Topic Overview
What is carpal tunnel syndrome?
Carpal tunnel
syndrome is pain, tingling, and other problems in your hand because of pressure
on the
median nerve in your wrist.
The median
nerve and several
tendons run from your forearm to your hand through a
small space in your wrist called the carpal tunnel. The median nerve controls
movement and
feeling in your thumb and first three fingers (not
your little finger).
See a picture of the
carpal tunnel.
What causes carpal tunnel syndrome?
Pressure on
the median nerve causes carpal tunnel syndrome. This pressure can come from
swelling or anything that makes the carpal tunnel smaller. Things that can lead
to carpal tunnel syndrome include:
- Illnesses such as
hypothyroidism,
rheumatoid arthritis, and
diabetes.
- Pregnancy.
- Obesity.
- Making
the same hand movements over and over, especially if the wrist is bent down
(your hands lower than your wrists), or making the same wrist movements over
and over.
- Wrist injuries and bone spurs.
- Smoking,
because it can reduce blood flow to the median nerve.
What are the symptoms?
Carpal tunnel syndrome can
cause tingling, numbness, weakness, or pain in the fingers or hand. Some people
may have pain in their arm between their hand and their elbow.
Symptoms most often occur in the thumb, index finger, middle finger, and
half of the ring finger. If you have problems with your other fingers but your
little finger is fine, this may be a sign that you have carpal tunnel syndrome.
A different nerve gives feeling to the little finger.
You may
first notice symptoms at night. You may be able to get relief by shaking your
hand.
How is carpal tunnel syndrome diagnosed?
Your
doctor will do a physical exam and ask about your health and activities. You
also may have some tests.
Your doctor will ask if you have any
health problems—such as arthritis, hypothyroidism, or diabetes—or if you are
pregnant. He or she will ask if you recently hurt your wrist, arm, or neck.
Your doctor will want to know about your daily routine and any recent
activities that could have hurt your wrist.
During the exam, your
doctor will check the feeling, strength, and appearance of your neck,
shoulders, arms, wrists, and hands.
Your doctor may suggest
tests, such as:
- Blood tests to see if any health problems
might be causing your symptoms.
- Nerve testing to find out if the
median nerve is working as it should.
How is it treated?
Mild symptoms usually can be
treated with home care. The sooner you start treatment, the better your chances
of stopping symptoms and preventing long-term damage to the nerve.
You can do a few things at home to help your hand and wrist feel
better:
- Stop activities that cause numbness and pain.
Rest your wrist longer between activities.
- Ice your wrist for 10 to
15 minutes 1 or 2 times an hour. Try taking
nonsteroidal anti-inflammatory drugs (NSAIDs) to
relieve pain and reduce swelling.
- Wear a wrist splint at night to
keep your wrist in a neutral position. This takes pressure off your median
nerve. Your wrist is in a neutral position when it is straight or only slightly
bent. Holding a glass of water is an example of your wrist in a neutral
position.
See your doctor if your symptoms do not get better after
1 to 2 weeks of home care, or if you have had bad symptoms from the start. You
may need medicine for carpal tunnel syndrome or for a health problem that made
you likely to get carpal tunnel syndrome.
Surgery is an option.
But it's usually used only when symptoms are so bad that you can't work or do
other things even after several weeks to months of other treatment.
During
surgery, the doctor cuts the ligament at the top of the carpal tunnel. This
makes more room in the tunnel and relieves pressure on the nerve. Surgery
usually works to ease symptoms. But in some cases it does not completely get
rid of numbness or pain.
How can you keep carpal tunnel syndrome from coming back?
To keep carpal tunnel syndrome from coming back, take care of
your basic health. Stay at a healthy weight. Don't smoke. Exercise to stay
strong and flexible. If you have a long-term health problem, such as arthritis
or diabetes, follow your doctor’s advice for keeping your condition under
control.
You can also try to take good care of your wrists and
hands:
- Try to keep your wrist in a neutral
position.
- Use your whole hand—not just your fingers—to hold
objects.
- When you type, keep your wrists straight, with your hands
a little higher than your wrists. Relax your shoulders when your arms are at
your sides.
