Carpal tunnel syndrome is caused by pressure on the median nerve at the wrist.  The carpal tunnel is a very narrow space, where this nerve and nine other tendons are surrounded by bones and ligaments.  The structure that can become thick and tight over the nerve is called the transverse carpal ligament.


There are several causes of carpal tunnel syndrome, including repetitive wrist overuse, frequent vibration, fractures, arthritis, pregnancy, and other medical conditions such as diabetes, thyroid disease, or rheumatoid arthritis.  These and other conditions can cause increased swelling within the carpal tunnel, which adds pressure on the median nerve.


The symptoms may include wrist pain, numbness and tingling in the thumb, index, middle, and ring fingers, hand clumsiness, as well as loss of grip and pinch strength.  Symptoms may be worse at night and during repetitive activities or driving.


Treatment options include activity modifications, ergonomic changes, night-time wrist splinting, steroid injections, and surgery, known as carpal tunnel release.  To find out more about carpal tunnel syndrome, please feel free to visit HandCare, the patient education website of the American Society for Surgery of the Hand: