Carpal tunnel syndrome (CTS) develops when inflammation narrows the tunnel and compresses the nerve. This can cause numbness, tingling, pain, and weakness in your hands. Carpal tunnel syndrome is a repetitive stress injury, which means it develops gradually.

This article will teach you the most common signs and symptoms and when to see your healthcare provider.

Symptoms

The symptoms of carpal tunnel syndrome often affect your dominant hand first. Without treatment, they tend to get worse over time. That’s especially true if you continue the activity that caused it.

Symptoms are often most bothersome at night and may even wake you up. Activities that involve repetitive hand motions can also worsen symptoms. Some of these activities include:

DrivingHolding your phoneHolding a book or newspaperGripping a penButtoning your clothes

Symptoms can progress until you feel them often or all the time.

Changes in Sensation

The most common symptoms of carpal tunnel are tingling and numbness. Some people also experience electric-shock sensations. You may feel the tingling or shock sensation traveling up from your wrist to your arm. 

You’re most likely to have these feelings along the median nerve. This nerve passes through the carpal tunnel in your wrist. It then runs through your palm and into your ring, middle, and index fingers plus the thumb. With carpal tunnel, the little finger shouldn’t go numb.

Symptoms are sometimes relieved by shaking your hands. Over time, you may lose the ability to tell hot from cold in the numb areas.

Pain

Many people have pain in the same location as their numbness. Others have pain radiating up the forearm as well as down into the hand. Like the tingling, pain is often relieved by shaking out the hand.

Swollen Feeling

You may feel like your fingers are swollen and have a hard time using them. However, there’s usually no evidence of swelling. For example, your rings will still fit as usual.

Weakness and Atrophy

As symptoms progress, you may discover you don’t have as much grip strength. It can become hard to hold objects and perform tasks that require manual dexterity.

You may find yourself dropping things. It can feel like you’re clumsy, but it’s from the weakness and numbness. It’s also because the nerves can’t maintain a sense of where your hand is in space (proprioception).

When CTS is severe, messages from the brain to the small muscles in the palm of the hand can be interrupted. That can cause atrophy (weakening) in muscles at the base of the thumb.

Sending messages to the brain about pain and sensationsProcessing sensory information Sending messages from the brain to contract muscles

In severe cases, the meaty part of the affected palm can look significantly smaller than in the other hand. Muscle atrophy makes treatment and recovery less effective, even after surgery.

When to See a Healthcare Provider

You should see a healthcare provider if you have possible CTS symptoms for two weeks or longer. At first, the symptoms may come and go. See your provider if they’re:

ConstantWaking you up at nightInterfering with everyday tasks

Allowing CTS symptoms to go on for too long increases the risk of muscle atrophy and permanent nerve damage. Early treatment can also help you avoid surgery.

Visit your primary care provider for an assessment and general health check. If you don’t have a primary care provider, you can see an internal medicine physician or an occupational medicine specialist. You may be referred to an orthopedic surgeon, neurologist, hand surgeon, rheumatologist, or physiatrist for further testing or treatment.

To diagnose CTS, your healthcare provider will consider other possible causes of your symptoms. That includes other nerve conditions and arthritis.

There was an error. Please try again.

CTS is more common in people with underlying conditions such as:

​Hypothyroidism Diabetes Rheumatoid arthritis

It’s possible that you have one of these conditions without knowing it. Seeing your healthcare provider will allow you to get a diagnosis and appropriate treatment for both CTS and other conditions.

If you have a sudden loss of feeling in your arm, go to an emergency room. This is a sign of a more serious condition, not CTS.

Summary

Compression of the median nerve in the carpal tunnel can cause pain, numbness, tingling, weakness, and other symptoms.

If symptoms impact your sleep or activities, get medical help. Letting it go for too long can lead to permanent nerve damage and makes surgery more likely.

A Word From Verywell

Because early CTS symptoms come and go, you might think nothing serious is wrong. Remember that the sooner you have it diagnosed, the faster and easier your recovery is likely to be.

If you do need surgery, don’t panic. It’s a simple, routine surgery that helps many people get back full function in their hands.

Tingling, numbness, and/or electric shock sensationsShooting or tingling pain that radiates into your wrist or forearmFingers that feel swollen when they aren’tSymptoms that set in mostly at night, at least at firstHand weakness, especially a weak grip

The symptoms of CTS tend to be felt throughout most of your hand, including your palm, thumb, and fingers—except for the pinky.

Certain wrist positions (e.g., sleeping with flexed wrists) and repetitive activities can increase pressure. Other causes include:

A wrist injury, like a sprain or fractureStructural issues in the wristAn underactive thyroidRheumatoid arthritisFluid retention during pregnancy or menopause

Icing your risk to reduce swellingTaking frequent breaks from activities that make your pain worseWearing a wrist brace at night or while you’re performing activities that aggravate the nerveDoing wrist stretches and exercises or yogaGetting acupuncture

Corticosteroid injections or oral prednisone may help with more intense pain. Carpal tunnel release surgery is an option if other treatments fail. Like any surgical procedure, it comes with some risks.

Once the muscles have atrophied, even surgery cannot fully recover hand function. Prevention and early treatment are essential.

Regular breaks and wrist stretches can help, too. Wearing fingerless gloves can keep hands and wrists warm plus promote circulation and flexibility.