Carpal Tunnel Syndrome (CTS) is a common condition causing pain, numbness and tingling in the hands and wrists. In this blog, we discuss the signs and symptoms of carpal tunnel syndrome to help you recognise the condition and seek appropriate help.
What are the signs and symptoms of carpal tunnel syndrome?
The following signs and symptoms are among the most common:
- Hand and wrist pain: the most common symptom of carpal tunnel syndrome is pain and discomfort in the hand and wrist. This pain may radiate up the arm or towards the fingers. It’s often described as a dull ache or a burning sensation
- Numbness and tingling: another hallmark symptom of CTS is numbness and tingling in the affected hand and fingers. Patients may experience this in the form of “pins and needles”, particularly in the thumb, index, and middle fingers. These sensations may worsen at night or upon waking
- Hand and finger sensitivity: people with CTS often develop increased sensitivity to touch. The affected hand may become more sensitive to cold or hot temperatures. Light touch or pressure on the palm and fingers may cause discomfort or even pain
- Night-time symptoms: many people with the syndrome report worsening symptoms at night. You may wake up with numbness or tingling in the affected hand.
Carpal tunnel symptoms in the hand
Symptoms typically manifest in the hand. Understanding the specific signs can help you identify if you are experiencing carpal tunnel. Common symptoms in the hand include:
- pain and discomfort which may be localised to the palm and wrist, or radiate up the forearm. The intensity of the pain can vary, ranging from mild discomfort to severe and debilitating
- numbness and tingling
- weakness of grip
- sensitivity to temperature and touch.
Diabetes and carpal tunnel syndrome symptoms
Scientific studies have proven that diabetes can contribute to the development or worsening of carpal tunnel symptoms. The following symptoms detail the relationship between the two conditions:
- Increased nerve vulnerability: nerves throughout the body (including the median nerve that passes through the carpal tunnel) can become more susceptible to compression or irritation. This increased vulnerability can make those with diabetes more prone to developing carpal tunnel syndrome
- Worsening symptoms: if you have diabetes and develop CTS, you may experience more severe symptoms compared to those without diabetes
- Impaired wound healing: diabetes can affect the body’s ability to heal wounds and recover from injuries. In the context of carpal tunnel syndrome, this can delay the recovery process following surgical interventions, such as carpal tunnel release surgery.
Early symptoms of carpal tunnel
In the early stages of carpal tunnel syndrome, you may experience mild discomfort in the hand and wrist. It may feel like a dull ache, mild pain, or a sense of heaviness. This discomfort may come and go initially, particularly after repetitive hand movements or prolonged wrist flexion. People typically experience the symptoms of carpal tunnel syndrome whilst driving, cycling, using their phone, or reading book.
It’s important to pay attention to these early symptoms and seek medical advice if they persist or worsen. Early intervention can help prevent further progression of the condition and alleviate symptoms, improving overall hand function and quality of life.
Advanced carpal tunnel syndrome symptoms
When CTS progresses without intervention, symptoms can become more pronounced and debilitating. Advanced CTS symptoms may significantly impact your daily activities and require more extensive treatment. You may experience the following:
- Persistent pain: the pain may radiate up the forearm towards the upper arm. This discomfort has been known to interfere with daily tasks and affect quality of life
- Severe numbness and tingling: the tingling sensations can be distracting and affect hand dexterity
- Muscle weakness: as the syndrome progresses, you may notice weakness in the affected hand. Grip strength may decrease, making it more challenging to perform simple tasks like opening jars or holding objects. Over time, muscle wasting or atrophy may occur due to nerve compression
- Decreased sensation and coordination: advanced CTS can result in reduced sensation in the affected fingers and hand. You may find it challenging to discern textures, temperatures, or subtle touches. Decreased coordination may make precise movements and tasks that require finger dexterity, such as buttoning clothes or tying shoelaces, more difficult
- Sleep disturbance: individuals with advanced carpal tunnel syndrome often experience sleep disturbances due to persistent pain, numbness and tingling. The discomfort can disrupt sleep patterns, leading to poor sleep quality and fatigue during the day.
Recognising carpal tunnel syndrome
It is important to note that the symptoms of carpal tunnel syndrome can vary in severity from person-to-person. Some people may experience mild symptoms, while others may face more significant challenges.
If you are experiencing any of these symptoms, be sure to consult a healthcare professional for a proper diagnosis. They will evaluate your symptoms and medical history and perform a physical examination to determine if carpal tunnel is the cause.
Causes of carpal tunnel syndrome
CTS occurs when the median nerve becomes compressed at the wrist.
The median nerve controls sensation in the thumb, index finger, middle finger, and half of the ring finger (along with some movement in the thumb). When the nerve is compressed and the electrical signals which travel in the nerve are altered, symptoms may appear.
Several factors can contribute to the development of CTS symptoms:
- a narrow existing carpal tunnel
- conditions that affect the bones and joints, such as arthritis, fractures, or dislocations
- hormonal changes.
- certain medical conditions are associated with an increased risk of carpal tunnel syndrome. These include diabetes, thyroid disorders, obesity, rheumatoid arthritis and kidney failure
- pre-existing genetic predispositions to developing the syndrome.