- If you can, switch hands often when you repeat
movements.
Frequently Asked Questions
Learning about carpal tunnel syndrome: | |
Being diagnosed: | |
Getting treatment: | |
Ongoing concerns: | |
Cause
Carpal tunnel syndrome occurs when a combination of health conditions and activities
puts pressure on the
median nerve as it passes through the
carpal tunnel in your wrist. This pressure leads to
tingling, numbness, pain, and/or weakness in parts of your hand and, sometimes,
up into your arm. Anything that decreases the amount of space in the carpal
tunnel, increases the amount of tissue in the tunnel, or increases the
sensitivity of the median nerve can lead to carpal tunnel syndrome.
Things that help cause carpal tunnel syndrome include:
- Conditions or illnesses that can cause or
contribute to arm pain or swelling in the joints and soft tissues in the arm,
or to reduced blood flow to the hands. These conditions and illnesses include
obesity,
rheumatoid arthritis,
gout,
diabetes,
lupus, or
hypothyroidism.
- Repeated hand and wrist movements that cause the membranes surrounding the tendons (tendon
sheaths) to swell (tenosynovitis).
- Buildup of fluid (edema) in the
carpal tunnel that can occur from pregnancy or such conditions as rheumatoid
arthritis or diabetes.
- Broken wrist bones, dislocated bones, new
bone growth from healing bones, or bone spurs. These can take up space in the
carpal tunnel and put more pressure on the median nerve.
- Tumors and
other growths (such as
ganglions). These uncommon causes of carpal tunnel
syndrome are usually benign.
- Normal wear and tear of the tissues in the hand and wrist caused
by aging and repeated movements of the hand or wrist.
- Smoking,
which may contribute to carpal tunnel syndrome by affecting the blood flow to
the median nerve.
Carpal tunnel syndrome is a common work-related injury.
Work that requires forceful or repetitive hand movements, hand-arm vibration,
or working for long periods in the same or in awkward positions—especially when
combined with other health conditions—may cause carpal tunnel syndrome.
In some cases the cause of carpal tunnel
syndrome cannot be determined.
Symptoms
The most common symptoms of
carpal tunnel syndrome are tingling, numbness,
weakness, or pain felt in the fingers or, less commonly, in the palm. Symptoms
most often occur in the parts of the hand supplied by the
median nerve: the thumb, index finger, middle finger,
and half of the ring finger. If your little finger is not affected, this may be
a sign that the condition is carpal tunnel syndrome, because the little finger
is usually controlled by a different nerve than the thumb and other fingers.
See a picture of
areas affected in the hand.
The symptoms of carpal tunnel
syndrome often occur in both hands, but symptoms are usually worse in one hand
than the other. You may first notice symptoms at night. People with carpal
tunnel syndrome can usually fall asleep, but pain or numbness may wake them up.
Mild carpal tunnel symptoms primarily affect the hand and
sometimes the forearm, but they can radiate up to the shoulder. Symptoms
include:
- Numbness or pain in your hand, forearm, or
wrist that awakens you at night. (Shaking or moving your fingers may ease this
numbness and pain.)
- Occasional tingling, numbness,
"pins-and-needles" sensation, or pain. The feeling is similar to your hand
"falling asleep."
- Numbness or pain that gets worse while you are
using your hand or wrist, especially when gripping an object with your hand or
bending (flexing) your wrist.
- Occasional aching pain in your
forearm between your elbow and wrist.
- Stiffness in your fingers when you get up in the morning.
With moderate or severe carpal tunnel symptoms, you may
have numbness or reduced strength and grip in your fingers, thumb, or hand. It
may be difficult to:
- Do simple hand movements, such as brushing your
hair or holding a fork. You may accidentally drop objects.
- Pinch an
object between your thumb and first finger (loss of pinch
strength).
- Use your thumb while doing simple tasks such as opening
a jar or using a screwdriver. With long-lasting carpal tunnel syndrome, the
thumb muscles can get smaller and weaker (atrophy).
Not all pain in the wrist or hand is caused by carpal
tunnel syndrome. There are many
other conditions with similar symptoms.
What Happens
The tingling, numbness, and
pain of
carpal tunnel syndrome usually develop gradually.
