Wrist Pain and Tingling Fingers: Is It Carpal Tunnel Syndrome?

Does your hand go numb or tingly at night — often waking you up? Do you shake your hand to relieve the sensation? This is the classic presentation of carpal tunnel syndrome, the most common nerve entrapment in the body. The good news: it is very treatable.

What Is Carpal Tunnel Syndrome?

The carpal tunnel is a narrow passageway at the wrist, through which the median nerve passes from the forearm to the hand. When this tunnel becomes narrowed or inflamed — for any reason — it compresses the median nerve, causing the characteristic symptoms.

Symptoms

• Numbness, tingling, or "pins and needles" in the thumb, index finger, middle finger, and half of the ring finger
• Symptoms are classically WORSE at night — many patients wake up with a numb hand and shake it to get relief
• Pain in the wrist, palm, or fingers that may travel up the forearm
• Weakness of grip — difficulty opening jars, holding objects, or doing fine tasks
• In advanced cases: visible wasting of the muscle at the base of the thumb (thenar wasting)

Who Gets Carpal Tunnel Syndrome?

• More common in women than men
• Associated with pregnancy (fluid retention), hypothyroidism, diabetes, rheumatoid arthritis, and obesity
• Repetitive hand or wrist use (though the evidence for keyboard use specifically is less clear than popularly believed)

Diagnosis

Clinical diagnosis is straightforward for most cases. A nerve conduction study (NCS) confirms the diagnosis, assesses severity, and rules out other causes of hand numbness (cervical radiculopathy, peripheral neuropathy).

Treatment

• Mild cases: Wrist splint at night to keep the wrist in neutral position; activity modification; treatment of underlying conditions
• Moderate cases: Corticosteroid injection into the carpal tunnel — provides significant relief for months in many patients
• Severe or refractory cases: Surgical decompression (carpal tunnel release) — a minor procedure with very high success rates, done under local anaesthesia

"Carpal tunnel syndrome is one of the most satisfying conditions to treat — because a definitive treatment (surgery or injection) gives dramatic, lasting relief after months of disrupted sleep and discomfort."

Dr. Anand Karnam performs nerve conduction studies and manages carpal tunnel syndrome at Sri Anand Child and Neuro Center, Chanda Nagar. Call +91 90633 66983.