Carpal tunnel syndrome is compression of the median nerve within the channel at the wrist. Numbness in the thumb, index, and middle fingers; symptoms that worsen at night; and difficulty gripping may occur. Treatment is planned according to the severity of findings and the degree of nerve involvement.
Which nerve is compressed in carpal tunnel syndrome?
The median nerve passes from the forearm into the hand through a narrow channel at the wrist. Swelling of the tissues within the channel, or narrowing of the channel itself, can put pressure on the nerve. The nerve contributes both to sensation in part of the fingers and to the function of certain muscles around the thumb.
Symptoms and effect on daily life
- Numbness or tingling in the thumb, index finger, middle finger, and the half of the ring finger nearest the thumb.
- Symptoms that wake you at night or become more noticeable while holding a phone.
- Difficulty with fine tasks such as buttoning, reduced grip strength, and dropping objects.
Numbness predominantly in the little finger does not fit the typical distribution of carpal tunnel syndrome. In this case, other causes such as ulnar nerve compression are also investigated.
Examination and nerve conduction studies
The examination assesses sensation, the strength of the thumb muscles, and movements that reproduce the symptoms. When necessary, nerve conduction studies and EMG are used to investigate the degree of involvement. The findings are interpreted together with the duration of symptoms and the examination findings.
Non-surgical treatment and the decision for surgery
In mild cases, a night splint and adjusting movements that strain the wrist can be helpful. If the physician considers it suitable, options such as injection may also be considered. Persistent symptoms, significant loss of strength, or advanced nerve involvement are important factors in the decision for surgery.
The aim of surgery is to reduce pressure on the nerve. Night-time symptoms and permanent loss of sensation may not improve at the same rate; recovery may remain limited where damage has been present for a long time. Wound healing and hand function are monitored at follow-up visits.
Preparing for your examination
Note which fingers are numb, how long the symptoms have been present, and whether they affect your sleep at night. Bring any previous EMG reports, any splint you use, and information about your treatment with you.
Frequently Asked Questions
The little finger is not in the typical area supplied by the median nerve. Numbness in this area should be assessed for other causes.
No. In mild cases, non-surgical options may be considered; the decision for surgery is based on severity and response to treatment.
Sources and information
This content is for general information only; it does not replace personal diagnosis, treatment advice or a medical consultation. The applicability of recommendations in these sources depends on your individual situation and local practice.