Symptoms often get worse if you do not stop or change an activity that is
helping to cause the condition.
In the early stages of carpal
tunnel syndrome, you may sometimes lose some feeling in your hand. Most mild
cases of carpal tunnel syndrome get better with treatment. Usually there is no
permanent damage to the
median nerve. Your symptoms may improve by themselves
when:
- Fluid buildup decreases, such as after
pregnancy.
- You change or stop the activity that has caused your
carpal tunnel syndrome.
- Other health problems that cause or
contribute to your carpal tunnel symptoms improve.
Carpal tunnel syndrome can eventually lead to constant
numbness in the fingers or hand and some loss of strength and coordination.
Nonsurgical treatment may still be helpful at this point.
Long-standing carpal tunnel syndrome can cause:
- A loss of feeling and coordination in the
fingers and hand. The thumb muscles can become weak and waste away (atrophy),
making it difficult to grip or hold objects.
- Permanent damage to
the median nerve that results in difficulty using the hand. A damaged nerve may
require surgery, which may not completely restore the feeling and coordination
to the fingers and hand.
When compared with other illnesses and injuries, carpal
tunnel syndrome is one of the most common causes of absence from
work.
What Increases Your Risk
Carpal tunnel syndrome can
result from any combination of health conditions and physical activities that
increase pressure on the median nerve as it passes through the wrist. Things that put you at risk for
carpal tunnel syndrome include:
- Health problems or illnesses that can cause arm
pain, swelling in the joints and soft tissues in the arm, or reduce the blood
flow to the hands. These include
obesity,
rheumatoid arthritis,
diabetes,
lupus,
hypothyroidism, and
multiple sclerosis.
- Age and being female.
Women between the ages of 40 and 60 have the highest risk. Pregnant women near
the end of their pregnancies often develop temporary symptoms when they retain
fluid. Women taking birth control pills, going through menopause, or taking
estrogen are also thought to be at risk.
- Activities that require repeated motions, especially
in awkward positions. These movements might be related to work, home
activities, hobbies, or sports.
- Smoking, which may contribute to carpal tunnel syndrome by
affecting the blood flow to the median nerve.
- Forceful or prolonged
activities such as clenching your hands or routinely driving long
distances.
The most important step in controlling carpal tunnel
syndrome is to stay fit and in good overall health. But if you suspect that
certain activities at your workplace are helping to cause tingling, numbness,
weakness, and pain in your fingers or hand, make some changes now. For example,
prolonged and forceful hand movement or using vibrating machinery may
contribute to symptoms of carpal tunnel syndrome. Talk to your human resources
department about different ways of doing your job, changes in your equipment,
or having an ergonomic consultation if you notice these symptoms. For more
information, see the topic
Office Ergonomics.
When To Call a Doctor
Call 911 or go to an emergency room immediately if you notice sudden loss of feeling in your
arm.
Call your doctor if you:
- Have tingling, numbness, weakness, or pain in
your fingers or hand that keeps coming back or that has not gone away after 2
weeks of home treatment.
- Have gradually developed little or no
feeling in your fingers or hand.
- Cannot do simple hand movements,
or you accidentally drop things.
- Cannot pinch your thumb and index
finger together, or your pinch is weak.
- Cannot use your thumb
normally (diminished thumb strength).
- Have problems at work because
of pain in your fingers or hand.
Watchful Waiting
You can treat mild symptoms of wrist and hand
pain or numbness at home. You may try home treatment for 1 to 2 weeks before
calling your doctor.
Who To See
For the evaluation of symptoms, you may first want to
consult the doctor who provides care for your other health conditions,
especially conditions that may be contributing to
carpal tunnel syndrome. (Health conditions such as
rheumatoid arthritis, hypothyroidism, or diabetes can all lead to carpal tunnel
syndrome.) Or, you may choose to see:
For further testing or evaluation, see:
For treatment, see:
- An orthopedic surgeon.
- A
physical or
occupational therapist specializing in hands or
overuse injuries.
- A specialist who identifies workplace situations
that contribute to repetitive-motion injuries (an ergonomist).
- A
hand surgeon.
