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Do You Have Carpal Tunnel Syndrome? 

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Pain and Numbness of Fingers are Common Symptoms of Carpal Tunnel Syndrome

By Caroline R. Triepel, M.D., Sentara Hand Surgery Specialists


 Caroline R. Triepel, M.D.
Sentara Hand Surgery Specialists

NORFOLK, VA (April 5, 2011) –   Do you sometimes wake at night because your fingertips or hands have that “pins and needles” feeling?

Pain and numbness of fingers are common symptoms of carpal tunnel syndrome, or CTS, a condition in which the median nerve in the hand becomes compressed at the wrist. This causes pain, tingling and other problems. Symptoms of CTS often include burning in the affected hand(s) at night, which can cause patients to wake up frequently and impact the quality of their sleep.

As CTS progresses, symptoms begin to occur during the day. Patients often complain of tingling in the fingers and hands with common activities like driving and talking on a cell phone.

Causes of Carpal Tunnel Syndrome
Workers who use their hands and wrists repetitively are at risk for CTS.
Today, CTS is often seen in patients who use their hands frequently for heavy gripping activities, especially with tools that vibrate.

Some people develop carpal tunnel syndrome without an apparent cause, with women being three times more likely than men to have CTS. Pregnant women may develop CTS over the course of their pregnancy, though it typically clears up within about 6 months of having the baby.

CTS is often linked to patients with other health concerns such as:
Rheumatoid arthritis
Thyroid problems

 Sketch courtesy of the American Academy of Orthopaedic Surgeons
Carpal Tunnel Syndrome
Doctors can usually diagnose CTS through patient history and an exam. X-rays may be ordered to look for arthritis or other problems. Sometimes doctors order lab tests to look for medical conditions such as diabetes.

Electro-diagnostic tests may be used to look for potential muscle damage. These tests are also helpful in guiding treatment. Some patients may also see specialists such as a rheumatologist, neurologist or hand surgeon for symptoms that indicate other medical disorders may be present. 

Treating Carpal Tunnel Syndrome
A common first treatment of CTS is to wear a wrist splint at night. They can be found at most pharmacies and are available without a prescription. This often significantly diminishes the night pain and numbness of CTS. 

CTS can also be treated with a cortico-steroid injection. If a patient has good relief of night pain and numbness after a steroid injection, this is a good sign that he/she would have the same relief after surgery. Relief after steroid injection tends to be temporary and relief after surgery tends to be permanent. A patient can only get a certain number of steroid injections into the carpal tunnel to avoid possible complications.

Surgical Treatment of Carpal Tunnel Syndrome
If CTS does not improve with non-surgical measures, surgery may be recommended. The goal of carpal tunnel surgery is to relieve the pressure on the median nerve by cutting the ligament pressing on the nerve.

After surgery, the ligament tissues gradually grow back together but allow more room for the nerve than existed beforehand. The surgery may be done through an open incision or endoscopically. Each technique has risks and benefits that should be discussed with a surgeon to determine the best solution.

If you think you may have CTS, make an appointment with your family physician or a hand surgeon.

Symptoms of Carpal Tunnel Syndrome

Options for Short-Term Carpal Tunnel Syndrome Relief

Numbness or tingling in the thumb and next two or three fingers of one or both hands
umbness or tingling of the palm of the hand
Pain extending to the elbow
Pain in wrist or hand in one or both hands
Problems with fine finger movements (coordination) in one or both hands
Wasting away of the muscle under the thumb (in advanced or long-term cases)
Weak grip or difficulty carrying bags (a common complaint)
Weakness in one or both hands

Wearing wrist splint at night.
Steroid medication taken by mouth
Physical therapy exercises


Caroline R. Triepel, M.D., is a board-certified and fellowship-trained hand surgeon practicing with Sentara Hand Surgery Specialists

Related Links:
Carpal Tunnel Syndrome
Sentara Hand Surgery Specialists
Sentara Neurology Specialists
Sentara Rheumatology Specialists

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