Carpal Tunnel Syndrome

The most common nerve compression in the body. Treatable with splinting, injection, or a short outpatient surgery.

Cross-section of the wrist showing the carpal tunnel, median nerve, flexor tendons, transverse carpal ligament, and small bones of the wrist — The carpal tunnel: the median nerve and flexor tendons pass under the transverse carpal ligament.

What is carpal tunnel syndrome?

The median nerve runs from the neck through the arm and into the hand, passing through a narrow passage at the wrist called the carpal tunnel. When the tunnel becomes tight, the nerve gets squeezed. Over time this causes numbness, tingling, and weakness in the hand.

Common symptoms

Numbness or tingling in the thumb, index, middle, and half of the ring finger
Symptoms that wake you up at night and make you shake your hand to relieve them
Dropping objects or difficulty with fine tasks like buttoning a shirt
Weakness when pinching or gripping
A feeling that the whole hand is numb, even though the small finger is usually spared

Why does it happen?

In most people there is no single cause. The tunnel is simply narrow and the lining around the tendons becomes thicker with age or use. Carpal tunnel syndrome is more common in women, in people with diabetes or thyroid disease, during pregnancy, and in jobs with prolonged gripping or vibration.

Treatment options

Non-surgical treatment

Night splint. A wrist splint that keeps the wrist straight at night relieves pressure on the nerve and helps many patients, especially early in the disease.
Activity changes. Avoiding bent-wrist positions and taking breaks from repetitive tasks can help.
Steroid injection. A cortisone injection into the carpal tunnel can calm the swelling around the nerve. Relief is often temporary but can last months and sometimes confirms the diagnosis.

Surgical treatment

Carpal tunnel release. A small surgery that opens the tight ligament over the nerve. It can be done through a small incision in the palm (open) or through a tiny incision with a camera (endoscopic). It takes about 10 to 15 minutes, uses local numbing, and you go home the same day. Most patients use the hand for light activity within a few days. Numbness that has been present for a long time can take months to recover; night symptoms usually improve quickly.

The median nerve shown with hourglass compression under the transverse carpal ligament before carpal tunnel release surgery — Hourglass compression of the median nerve before surgery. Carpal tunnel release opens the transverse carpal ligament to relieve pressure on the nerve.

What to expect at your visit

Dr. Barrera will ask about your symptoms and examine your hand, including tests that reproduce tingling by tapping on or bending the wrist. Often the diagnosis is clear from the exam. A nerve study (EMG) may be ordered to confirm the diagnosis, measure severity, and rule out other problems. Imaging is usually not needed.

When to call the office sooner

Call us if you develop sudden severe pain, cannot move the thumb at all, or notice your fingers turning pale, blue, or cold. If you have an open cut or a recent wrist injury along with new numbness, seek care right away.

After carpal tunnel release: recovery guide

Questions?

Call your office location for non-urgent questions:

NYU Langone Laurelton · 646-501-4950
NYU Orthopedic, Woodside · 929-429-3222
NYU Orthopedic, Richmond Hill · 718-206-6923
Jamaica Hospital Ambulatory Care Center (ACC) · 718-301-0720

See our office contact information for addresses and fax numbers.