Carpal tunnel syndrome test and diagnosis
Diagnosing carpal tunnel syndrome involves a combination of clinical assessments and diagnostic tests. During the physical exam, a healthcare professional may assess the sensation, strength, and appearance of your hand. They may also perform a Tinel’s test, tapping the median nerve to elicit tingling or electric shock-like sensations.
To reproduce your symptoms, a doctor may bend your wrist down. When a diagnosis is not forthcoming, your doctor may request a set of nerve conduction studies. This involves the use of small electrical currents that are passed across the nerves. The idea is to find out whether the electrical signal slows down or reduces in strength as it travels across the carpal tunnel. This is usually performed in a neurophysiology department.
Carpal tunnel symptoms and treatment
Treatment for carpal tunnel syndrome depends on the severity of symptoms and your specific situation.
Treatment might include some or all of the following:
- physiotherapy
- rest
- modification or restriction of activities
- use of wrist splints or medication such as anti-inflammatory drugs or steroid injections into the carpal tunnel.
You may also need to adjust your working setup. For example, an ergonomic keyboard and mouse can help to keep your wrist straight and reduce strain.
Carpal tunnel syndrome surgery
If conservative treatments don’t work, or if there is severe nerve compression, surgery may be recommended. Carpal tunnel release surgery involves enlarging the carpal tunnel by cutting the ligament that forms its roof. This relieves pressure on the nerve. Learn more about the costs of carpal tunnel surgery.
Carpal tunnel syndrome can significantly impact your quality of life. However, if the symptoms are spotted early enough, it is possible to find relief and regain full use of your hands.
If you are experiencing any of these symptoms, talk to a healthcare professional to get an accurate diagnosis and a personalised treatment plan.
Signs of carpal tunnel FAQs
Not quite found what you’re looking for? Our dedicated carpal tunnel syndrome symptoms might be able to help!
Yes. The severity and frequency of symptoms varies from patient-to-patient. Symptoms can be triggered by repetitive hand movements or certain positions. Discomfort may also be more noticeable at night or upon waking.
Symptoms don’t usually come on suddenly. Development is typically gradual, with symptoms worsening over time. However, in some cases, certain activities or movements can trigger a sudden onset or worsening of symptoms.
The top warning signs are:
- hand and wrist pain
- numbness or tingling
- hand weakness
- sensitivity.
Yes. While the primary symptoms are usually felt in the hand and wrist, the pain, numbness, and tingling sensations can radiate to the upper arm.
Yes. The severity of symptoms can vary between individuals and even between hands in the same person. Factors such as the frequency and intensity of repetitive hand movements, the duration of untreated symptoms, and individual anatomy can contribute to the worsening of carpal tunnel syndrome in one hand.
The duration of symptoms varies from person-to-person. For some, symptoms may come and go, while for others, they may be persistent. The length of time that symptoms last depends on factors like the severity of the condition and the effectiveness of treatment.
To relieve symptoms, try resting and immobilising the affected hand. You can also apply cold or heat, modify activities to reduce stress on the wrists, do hand and wrist exercises, and take pain medications as directed. These measures can help alleviate pain, reduce inflammation and improve symptoms. Consult a healthcare professional for personalised advice and treatment recommendations.
Carpal tunnel syndrome can be a symptom experienced during pregnancy. Hormonal changes, fluid retention and increased swelling in the body can contribute to the development or exacerbation of carpal tunnel syndrome symptoms in pregnant women. If you experience these symptoms during pregnancy, consult with your healthcare provider to alleviate discomfort and ensure the wellbeing of both you and your baby.
This can be due to fluid accumulation, sleep position and inactivity. Fluid retention increases pressure within the carpal tunnel and sleeping with the wrists flexed or in a curled position further compresses the median nerve.
Symptoms can be worsened by factors such as:
- repetitive hand movements
- awkward or unnatural hand positions
- high force or vibrations
- pregnancy
- underlying pre-existing medical conditions
- wrist trauma or injury.
Identifying and addressing these triggers, along with proper ergonomics and hand care can help manage symptoms.
CTS can occur at any age, but it is more commonly seen in adults between the ages of 30 and 60.
The level of pain experienced with carpal tunnel syndrome varies from person-to-person. Some individuals may experience mild discomfort or a dull ache, while others may experience moderate to severe pain.
You should seek medical advice for carpal tunnel syndrome if you experience persistent symptoms. These include:
- difficulty with daily activities
- nighttime symptoms
- progressive symptoms that negatively impact your work or lifestyle.
Consulting a healthcare professional can provide an accurate diagnosis and guide you toward appropriate treatment options.
Acknowledgements
This article was completed with the help of Miss Alison Edwards, Medical Director at Practice Plus Group Hospital, Shepton Mallet. Miss Edwards graduated from Oxford University Medical School in 1992. In 2003 she completed higher surgical training at the West Midlands Deanery, in trauma and orthopaedics.
Working at University Hospitals Coventry, Warwickshire, and Bristol & Weston, she joined Practice Plus Group in 2022 as a hand and wrist surgeon.
Over the last few years Practice Plus Group has grown its Marketing Team to include art workers, campaign and social media managers, content editors, and digital analysts. Together, they provide a responsive and comprehensive service, ensuring all content is on-brand and in-line with relevant medical guidelines.
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