Carpal Tunnel Still Impacts Millions – Here's How You Can Manage It

“I started waking up in the middle of night with pain in my hand,” says Moon-Moon Majumdar, a medical doctor in the U.K. who has suffered from carpal tunnel for the past four years. “It’s a kind of tingling and burning sensation.”

Majumdar sought medical advice and was told to wear a wrist brace at night to prevent her arm and hand from getting into positions that could aggravate the problem.

Even though we haven’t seen carpal tunnel appear in the news as much lately, somewhere between 1 and 5 percent of the general population are thought to have the syndrome. 

The carpal tunnel is a narrow conduit in the wrist made up of small bones and soft tissues. The median nerve lies within this tunnel, and it acts as a kind of pulley for the tendons that control finger movement. Carpal tunnel syndrome happens when pressure on the median nerve builds up. 

Majumdar’s experience is fairly typical. In the early stages, carpal tunnel syndrome does tend to manifest at night and then improve during the day. This is because tissue fluid builds up in the arm when we don’t move as much during sleep, heaping further pressure on the carpal tunnel.

But over time, most patients will begin to experience the pain during the day as well – this is especially true for people who spend a lot of time doing repetitive tasks with their hands and arms such as driving or typing. When the syndrome becomes advanced, symptoms are almost constant, and patients will likely require professional pain management or even surgery.

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It can be difficult to put a finger on a single cause of carpal tunnel; it is often a complicated back-and-forth of several different factors.

But repetitive hand use stands out as one of the more prominent culprits; the condition is therefore more common amongst occupations such as office workers, factory laborers and tradespeople. But there is more to it than just repetitive strain.

There could be a genetic component to consider. Carpal tunnel can affect people whatever their ethnic heritage, but there is emerging research to suggest that its prevalence might be higher among certain populations than others. Those studies are only preliminary, however, and in the absence of more evidence, ethnicity alone is not considered a determining factor.

Gender, on the other hand, does play a significant role. Women make up about three quarters of all carpal tunnel syndrome patients and pregnancy can be a trigger for its onset, according to a 2023 book written by researchers at Michigan State University. Other diseases such as diabetes, thyroid problems, rheumatoid arthritis and obesity have also been shown to increase the risk of developing carpal tunnel. The same is true of age, it’s rare to find children suffering from symptoms. Most cases occur in people aged between 40 and 60.

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Fortunately, there are various treatment options available ranging from simple home remedies to surgical interventions. These treatments aim to relieve the pressure on the nerve and alleviate the associated symptoms. Here are various approaches to treating carpal tunnel syndrome.

Splinting the hand, especially at night, is probably the first course of action for most carpal tunnel patients. It helps to ease the compression on the nerves. But if symptoms persist and worsen, some doctors might consider anti-inflammatory medications to reduce the swelling, which might be injected or given orally. 

Finally, there’s surgery. The surgeon will cut the tissue that is pressing down on the nerves to reduce the pressure.

When it comes to assessing which option is optimal, however, the evidence is limited. A 2024 update to a Cochrane review compared the clinical outcome of 14 studies, which included more than 1,200 carpal tunnel patients who had either opted for splints, surgery or anti-inflammatory injections.

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The authors found that the average duration that people experienced symptoms ranged from 31 weeks to 3.5 years and that when examining the longer-term effects of these interventions, none of them really stood out as the best.

“We are uncertain if surgery provides more benefits compared with a combination of splint and corticosteroid injection,” the paper concludes.

That isn’t to say that none of these options work. Patients do report improvements for all types of interventions, so it’s more about finding the option that makes the most sense for each individual patient.

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Interventions for work-related carpal tunnel symptoms include alternative keyboards, computer mouse designs and wrist supports, keyboard support systems, and tool redesign, ergonomics training, splint wearing, on-the-job exercise programs, and job rotation.

Carpal tunnel syndrome causes discomfort where the median nerve travels: from your forearm through your wrist and into your palm. This pain primarily affects the thumb, index, middle, and part of the ring finger, and can also impact the base of the thumb where small muscles are controlled.

While it varies for what type of carpal tunnel surgery, studies have shown that it can take at least 9 months to recover from carpal tunnel surgery. Results can vary due to scar tissue, infection, and other factors.

Carpal tunnel diagnosis may include physical tests such as the flick sign, Phalen maneuver, and median nerve compression test. While typical cases may not need further testing, ultrasonography and electrodiagnostic studies are used for atypical cases to confirm the diagnosis and exclude other conditions. These studies are also important before considering surgical decompression, to assess the severity and help predict the outcome of the surgery.

Surgery for carpal tunnel syndrome is typically considered when symptoms frequently recur and worsen, despite trying other treatments like splints or corticosteroid injections. In such situations, surgery may offer more effective relief than repeated non-surgical treatments.

Carpal tunnel can cause shoulder pain. This is often not recognized, particularly if the patient doesn't have hand symptoms. Mild nerve compression in carpal tunnel syndrome might be a hidden reason for shoulder problems.

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Our writers at Discovermagazine.com use peer-reviewed studies and high quality sources for our articles, and our editors review for scientific accuracy, and editorial standards. Here are the sources used in this article:

• National Library of Medicine. Carpal Tunnel Syndrome.

• Cochrane Database of Systematic Reviews. Surgical versus non‐surgical treatment for carpal tunnel syndrome.

• American journal of preventive medicine. Interventions for the primary prevention of work-related carpal tunnel syndrome.

• National Institute of Arthritis and Musculoskeletal and Skin Diseases. Carpal Tunnel Syndrome.

• Hand. Long-term outcomes of carpal tunnel release: a critical review of the literature.

• American Family Physician. Carpal Tunnel Syndrome: Diagnosis and Management.

• Institute for Quality and Efficiency in Health Care. Carpal tunnel syndrome: When is surgery considered or needed?

• Plastic and reconstructive surgery. Global open. “Idiopathic” Shoulder Pain and Dysfunction from Carpal Tunnel Syndrome and Cubital Tunnel Syndrome.

Read More: What’s Really Happening When Your Hands or Feet Fall Asleep?