For surgery, see:
- An orthopedic surgeon.
- A hand
surgeon.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
Carpal tunnel syndrome is usually diagnosed from the results of a:
- Medical history, including any medical problems
or illnesses, prior injuries, current symptoms, or daily activities that may be
causing your symptoms.
- Hand diagram. You may be asked to help fill
in a diagram of your hand to show where you have numbness, tingling, or
pain.
- Physical exam, including the tests for Tinel's sign,
Phalen's sign, and two-point discrimination. Although many other tests have
been developed for diagnosing carpal tunnel syndrome, there is no convincing
evidence of their accuracy.
Additional testing
If your symptoms are severe,
if nonsurgical treatment has not improved symptoms, or if your symptoms are not
clearly caused by carpal tunnel syndrome, your doctor may recommend:
- Nerve testing (electromyogram [EMG] and nerve
conduction studies), to evaluate any loss of normal functioning in the
median nerve.
Nerve testing for carpal tunnel syndrome is used in
specific situations, such as when surgery is being considered or the diagnosis
is unclear.
- X-rays, to check for bone problems
caused by past injury,
arthritis, recently broken or dislocated bones, or
tumors. X-rays are not used to diagnose carpal tunnel syndrome, but they can be
helpful for identifying signs of arthritis or an old or new wrist or neck
injury that may be contributing to your symptoms.
- Ultrasound, to look at the size of the median nerve.
It is inexpensive, comfortable, and quick. But its use for carpal tunnel
syndrome diagnosis is still unproved and relatively uncommon.
- MRI (magnetic resonance imaging), to look for swelling
of the median nerve, narrowing of the carpal tunnel, or problems with
circulation of blood through the carpal tunnel.
- Blood tests, which are sometimes done to check
for a
thyroid problem,
rheumatoid arthritis, or other medical problem. If the
cause of your symptoms is unclear and your medical history suggests other
possible conditions, your doctor may order blood tests.
Treatment Overview
The goal of treatment for
carpal tunnel syndrome is to allow you to return to
your normal function and activities and to:
- Address other health conditions if they are
making your symptoms of carpal tunnel syndrome worse.
- Reduce any
inflammation of tissues in the wrist that puts
pressure on the
median nerve.
- Determine the causes of your
carpal tunnel symptoms. You can then identify whether there are activities for
you to avoid or do differently and ways you can help prevent the
condition.
- Prevent nerve damage and loss of muscle strength in your
fingers and hand.
Treatment for carpal tunnel syndrome is based on the
seriousness of the condition, whether there is any nerve damage, and whether
other treatment has helped. Treatment options include treatment without surgery
(nonsurgical treatment) or with surgery.
- If treated early, carpal tunnel symptoms
usually go away with nonsurgical treatment.
- If your symptoms are
mild, with occasional tingling, numbness, weakness, or pain, 1 to 2 weeks of
home treatment are likely to relieve your symptoms.
- If home
treatment does not help, or if your symptoms are more severe (including the
loss of feeling in your fingers or hand, or the inability to perform simple
hand movements such as holding objects or pinching), have your doctor examine
you and recommend treatment.
Nonsurgical treatment
If your symptoms are not
severe, expect your doctor to recommend nonsurgical treatment to see whether
symptoms improve. Nonsurgical treatment includes:
- Evaluating any other medical problems that
might contribute to carpal tunnel syndrome, and changing your treatment for
those problems if needed.
- Changing or avoiding activities that
may be causing symptoms, and taking frequent breaks from repetitive
tasks.
- Wearing a
wrist splint to keep your wrist straight, usually just
at night. See a picture of a
wrist splint.
- Using nonsteroidal anti-inflammatory drugs (NSAIDs)
to relieve pain and reduce inflammation. Although studies have not shown NSAIDs
to be effective for carpal tunnel syndrome, they may help relieve your
symptoms.
- Learning ways to protect your joints as you go through your
daily activities.
In some cases, oral corticosteroids or corticosteroid
injections into the carpal tunnel may be considered if other methods to reduce
inflammation do not work.
