What can I do to help my carpal tunnel?

Does the thumb side of your hand feel like it’s going to sleep — that weak, numb, pins-and-needles feeling — for no apparent reason? You may suspect that you have carpal tunnel syndrome.

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The good news is that there are a number of methods you can try at home to ease your pain. And if those don’t work, surgery can be a highly effective treatment.

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a fairly common condition that affects the hand and wrist, says hand, wrist, elbow and shoulder surgeon William Seitz, MD.

“Symptoms include numbness, tingling and pain, usually in your thumb and the first three fingers of your hand,” Dr. Seitz says.

Carpal tunnel syndrome happens when the median nerve, which runs from your forearm to your hand through a narrow space called the carpal tunnel, is compressed or pinched, Dr. Seitz says.

Nine tendons that flex the first three fingers and thumb also run through the carpal tunnel.

Anything that makes the carpal tunnel smaller — and pinches the median nerve — can result in carpal tunnel syndrome, Dr. Seitz says. These can include:

  • Medical conditions such as hypothyroidism, rheumatoid arthritis, and diabetes
  • Repetitive hand movements, especially if the wrist is bent so that your hands are lower than your wrists
  • Pregnancy

Home treatments

While carpal tunnel syndrome can be uncomfortable or painful, you can treat it at home. The first step to take is to stop the activity that is causing the compression.

“Think about the activities that you think may be causing numbness and pain in your wrist and try to stop or reduce them,” Dr. Seitz says. “You can resume the activity when your symptoms improve.”

Here are five ways you can treat your carpal tunnel syndrome at home:

  • Ice your wrist or soak it in an ice bath for 10 minutes to 15 minutes once or twice an hour.
  • Relieve nighttime pain by gently shaking your hand and wrist or hanging your hand over the side of the bed.
  • Buy a wrist splint at the drugstore to keep your hand properly aligned. It may help to wear the splint at night to keep you from flexing or overextending your wrist while you sleep.
  • Take a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen or naproxen to relieve pain. Take NSAIDs with food and after consulting your primary care physician to make sure there are no medical reasons — such as interaction with other medicines you may be taking — to avoid these pain relievers.
  • Immerse your hand in warm water — with a temperature between 92 and 100 degrees — and gently move or flex your hand and wrist. Do this three to four times a day.

When it’s time to see the doctor

If these home treatments don’t ease your pain in one or two weeks, it might be time to see an orthopaedic physician, who specializes in treatment of bones, joints and muscles.

“Your doctor may recommend surgery if there’s severe damage to your median nerve or to prevent permanent sensory or functional loss,” Dr. Seitz says.

The surgery involves cutting the band of tissue in the wrist that crosses the median nerve to lessen the pressure.

“Over time, surgery may be the best route to permanent relief,” Dr. Seitz says.

Hand and wrist pain: What causes it? What can you do about it?

In this day and age of smartphone texting, video game controllers, computers – the keyboard, mouse and even the mousing surface on our laptops – it’s no wonder so many people have pain in their hands and wrists.

Made of dozens of small bones, our hands and wrists can easily get sore. The wrist alone has eight bones lined up, four on top, four below. All eight bones are connected by ligaments that keep the joints together, while giving a wide range of motion for our hands. There are also many tendons that pass the wrist. These control the motion of our wrist, fingers, and thumb. Because each of those parts serves a purpose in movement, if even one area in the wrist gets inflamed or injured, you’re going to feel it.

Injuries or conditions affecting the hands can make tasks that were once simple “no-brainers” painful and difficult. Something as mundane as lifting a coffee cup or brushing your teeth can shoot pain through your arm. The pain may even cause you to change the way you do things, such as buttoning a shirt, tying a shoelace and even signing your name.

Arthritis, carpal tunnel syndrome, tendonitis, ganglion cysts and injuries are some of the most common conditions affecting the wrist and hand. Developing any of these conditions, especially carpal tunnel syndrome, is possible for almost anyone.

Treatment for injuries can vary from icing it at home to a visit to the emergency center.

When to see a doctor

A common myth about hand and wrist injuries is that if you can move it, it’s not broken. That’s simply not true. Often, fractures feel tender right at the bone. If you have an obvious deformity or your skin is cut, you should get medical attention as soon as you can. If you have swelling, bruising and/or pain that lasts more than a day or two, it is worth seeing a physician to check it.

Preventing hand and wrist pain

There are things you can do to ward off hand and wrist pain, though. Try to keep your bones strong by getting enough calcium and vitamin D, which your body needs to use that calcium. Your doctor will have a recommendation on how much and the best way for you to work calcium and vitamin D into your diet.

Next, look at the ergonomics of how you work and live. If you’re straining, re-organize until you’re more comfortable.

Finally, make sure you’re protected. Whether you’re in your own home or playing your favorite sport, it’s important to think about safety. Make sure your shoes fit properly, there are no tripping hazards and you’re wearing the appropriate protective sporting gear.

