developing carpal tunnel syndrome. Wrist injuries or fractures can also cause deformities that lead to compression of the median nerve.
  • Medical conditions: Certain medical conditions, such as diabetes, hypothyroidism, and rheumatoid arthritis, can cause inflammation and swelling that compress the median nerve. Pregnancy can also cause fluid retention and increased pressure on the median nerve.
  • Obesity: Being overweight or obese can increase the risk of developing carpal tunnel syndrome.
  • Genetic predisposition: Some people may have a genetic predisposition to carpal tunnel syndrome, making them more susceptible to developing the condition.


  • According to the American Academy of Orthopedic Surgeons, carpal tunnel syndrome is one of the most common nerve disorders in the United States, affecting up to 10 million Americans.
  • Carpal tunnel syndrome is more common in women than in men, and it often occurs in people who are middle-aged or older.
  • People who work in jobs with repetitive hand motions, such as assembly line workers, computer programmers, and musicians, are at higher risk of developing carpal tunnel syndrome.
  • According to a study published in the Journal of Occupational and Environmental Medicine, the incidence rate of carpal tunnel syndrome among US workers is 1.5 per 10,000 workers per year.
  • Carpal tunnel syndrome is responsible for an estimated 500,000 surgeries in the United States annually.


  • It can affect anyone: While carpal tunnel syndrome is often associated with people who perform repetitive hand or wrist motions, it can affect anyone. Some people are more susceptible due to their occupation or hobbies, but it can also occur due to health conditions or genetic predisposition.
  • It can have a variety of symptoms: While numbness, tingling, and weakness are the most common symptoms of carpal tunnel syndrome, some people may experience different symptoms, such as aching or swelling in the wrist and hand.
  • It can be misdiagnosed: Carpal tunnel syndrome can sometimes be misdiagnosed as another condition, such as a pinched nerve or arthritis. It’s important to see a doctor who is knowledgeable about carpal tunnel syndrome to get an accurate diagnosis.
  • It can be prevented: There are steps people can take to reduce their risk of developing carpal tunnel syndrome, such as taking frequent breaks when performing repetitive tasks, using ergonomic equipment, and practicing proper wrist and hand posture.
  • It can be treated with non-surgical methods: In many cases, carpal tunnel syndrome can be treated with non-surgical methods such as wearing wrist splints, making lifestyle changes, and doing exercises to stretch and strengthen the wrist and hand muscles. Surgery is usually only recommended for severe cases or when other treatments have been ineffective.


Carpal tunnel syndrome can cause a range of symptoms that affect the hand, wrist, and arm. Some of the most common symptoms include:

  • Numbness or tingling: Many people with carpal tunnel syndrome experience numbness, tingling, or a pins-and-needles sensation in the fingers, particularly the thumb, index, middle, and ring fingers.
  • Pain: Pain in the hand, wrist, and forearm is another common symptom of carpal tunnel syndrome. The pain may be sharp or dull. It can be felt at any time of day but is often worse at night.
  • Weakness: As carpal tunnel syndrome progresses, it can cause weakness in the hand and wrist, making it difficult to grip objects or perform fine motor tasks.
  • Difficulty with fine motor tasks: Carpal tunnel syndrome can make it hard to perform tasks that require fine motor skills, such as writing, typing, or buttoning a shirt.
  • Shock-like sensations: Some people with carpal tunnel syndrome may experience shock-like sensations in the hand and wrist.

If you are experiencing any of these symptoms, it is important to call us for an appointment immediately so that we can start a diagnosis and treatment plan.


Treatment options range from at-home remedies such as avoiding the activity, using ice and over-the-counter anti-inflammatory medication, and wearing a wrist splint or undergoing corticosteroid injections, to physical therapy and carpal tunnel release surgery.

During open carpal tunnel release surgery, the transverse carpal ligament is cut to relieve pressure on the median nerve and improve symptoms.


Endoscopic carpal tunnel surgery is a minimally invasive procedure that involves using an endoscope, a small tube with a camera, to visualize the wrist structures without making a large incision. Depending on the procedure, the surgeon uses specialized tools to make a small incision, either at the wrist or the wrist and palm. In a single-portal procedure, the camera and cutting tool are contained in a single tube.

During endoscopic carpal tunnel surgery, the surgeon cuts the transverse carpal ligament to release pressure on the median nerve, thereby relieving carpal tunnel syndrome symptoms. Compared to open surgery, endoscopic surgery has a shorter recovery period since it doesn’t need a large incision that disrupts a larger area of the hand.


At our clinic, Dr. Howard, a specialized hand and wrist surgeon, evaluates patients with carpal tunnel syndrome by taking their medical history, assessing physical activity, evaluating strength, and conducting blood or nerve tests if necessary. Effective treatment is available to relieve symptoms and restore wrist and hand function, starting with non-surgical therapies. Non-surgical treatments are tried first, and surgery is considered if other options are not effective.