Carpal Tunnel Syndrome

The median nerve, which runs through an area in the wrist (carpus in Latin) known as the carpal tunnel, provides power and sensation to the first three fingers and half of the fourth. The illustrations below display in blue the areas affected by CTS.

There is little ‘spare’ room around the nerve. Repetitive hand motion, like typing on a computer keyboard, or prolonged heavy vibration, like operating a jackhammer, can result in swelling of the tissues surrounding the median nerve.

A compressed median nerve can often lead to CTS, a condition that causes weakness, numbness, tingling, and pain in the fingers, wrists, forearms, and elbows (the little finger is never involved). Some causes of carpal tunnel syndrome besides repetitive trauma include various sorts of acute trauma, diabetes, hypothyroidism, pregnancy, or rheumatoid arthritis.

The earliest symptoms of CTS include numbness, tingling, or a sensation that the hand is falling asleep, especially in the middle of the night or early in the morning. Those with CTS may drop a coffee cup in the morning or experience similar problems.

In most cases numbness and pain can be treated with medication, splinting, or physical therapy. Injections of anesthetics and steroids (cortisone-like drugs) into the wrist can sometimes be extremely effective and relatively painless while helping to avoid surgery. Left untreated for a prolonged period of time CTS can lead to irreversible loss of neuromuscular function in the hand. While severe cases may eventually require surgery, most people can be helped with much more conservative measures.

The Arthritis Center has the professional knowledge and experience it takes to diagnose, treat, and if necessary, perform surgery for all phases of CTS.