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Carpal Tunnel Syndrome Health Channel

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Carpal tunnel syndrome
Surface anatomy - normal wrist

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Carpal tunnel syndrome

Definition

Carpal tunnel syndrome is pressure on the median nerve -- the nerve in the wrist that supplies feeling and movement to parts of the hand. It can lead to numbness, tingling, weakness, or muscle damage in the hand and fingers.

See also: Carpal tunnel release

Alternative Names

Median nerve dysfunction; Median nerve entrapment

Causes, incidence, and risk factors

The median nerve provides feeling and movement to the "thumb side" of the hand (the palm, thumb, index finger, middle finger, and thumb side of the ring finger).

The area in your wrist where the nerve enters the hand is called the carpal tunnel. This tunnel is normally narrow, so any swelling can pinch the nerve and cause pain, numbness, tingling or weakness. This is called carpal tunnel syndrome.

Carpal tunnel syndrome is common in people who perform repetitive motions of the hand and wrist. Typing on a computer keyboard is probably the most common cuase of carpal tunnel. Other causes include:

  • Sewing
  • Driving
  • Assembly line work
  • Painting
  • Writing
  • Use of tools (especially hand tools or tools that vibrate)
  • Sports such as racquetball or handball
  • Playing some musical instruments

The condition occurs most often in people 30 to 60 years old, and is more common in women than men.

A number of medical problems are associated with carpal tunnel syndrome, including:

Symptoms

  • Numbness or tingling in the thumb and next two or three fingers of one or both hands
  • Numbness 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

Signs and tests

During a physical examination, the doctor may find:

  • Numbness in the palm, thumb, index finger, middle finger, and thumb side of the ring finger
  • Weak hand grip
  • Tapping over the median nerve at the wrist may cause pain to shoot from the wrist to the hand (this is called Tinel's sign)
  • Bending the wrist forward all the way for 60 seconds will usually result in numbness, tingling, or weakness (this is called Phalen's test)
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Distal median nerve dysfunction (1 image) (Doctor-Reviewed information)
Distal median nerve dysfunction is a form of peripheral neuropathy that affects the movement of or sensation in the hands. Peripheral means further out from the spinal cord. A common type of distal median nerve dysfunction is carpal tunnel syndrome.Reviewer: Sean O. Stitham, MD, private practice in Internal Medicine, Seattle, Washington; and Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 09/11/2008

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This test is an x-ray of a knee, shoulder, hip, wrist, ankle, or other joint.Reviewer: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 05/02/2009

Carpal tunnel release (4 images) (Doctor-Reviewed information)
Carpal tunnel release is surgery to treat carpal tunnel syndrome. Carpal tunnel syndrome is pain and weakness in the hand that is caused by pressure on the median nerve in the wrist.Reviewer: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 02/03/2009

Rheumatoid factor (RF) (1 image) (Doctor-Reviewed information)
Rheumatoid factor (RF) is a blood test that measures the amount of the RF antibody in the blood.Reviewer: Mark James Borigini, Associate Clinical Professor of Medicine, University of California, Irvine, Irvine, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.Date: 05/31/2009

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