Surgical treatment
Surgery is sometimes
recommended when other treatment has not helped, if a carpal tunnel condition
has continued for a long time, or if there is nerve damage or the risk of nerve
damage. Surgery involves cutting the
ligament that forms the roof of the carpal tunnel.
This relieves the pressure on the median nerve, which eases or ends the
symptoms of carpal tunnel syndrome.
See a picture of the ligament
involved in
carpal tunnel release surgery.
Surgery is usually successful. In
some cases it does not completely relieve the numbness and pain in the fingers
or hand. This may be the case if there has been permanent nerve damage caused
by long-standing carpal tunnel syndrome or by other health problems such as
diabetes.
Carpal Tunnel Syndrome: Should I Have Surgery?
Prevention
Because
carpal tunnel syndrome is usually caused by multiple
factors—including health problems and activities—the most important step in
preventing it is to take good care of your general health. This includes
staying at a healthy weight, not smoking, and getting regular exercise. Other
steps to prevent carpal tunnel syndrome include the following:
- Keep your arm, hand, and finger muscles
strong and flexible.
- Stop any activity
that you think may be causing finger, hand, or wrist numbness or
pain.
- Use
hand and wrist movements that spread the pressure and
motion evenly throughout your hand and wrist.
- Switch hands and
change positions often when you are doing repeated motions. Take breaks and
rest your hands.
- Use
correct
posture.
- Restrict your salt intake if you
tend to retain fluid.
- Wear a
wrist splint to keep your wrist in a neutral position
and to reduce the stress on your fingers, hand, or wrist at times when you
cannot control your wrist motion, such as while sleeping. See a picture of a
wrist splint.
Wrist Care: Preventing Carpal Tunnel Syndrome
If you feel that certain work activities are causing
finger, hand, or wrist numbness or pain, talk to your human resources
department about different ways of doing your job, changes in
your equipment, other job assignments, or the possibility of an ergonomics
evaluation of your work space and procedures.
In daily routines at
home or while doing hobbies, think about changing activities in which you make
repeated finger, hand, or wrist movements. Train yourself to use other
positions or techniques that will not stress your hand or wrist.
Home Treatment
Home treatment for
carpal tunnel syndrome:
- Can ease pain and prevent further or permanent
damage to your median nerve.
- May completely relieve your symptoms
if you start treatment when symptoms first occur.
If you have mild symptoms, such as occasional tingling,
numbness, weakness, or pain in your fingers or hand, follow these steps to
reduce
inflammation:
- Rest your fingers, hand, and wrist.
Stop activities that you suspect are causing numbness
and pain.
- Ice your wrist for 10 to 15 minutes at a time, as often
as once or twice an hour, and take nonsteroidal anti-inflammatory drugs
(NSAIDs) to
relieve pain and reduce swelling. Studies
have not shown NSAIDs to be effective for carpal tunnel syndrome, but they may help
relieve your symptoms.
- Wear a
wrist splint at night to keep your wrist in a neutral
position and relieve pressure on your median nerve. See a picture of a
wrist splint.
- Wrist Care: Preventing Carpal Tunnel Syndrome
When your pain is gone, begin
exercises for flexibility and strength for your arm
and wrist. Learn the best positions and posture for hand and wrist
movements.
Medications
Medicine is often used to treat symptoms
of
carpal tunnel syndrome. Medicine may relieve swelling,
inflammation, and pain in the wrist or hand. Reducing
swelling in the wrist will relieve pressure on the
median nerve in the carpal tunnel and relieve carpal
tunnel symptoms.
Medication Choices
Nonsteroidal anti-inflammatory drugs (NSAIDs) are the
most commonly used medicines for carpal tunnel syndrome. NSAIDs relieve pain
and inflammation and are available with or without a prescription. But a review
of research suggests that NSAID treatment for 2 and 4 weeks may not improve
carpal tunnel symptoms. NSAIDs may be most effective if the tendon is
inflamed.1 Although studies
have not shown NSAIDs to be effective for carpal tunnel syndrome, they may help
relieve your symptoms.
Corticosteroids may be an effective
treatment option when NSAIDs do not effectively relieve pain and
inflammation.1 But corticosteroids are powerful
anti-inflammatory medicines and have side effects that should be considered.
