Carpal tunnel syndrome has become more well-known in recent decades. The condition only affects 2-6 percent of the U.S. working adult population, so it's presence is not necessarily synonymous with being employed. most commonly this condition arises developmentally and without explanation. 

If you are currently experiencing wrist or hand pain, you may wonder whether you are developing carpal tunnel syndrome. But how can you know?

First, recognize that it is always wise to see an experienced hand surgeon early on if you are experiencing any type of hand or joint pain so that you can be properly diagnosed. Second, keep in mind that it can be very helpful to document your symptoms - that way, you will have helpful information to refer back to when you see the doctor. This can aid in determining whether you have carpal tunnel syndrome. 

Occupations, where people are more likely to develop carpal tunnel syndrome include those where frequent use of vibrational equipment (e.g drills, pneumatic tools, saws) is necessary, high force and high repetition (e.g. production labor, meat packing industry) is required, or working in a cold environment (e.g. butchers, frozen food industry) is essential. The incidence of carpal tunnel syndrome is higher in women patients with diabetes, and rheumatoid arthritis. 

Symptoms of Carpal Tunnel Syndrome

Carpal tunnel syndrome involves compression of the median nerve at the wrist. Symptoms of carpal tunnel syndrome vary, but include:

  • Tingling or numbness in the fingers, particularly the thumb, index, middle and ring fingers. 
  • Impaired dexterity of the thumb and fingers (dropping change, difficulty buttoning buttons).
  • Pain in the hand that extends up the forearm (most commonly at nighttime).
  • The requirement to switch hands to relieve symptoms for activities such as driving, reading, or holding a telephone. 
  • For night symptoms, improvement with shaking the hands out.

Carpal Tunnel Syndrome Diagnosis 

Here are some tests a hand surgeon may use to determine whether a patient has carpal tunnel syndrome:

  • Tapping on the wrist adjacent to the palm to determine if there is tingling in the fingers. 
  • Pressing the backs of both hands together for several minutes to check if tingling is reproduced in the fingers. 
  • EMG/NCV (electromyography/nerve conduction velocity) to determine the degree of electrical delay where the nerve is pinched. 

If you are diagnosed with carpal tunnel syndrome, your hand surgeon may offer night splinting and/or a cortisone injection. Alternatively, surgery through open or endoscopic techniques will help to relieve symptoms, which is often successful and definitive in resolving this condition. With very severe changes on the EMG/NCV, surgery may not fully yield improvement. 

This article was written by Lawrence E. Weiss, MD, hand and upper extremity surgeon at OAA Orthopaedic Specialists.