Numbness, Tingling and Pain: When Carpal Tunnel Syndrome Is to Blame

You recently moved to a new desk that isn’t quite as comfortable as your old work setup. After a month or so, you started to notice tingling and numbness in your thumb and index finger. Could it be carpal tunnel syndrome? Quite possibly. 

“Carpal tunnel syndrome is a common condition that causes numbness, tingling, pain and other symptoms in the wrist and hand,” says Richard Craner, OTR/L, with Beaufort Memorial Outpatient Rehabilitation. “The symptoms are most often felt in the index finger, the middle finger and the thumb, and it becomes progressively more uncomfortable over time.”

If carpal tunnel syndrome is what’s causing your symptoms, you can’t exactly just stop working at a desk. The good news is you don’t usually need to take drastic action to relieve carpal tunnel symptoms or to prevent it in the future. Making a few small adjustments can have a big impact.

Read More: Chronic Pain? It Could Be a Repetitive Stress Injury

Finding the Carpal Tunnel

First things first: What is carpal tunnel syndrome? 

The condition occurs when the median nerve in the hand is squeezed on its path through the wrist — otherwise known as the carpal tunnel.

The carpal tunnel is a narrow path through the wrist, created by the carpal bones and the transverse carpal ligament. This tunnel is only about an inch wide, so when it’s compressed, it puts pressure on the median nerve. 

That nerve controls feelings in the thumb, index finger, middle finger and part of the ring finger. Continued, consistent pressure on the median nerve can lead to carpal tunnel syndrome.

The condition can cause uncomfortable sensations in the hands and fingers, often starting with numbness and tingling. At times, these feelings may be enough to wake you during the night. 

Other symptoms may include shock-like sensations radiating from the thumb to other fingers, pain in the forearm and hand weakness. While symptoms may come and go at first, they can persist for longer periods of time as the condition progresses.

Read More: 7 Trigger Finger Exercises for Quick Relief

The Causes of Carpal Tunnel Syndrome

Pressure on the median nerve causes carpal tunnel syndrome, but what causes that pressure? The answer is any number of things, including:

• Certain health conditions, such as diabetes and rheumatoid arthritis
• Differences in wrist anatomy, with small spacing around the nerve
• Fluid retention
• Hand and wrist positioning that involve extreme flexing of the hand and wrist
• Mechanical problems in the wrist joint
• Pregnancy-related swelling
• Repetitive hand and wrist motions
• Trauma to the wrist
• Use of vibrating machinery

These can all be considered risk factors for developing carpal tunnel syndrome. Other factors that increase your risk include being older and being a woman.

How Carpal Tunnel Syndrome Is Diagnosed and Treated

If you’re experiencing symptoms that might be caused by carpal tunnel syndrome, check in with your primary care provider. In many cases, providers diagnose the condition through a physical exam. During the exam, your provider will test for “Tinel’s sign,” which is tingling in your fingers caused by pressing down on the palm side of your wrist and hand.

Your provider will also look for other telltale signs of carpal tunnel syndrome, such as numbness, pain and sensitivity in your hands, along with weakness around the base of the thumb. Other tests, including nerve conduction studies, may be used to confirm a diagnosis of carpal tunnel syndrome. 

Stretch It Out

Guidance from your doctor or an occupational therapist can show you the correct exercises and ergonomic modifications to decrease symptoms and slow the progression of the disease.

“There are several simple exercises that target the wrist and hand that may help relieve pressure on the median nerve,” Craner says. 

The American Academy of Orthopedic Surgeons (AAOS) recommends these stretches, provided you perform them under a doctor’s supervision:

• Wrist extension stretch: Stretch out your arm with your hand facing up and out like you’re signaling “stop.” Use your other hand to gently pull your palm towards you until you feel a stretch. Hold for 15 seconds and repeat five times on both arms.
• Wrist flexion stretch: Stretch out your arm with your hand facing down and in – the opposite of the extension stretch. Use your other hand to gently push your hand down until you feel a stretch. Hold for 15 seconds and repeat five times on both arms.

Carpal Tunnel Syndrome Treatments

When the condition is diagnosed at an early stage, it can usually be treated without surgery. Nonsurgical treatments for carpal tunnel syndrome include: 

• Activity changes to avoid certain wrist positions
• Braces or splints to keep the wrist from bending during sleep
• Nonsteroidal anti-inflammatory drugs
• Steroid injections
• Therapeutic exercises (like these from the American Academy of Orthopedic Surgeons)

If these therapies don’t offer relief, surgery may be needed to relieve pressure on the median nerve and offer long-term symptom relief. During surgery for carpal tunnel syndrome, which is called carpal tunnel release, a surgeon cuts the transverse carpal ligament to increase the size of the carpal tunnel and decrease pressure on the median nerve.

What You Can Do to Prevent Carpal Tunnel Syndrome

Even if you spend your workdays typing away at a computer or performing repetitive movements, you can take steps to lower your risk of carpal tunnel syndrome. The key is to reduce pressure on your wrists, whenever you can and as much as possible.

“Many people assume that carpal tunnel syndrome is related to computer use, but any job or daily activity that involves repetitive forceful grip or motion of the hand and wrist could lead to the condition,” Craner says. “Whether you are working, playing or performing your regular activities of daily living, improved ergonomic awareness can help, especially if you have risk factors for carpal tunnel syndrome such as diabetes or a thyroid disorder, or if you have a family history of carpal tunnel syndrome.”

These tips may help you prevent carpal tunnel syndrome:

• Set your desk up with ergonomics in mind: Adjust the height of your desk to the most comfortable position. When you’re typing on your keyboard, your wrists should be in line with your elbows, which should be at about a 90-degree angle. Move your keyboard, your desk or your chair height up or down to keep things in line. If you’re using a laptop, look into getting an external keyboard for better wrist positioning.
• Take regular breaks: It can be tempting to fully immerse yourself in a project and emerge hours later, but that usually means keeping your hands and arms in the same position for a long time. Get up and move around frequently, and if you can’t leave your workstation, at least spend several minutes stretching and resting your hands and wrists.
• Keep your hands warm: If your office feels like the frozen tundra, do what you can to warm up your hands and fingers. When your hands are cold, they’re less flexible, which can increase the risk of strain. Gloves, hand warmers or even a hot mug of tea in your hands can help warm things up.
• Minimize repetitive movements: Whenever you can, vary your movements in at least small ways to avoid putting extended pressure on your wrists. If possible, mix up your tasks throughout the day so you’re regularly changing positions and movements. 

“When it comes to avoiding carpal tunnel syndrome, do your best to avoid putting stress on your wrists,” Craner says. “You may be doing it without even thinking about it, so be thoughtful about how you hold your hands and wrists during different activities, including your hobbies.”

If you’re experiencing the symptoms of carpal tunnel syndrome, find the diagnosis and treatment you need at Beaufort Memorial. Request an appointment with an orthopedic specialist.