Corticosteroids can be taken in pill form or injected into the wrist by a
doctor.
What To Think About
Medicine should be used with
other measures (such as ice, rest, and splints) to reduce pain and
inflammation.
Corticosteroids:
- Usually are not used until nonsurgical
treatments (such as rest, ice, splints, and anti-inflammatory medicines) have
been tried for several weeks with no improvement.
- Often provide
temporary relief (for several weeks or more). Injected corticosteroids usually
provide longer-lasting results than those taken by mouth (oral). But oral or
injected medicines rarely provide permanent relief from carpal tunnel
symptoms.
- Must be used with caution because both oral and injected
forms have potentially serious side effects.
Surgery
Most people with
carpal tunnel syndrome are treated without surgery.
Surgery is considered only when:
- Symptoms have not improved after a long period
of nonsurgical treatment. In general, surgery is not considered until after several weeks to months of nonsurgical treatment. But this assumes that you are having
ongoing symptoms but no sign of nerve damage. Nerve damage would make surgery
more urgent.
- Severe symptoms restrict normal daily activities, such
as when there is a persistent loss of feeling or coordination in the fingers or
hand, no strength in the thumb, or when sleep is severely disturbed by
pain.
- There is damage to the
median nerve (shown by nerve test results and loss of
hand, thumb, or finger function) or a risk of damage to the nerve.
Carpal tunnel release surgery is used to reduce the
pressure on the median nerve in the wrist. This is done by cutting the ligament
that forms the top of the carpal tunnel. Cutting this ligament relieves
pressure on the median nerve. Any other tissue (such as a tumor) that may be
putting pressure on the median nerve can also be removed during surgery.
- Carpal Tunnel Syndrome: Should I Have Surgery?
After surgery, it is important to avoid any activities that
may have caused carpal tunnel syndrome—or change the way you do them.
Surgery Choices
The most common surgery for relieving carpal tunnel
symptoms involves cutting the transverse carpal ligament to relieve pressure on
the median nerve in the wrist. Two approaches for this surgery are:1
- Open carpal tunnel release surgery, which allows the doctor to see more of the inner
tissues, including the full width of the transverse carpal ligament where it is
to be cut. Open surgery requires an incision in the palm and wrist, which
disturbs more of the tissues in the hand, and requires a longer recovery
period. It leaves a larger scar than does
endoscopic surgery. But there may be less chance of other complications. See a picture of
open carpal tunnel surgery.
- Endoscopic carpal tunnel release surgery, which requires only a small incision at the
wrist (single-portal technique) or at the wrist and palm (two-portal
technique), and which disturbs less tissue in the hand. Recovery is quicker
than with open surgery. And the scars heal more quickly, are smaller, and tend
to be less painful at 3 months after surgery. There
may be a slightly higher rate of reoperation after endoscopic carpal tunnel
surgery. See a picture of
endoscopic carpal tunnel surgery.
Some surgeons are now doing small- or mini-open
release surgery. This requires a smaller incision than standard open carpal
tunnel release surgery to minimize healing time and scar formation. But it also
allows the surgeon to view the ligament directly during the surgery to minimize
danger to the nerve itself. This procedure may be promising, but there are few
studies comparing it to the open carpal tunnel or endoscopic procedures at this
time.
What To Think About
When surgery is considered
necessary to treat severe carpal tunnel syndrome, it usually relieves symptoms.
Nerve tests (nerve conduction velocity
test and electromyogram) are usually completed before surgery is done. Surgery
is more likely to be successful if the results from nerve testing point to
carpal tunnel syndrome.
Unless carpal tunnel symptoms become
intolerable, a pregnant woman should delay surgery until after childbirth.
After delivery, symptoms often disappear without treatment when
pregnancy-related fluid buildup is relieved.
There are many health
problems, such as
rheumatoid arthritis or
diabetes, that can cause symptoms similar to carpal
tunnel syndrome. If you have a health problem that causes severe carpal tunnel
symptoms or makes symptoms worse:
- Ongoing treatment for that problem is
needed to help control those symptoms.
- Surgery may help prevent
median nerve damage and give you partial relief from
carpal tunnel symptoms.
