Could it be carpal tunnel syndrome?

You’ve tried ignoring the tingling and numbness in your hand and wrist when you’re working at your computer. Suddenly, a sharp, piercing pain shoots through your wrist and up your arm. It could be carpal tunnel syndrome.

Carpal tunnel syndrome is an inflammatory disorder caused by repetitive stress, physical injury or a medical condition. Once thought to be a condition of keyboard operators and others who use their hands in repetitive motions, studies now suggest that carpal tunnel syndrome is also associated with medical or physical conditions, such as diabetes and arthritis.

“Carpal tunnel syndrome develops from the nerves of the hands — not the muscles, as some people believe,” said Christopher Shields, M.D., neurosurgery. “In general, it develops when the tissues around the median nerve of the hand swell and press on the nerve. Symptoms usually progress gradually over weeks and months, or sometimes years.”

The median nerve travels through a compartment in the wrist called the carpal tunnel. The ligaments near the nerve are not very flexible. Any swelling can put pressure on blood vessels and the median nerve, which can constrict blood flow and cause nerve damage. This compression is what causes painful symptoms and decreased hand function.

“Early on, the process is reversible,” Dr. Shields said. “Over time, however, permanent nerve damage can develop. It is critical to begin treating symptoms of carpal tunnel syndrome early, before the damage progresses.”

Treatment can be as simple as ice and rest. Nonsteroidal anti-inflammatory drugs, corticosteroid injections, splinting and exercises also may be warranted. If those approaches don’t provide relief, surgery also is an option.

“Surgery is an effective treatment choice for people whose symptoms last longer than six months or when conservative treatment does not help,” Dr. Shields said. “There are several surgical options that reduce pressure on the median nerve, depending on the severity of the patient’s condition.”

–Jennifer Reynolds


Learn more about carpal tunnel syndrome. Ethan Blackburn, M.D., orthopedic surgeon at Louisville Arm & Hand, a part of Norton Orthopedic Care, answers eight frequently asked questions about the condition.