Carpal Tunnel

Carpal tunnel syndrome (CTS) is a frequent cause of hand and wrist pain, numbness, tingling, and weakness. It occurs when the median nerve is compressed within the carpal tunnel, a narrow channel in the wrist. At Cape Fear Valley, our specialists deliver thorough evaluations and individualized treatment plans to relieve symptoms, protect dexterity, and help you resume daily activities with confidence. CTS may involve one or both wrists, and early care reduces the risk of long-term nerve injury.
 

Overview of Carpal Tunnel

The carpal tunnel is a firm passage formed by wrist bones and roofed by the transverse carpal ligament. The median nerve and several flexor tendons travel through this tight space to the hand. Swelling, tendon irritation, or structural narrowing can raise pressure inside the tunnel, compressing the median nerve and triggering CTS.

CTS can develop at any age but is most common from 30 to 65. Women are affected more often, partly due to wrist anatomy. Repetitive or forceful hand use—such as assembly work, carpentry, hairdressing, food processing, and prolonged computer tasks—raises risk. Medical factors including diabetes, hypothyroidism, rheumatoid arthritis, pregnancy, and obesity also contribute. Because each wrist has its own carpal tunnel, symptoms may appear in one or both hands.

Symptoms often start intermittently and progress gradually. People commonly notice numbness and tingling in the thumb, index, middle, and part of the ring finger, especially at night or during activities like driving or holding a phone. Pain may intensify over time, with weakness and reduced fine motor control. Seek medical evaluation if symptoms persist beyond a few weeks, disturb sleep or daily activities, or if weakness or muscle loss at the base of the thumb appears. Early attention can prevent progression.
 

Symptoms and Signs of Carpal Tunnel

Typical features include intermittent numbness and tingling in the thumb, index, and middle fingers; hand pain that may radiate into the forearm; dropping objects due to grip weakness; and nighttime pain that disrupts sleep. Many people shake their hand to relieve symptoms. Discomfort often worsens with wrist flexion or extension and sustained gripping. Pain can radiate up the forearm from the wrist.

CTS can mimic other conditions, but key differences help distinguish it:

• Cervical radiculopathy (pinched neck nerve) may cause pain, numbness, and weakness from the neck down the arm and can involve the entire hand rather than the median-nerve pattern.
• Tendonitis usually causes localized tendon pain without the hallmark numbness and tingling of the thumb and index/middle fingers.
• Ulnar neuropathy primarily affects the ring and little fingers more than the thumb and index finger.
• De Quervain’s tenosynovitis causes pain near the thumb side of the wrist, especially with thumb motion, and lacks median nerve sensory changes.

Seek urgent care for sudden, significant weakness; progressive muscle wasting at the base of the thumb; loss of finger coordination; or symptoms after a wrist injury. Worsening issues despite conservative care, or signs of infection such as fever, redness, or warmth, also warrant prompt attention. Short rest may help briefly, but persistent symptoms should be evaluated.