Your decision about whether to use open or endoscopic
surgery depends on your doctor's experience with the procedures. Endoscopic
carpal tunnel surgery uses very technical equipment and is most successful when
the doctor has done the procedure many times.
Other Treatment
Other treatments for
carpal tunnel syndrome include:
- Physical therapy techniques, such as
ultrasound, stretching, and range-of-motion exercises. In some
clinics, these may be done by an
occupational therapist.
- Wrist splints. In mild cases of carpal
tunnel syndrome, rest and wearing a wrist splint at night may be enough to
relieve symptoms. Wrist splints keep the wrist from bending and minimize or
prevent pressure on the median nerve. Wrist splints are designed for different
purposes such as for certain jobs or for wearing at night. Splints are most
effective if they are used as soon as symptoms are
noticed.
- Retraining (learning new ways of doing things), and
ergonomic considerations (such as having your body in the correct posture and
position and using equipment that is right for your strength and ability).
Retraining and ergonomic considerations may not only relieve the symptoms of
carpal tunnel syndrome but also may prevent them from coming back.
Complementary and alternative treatments
Complementary and alternative treatments are sometimes
used to help with the symptoms of tingling, numbness, weakness, or pain felt in
the fingers or hand. Some of these treatments include:2
- Acupuncture, which has been suggested
as a useful treatment for some of the symptoms of carpal tunnel syndrome.
Because it is commonly used, the U.S. National Institutes of Health is
currently studying acupuncture for treating carpal tunnel
syndrome.
- Yoga, which can be helpful in relieving pain in the
hand.
- Manipulation therapies, such as
chiropractic, which involve realignment of joints and
bones by twisting, pulling, or pushing movements in the wrist and in the
forearm, upper arm, shoulder, upper back, and neck.
- Vitamin B6, which may help prevent or reduce carpal tunnel symptoms. Small
studies have produced mixed results. High doses of vitamin B6 can cause nerve
problems (neuropathy). Talk to your doctor before you use vitamin B6
supplements.
Other Places To Get Help
Organizations
| National Institute of Neurological Disorders and
Stroke |
| P.O. Box 5801 |
| Bethesda, MD 20824 |
| Phone: | 1-800-352-9424
(301) 496-5751 |
| TDD: | (301) 468-5981 |
| Web Address: | www.ninds.nih.gov |
| |
The National Institute of Neurological Disorders and
Stroke (NINDS), a part of the National Institutes of Health, is the leading
U.S. federal government agency supporting research on brain and nervous system
disorders. It provides the public with educational materials and information
about these disorders. |
|
| American Academy of Orthopaedic Surgeons
(AAOS) |
| 6300 North River Road |
| Rosemont, IL 60018-4262 |
| Phone: | 1-800-346-AAOS (1-800-346-2267)
(847) 823-7186 |
| Fax: | (847) 823-8125 |
| Email: | orthoinfo@aaos.org |
| Web Address: | www.orthoinfo.aaos.org |
| |
The American Academy of Orthopaedic Surgeons (AAOS)
provides information and education to raise the public's awareness of
musculoskeletal conditions, with an emphasis on preventive measures. The AAOS
website contains information on orthopedic conditions and treatments, injury
prevention, and wellness and exercise. |
|
| American College of Rheumatology |
| 2200 Lake Boulevard NE |
| Atlanta, GA 30319 |
| Phone: | (404) 633-3777 |
| Fax: | (404) 633-1870 |
| Web Address: | www.rheumatology.org |
| |
The American College of Rheumatology (ACR) and the
Association of Rheumatology Health Professionals (ARHP, a division of ACR) are
professional organizations of rheumatologists and associated health
professionals who are dedicated to healing, preventing disability from, and
curing the many types of arthritis and related disabling and sometimes fatal
disorders of the joints, muscles, and bones. Members of the ACR are physicians;
members of the ARHP include research scientists, nurses, physical and
occupational therapists, psychologists, and social workers. Both the ACR and
the ARHP provide professional education for their members. The ACR
