Carpal Tunnel Syndrome (cont.)

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What are carpal tunnel syndrome symptoms?

People with carpal tunnel syndrome initially feel numbness and tingling of the hand in the distribution of the median nerve (the thumb, index, middle, and thumb side of the ring fingers). These sensations are often more pronounced at night and can awaken people from sleep. The reason symptoms are worse at night may be related to the flexed-wrist sleeping position and/or fluid accumulating around the wrist and hand while lying flat. Carpal tunnel syndrome may be a temporary condition that completely resolves or it can persist and progress.

As the disease progresses, patients can develop a burning sensation, and/or cramping and weakness of the hand. Decreased grip strength can lead to frequent dropping of objects from the hand. Occasionally, sharp shooting pains can be felt in the forearm. Chronic carpal tunnel syndrome can also lead to wasting (atrophy) of the hand muscles, particularly those near the base of the thumb in the palm of the hand.

Picture of carpal tunnel syndrome
Picture of carpal tunnel syndrome

How is carpal tunnel syndrome diagnosed?

The diagnosis of carpal tunnel syndrome is suspected based on the symptoms and the distribution of the hand numbness. Examination of the neck, shoulder, elbow, pulses, and reflexes can be performed to exclude other conditions that can mimic carpal tunnel syndrome. The wrist can be examined for swelling, warmth, tenderness, deformity, and discoloration. Sometimes tapping the front of the wrist can reproduce tingling of the hand and is referred to as Tinel's sign of carpal tunnel syndrome. Symptoms can also at times be reproduced by the examiner by bending the wrist downward (referred to as Phalen's maneuver).

The diagnosis is strongly suggested when a nerve conduction velocity test is abnormal. This test involves measuring the rate of speed of electrical impulses as they travel down a nerve. In carpal tunnel syndrome, the impulse slows as it crosses through the carpal tunnel. A test of muscles of the extremity, electromyogram (EMG), is sometimes performed with the nerve conduction velocity test to exclude or detect other conditions that might mimic carpal tunnel syndrome.

Blood tests may be performed to identify medical conditions associated with carpal tunnel syndrome. These tests include thyroid hormone levels, complete blood counts, and blood sugar and protein analysis. X-ray tests of the wrist and hand might also be helpful to identify abnormalities of the bones and joints of the wrist.

Medically Reviewed by a Doctor on 7/10/2014

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Carpal or Tarsal Tunnel Syndrome - Experience Question: Please describe your experience with carpal tunnel syndrome or tarsal tunnel syndrome.
Carpal or Tarsal Tunnel Syndrome - Symptoms and Signs Question: What are your carpal tunnel syndrome symptoms and signs?
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Carpal Tunnel Syndrome And Tarsal Tunnel Syndrome - Causes Question: Did you develop carpal tunnel while pregnant, from computer use, or something else? Please discuss the cause.
Carpal Tunnel Syndrome And Tarsal Tunnel Syndrome - Diagnosis Question: Describe the exams that led to a diagnosis of carpal tunnel syndrome. Did you think it was something else?

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