Carpal Tunnel Syndrome Overview

Carpal tunnel syndrome is a condition in which the median nerve is compressed as it passes through an opening from the wrist to the hand called the carpal tunnel. The carpal tunnel is formed by the carpal bones on the bottom of the wrist and the transverse carpal ligament across the top of the wrist. Since the median nerve provides sensory and motor functions to the thumb and three middle fingers, many symptoms may result including:

• Weakness when gripping the hand
• Pain and/or numbness in the hand
• A "pins and needles" feeling in the fingers
• Swollen feeling in the fingers
• Burning or tingling in the fingers, especially the thumb and the index and middle fingers
• Pain and/or numbness that is worse at night, interrupting sleep

Most cases of carpal tunnel syndrome have no specific cause, although there are a few factors that may contribute to the condition:

• Frequent, repetitive, small movements with the hands (such as with using a keyboard)
• Frequent, repetitive, grasping movements with the hands (such as with sports and certain physical activities)
• Joint or bone disease (arthritis, osteoarthritis, or rheumatoid arthritis)
• Hormonal or metabolic changes (for example, menopause, pregnancy, or thyroid imbalance)
• Changes in blood-sugar levels (may be seen with type 2 diabetes)
• Other conditions or injuries of the wrist (for example, strain, sprain, dislocation, break, or swelling and inflammation)

How is Carpal Tunnel Syndrome Diagnosed?

In addition to a complete medical history and physical examination, electrodiagnostic tests involving stimulation of muscles and nerves are used to diagnose carpal tunnel syndrome.

• Nerve conduction velocity
• Electromyography (EMG test)

Treatment of Carpal Tunnel Syndrome

Specific treatment for carpal tunnel syndrome is based on:

• Age, overall health, and medical history
• Extent of the disease
• Tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease
• Patient opinion or preference

Common carpal tunnel treatments include:

• Splinting of the hand (to help prevent wrist movement and decrease the compression of the nerves inside the tunnel), especially when worn at night
• Oral or injected (into the carpal tunnel space) anti-inflammatory medications (to reduce the swelling)
• Changing position of a computer keyboard, or other ergonomic changes

In certain cases, carpal tunnel treatment may require surgery to relieve compression on the nerves in the carpal tunnel.

Carpal Tunnel Syndrome Treatment at Brigham and Women’s Hospital

Surgeons in the Department of Orthopaedic Surgery and the Division of Plastic Surgery at Brigham and Women’s Hospital provide unique, innovative and comprehensive diagnosis, treatment and management for carpal tunnel syndrome.

In addition to carpal tunnel syndrome, surgeons in the Brigham and Women’s Hospital Hand and Upper Extremity Service and the Division of Plastic Surgery treat the full spectrum of diseases of the hand. The Department of Orthopaedic Surgery also treats conditions of the upper extremity (shoulder, arm, elbow, and wrist), including fractures, tumors, ligament disruptions and tendonitis, helping thousands of patients every year.

BWH surgeons who specialize in carpal tunnel syndrome.

Patient- and Family-centered Care

BWH has long been committed to not only the care of our patients but also the many other needs that they and their families have. This philosophy of patient- and family-focused care - involves systems and services that emphasize healing in a comfortable, relaxed environment.

Quality of Patient Care

Brigham and Women’s Hospital is committed to providing all of our patients with the safest, highest-quality, most-satisfying care possible and follow established protocols that have been shown to improve patient outcomes. Our inpatient satisfaction survey, sent to patients’ to assess their total care experience, helps us to monitor what we are doing well and areas for improvement. We pride ourselves in the quality of patient care we provide and how we are measured compared with other hospitals.

Contact Us

If you believe you should have an evaluation and would like to schedule an appointment with one of our carpal tunnel syndrome experts, call 1-800-294-9999 to speak to one of our knowledgeable coordinators who can help to connect you to the doctor that best meets your needs, or fill out an online appointment request form.