website offers patient information fact sheets about rheumatic diseases, about
medicines used to treat rheumatic diseases, and about care
professionals. |
|
| American Occupational Therapy
Association |
| 4720 Montgomery Lane, P.O. Box 31220 |
| Bethesda, MD 20824-1220 |
| Phone: | (301) 652-2682 |
| Fax: | (301) 652-7711 |
| TDD: | 1-800-377-8555 |
| Web Address: | http://www.aota.org |
| |
The American Occupational Therapy Association (AOTA) is the
nationally recognized professional association of approximately 35,000
occupational therapists, occupational therapy assistants, and students of
occupational therapy. AOTA's mission is to advance the quality, availability, use,
and support of occupational therapy through standard-setting, advocacy,
education, and research on behalf of its members and the public. |
|
| American Society for Surgery of the Hand
(ASSH) |
| 6300 North River Road |
| Suite 600 |
| Rosemont, IL 60018-4256 |
| Phone: | (847) 384-8300 |
| Fax: | (847) 384-1435 |
| Email: | info@assh.org |
| Web Address: | www.assh.org |
| |
ASSH is a professional organization of hand surgeons
that provides education to the public about hand problems, such as Dupuytren's
disease, carpal tunnel syndrome, and tennis elbow. ASSH also provides education
about surgery, preventive tips to keep your hands safe, and an online tool to
find a hand surgeon. |
|
References
Citations
- Ashworth N (2010). Carpal tunnel syndrome, search date
March 2009. Online version of Clinical Evidence (3).
- Lewis DC (2006). Carpal tunnel syndrome. In JE
Pizzorno Jr, MT Murray, eds., Textbook of Natural Medicine, 3rd ed., vol. 2., pp. 1557–1561. St. Louis, Missouri:
Churchill Livingstone Elsevier.
Other Works Consulted
- American Academy of Orthopaedic Surgeons (2007).
Clinical guideline on diagnosis of carpal tunnel syndrome. Available online:
www.aaos.org/Research/guidelines/CTSdiagnosisguide.asp.
- American Academy of Orthopaedic Surgeons (2008).
Clinical practice guideline on the treatment of carpal tunnel syndrome. Available online:
www.aaos.org/Research/guidelines/CTStreatmentguide.asp.
- Bednar MS, Light TR (2006). Disorders of the nerves of
the hand. In HB Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 4th ed., pp. 559–567. New York: McGraw-Hill.
- El Miedany YM, et al. (2004). Ultrasonography versus
nerve conduction study in patients with carpal tunnel syndrome: Substantive or
complementary tests? Rheumatology (Oxford), 43(7):
887–895.
- Goodyear-Smith F, Arroll B (2004). What can family
physicians offer patients with carpal tunnel syndrome other than surgery? A
systematic review of nonsurgical management. Annals of Family Practice, 2(3): 267–273.
- Griffin LY, ed. (2005). Carpal tunnel syndrome. In Essentials of Musculoskeletal Care, 3rd ed., pp. 321–327. Rosemont, IL: American Academy of Orthopaedic Surgeons.
- Mercier LR (2008). Carpal tunnel syndrome section of The forearm, wrist, and hand. In Practical Orthopedics, 6th ed, p. 107–110. Philadelphia: Mosby Elsevier.
- National Institute of Neurological Disorders and Stroke (2009). Carpal tunnel syndrome fact sheet. Bethesda, MD: National Institutes of Health. Available online: http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm.
- Palmer KT, et al. (2007). Carpal tunnel syndrome and
its relation to occupation: A systematic literature review. Occupational Medicine, 57(1): 57–66.
- Piazzini DB, et al. (2007). A systematic review of the
conservative treatment of carpal tunnel syndrome. Clinical Rehabilitation, 21(4): 299–213.
- Zhao M, Burke D (2008). Median neuropathy (carpal tunnel syndrome). In WR Frontera et al., eds., Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation, 2nd ed., pp. 173–177. Philadelphia: Saunders Elsevier.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Adam Husney, MD, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | David Pichora, MD, FRCSC - Orthopedic Surgery |
|---|
| Last Revised | October 21, 2010 |
|---|
Seton is proud to have four hospitals – the only hospitals in Central Texas - that have earned the Magnet designation, the highest award for nursing excellence given by the American Nurses Association.