Treating hand and wrist pain

If the pain is creeping in, you can help relieve the pain at home. Applying heat or ice to the sore area can help reduce inflammation, relieve pain, and improve movement. Over-the-counter anti-inflammatories or pain relievers might help if needed. Try modifying your activities to give your achy hands or wrists a rest.

Worsening pain means making an appointment with your physician. They can offer you other treatments to help. Those treatments can range from splinting to various surgical techniques.

At Beaumont, our orthopedic hand and wrist surgeons use the most advanced and proven techniques to improve the lives of patients. We work closely with specialized hand therapists and other team members to relieve your pain, regain your function and get you back to activities.

Information provided by Rachel Rohde, M.D., Beaumont orthopedic surgeon.

Natural Ways to Ease Carpal Tunnel Pain

1. Buy a Wrist Brace

Wearing a wrist brace at night might help ease the symptoms of carpal tunnel syndrome, according to a study published in the January–March 2015 issue of the Journal of Hand Therapy. It’s common to sleep with the wrist flexed, which irritates the nerve and puts pressure on the carpal tunnel area, says Lenore Frost, PhD, chief clinical director at Hand Therapy Associates in Woodbridge, Connecticut, and clinical associate professor at Sacred Heart University in Fairfield, Connecticut. Braces sell online for about $50, but Dr. Frost suggests that people ask their doctors for a recommendation. You can wear it during the day, too, notes Paul Sueno, MD, a physiatrist in Tacoma, Washington. If you do decide to use it in the daytime, just limit it to six hours. There are also custom-made braces that can be worn during the day, including at work.

2. Stretch Your Hands and Wrists

Taking short stretch breaks during the day may open up the irritated nerve pathways that lead to the hand, says Frost. One of her favorite moves for people who work desk jobs is the “corner stretch,” which soothes the nerves in the shoulder and neck area before eventually calming the nerves near the wrists.

To try it, find an empty corner. Then, place a palm and a forearm on each wall at a height that’s slightly above your shoulders; your elbows should form a 90-degree angle. With one foot in front of the other, keep your feet on the ground and bring your body forward until you feel a slight stretch in your chest. Hold for 10 seconds. (If it hurts, stop.) Repeat this every 45 minutes.

3. Try Hand Exercises

Certain movements, called “tendon-gliding” exercises, which require tendons to extend to their maximum potential, may reduce the swelling around the median nerve, according to experts. A study published in August 2012 in the Journal of Orthopaedic Research found that these exercises could reduce a person’s symptoms, while people who just remained active and didn’t do these movements didn’t see any reduction in pain.

4. Pay Attention to Your Workstation

If you work at a desk job, it’s important to keep your hands in a “neutral” position, with your fingers in line with your forearms, says Dr. Sueno. “If your wrist is in a neutral position, that really minimizes the risk of carpal tunnel syndrome,” he says.

This might be easier with a desktop computer, since you can adjust them as needed. Frost is adamant that people shouldn’t use laptops, while Sueno says that either is fine. The most important thing, he says, is to be careful not to overextend your wrists while typing.

5. Cool It

Studies have produced conflicting results, but some experts say that icing your wrist may ease some of the pain from carpal tunnel syndrome. As Sueno tells patients, if icing helps, “go ahead and do it.”

One pilot study published in February 2015 in the journal Medical Science Monitor suggested that Thermacare cold packs may be more effective at treating carpel tunnel syndrome symptoms than a low-level heat wrap. (The research was supported by a contract from Pfizer, the manufacturer of Thermacare products.) In the study, people held the cold pack on the palm side of their hand for 20 minutes. If that’s too long — and you start seeing redness or irritation — experts caution to take off the ice or other cold pack.

6. Consider a Supplement

Experts disagree about whether vitamin B6 supplements can help people who are suffering from carpal tunnel syndrome. One study published in August 2013 in the Advanced Pharmaceutical Bulletin found that people who took a 120-milligram (mg) dose for three months experienced more pain relief at the end of the experiment than those who took a placebo.

Sueno says, “B vitamins are important for nerve functioning,” but you should only try taking B6 if you’re deficient in the vitamin already — and in this case, only if your doctor approves. The maximum amount of B6 people should get is 100 mg a day, so you should only go over that amount under your doctor’s supervision. Also, supplements may interact with other drugs, so be sure your doctor knows everything about your medication regimen, notes Sueno.

7. Ask About Acupuncture

Even a short-term acupuncture treatment might give long-term pain relief. A study published in February 2011 in The Journal of Pain found that people who underwent eight sessions of acupuncture a month reported an improvement in their symptoms even about a year later. The research also found that this treatment worked even better than a course of oral steroids. The study authors suspect that acupuncture may increase the blood flow in the arteries that supply blood to the nerves.

Additional reporting by Cheryl Alkon

11 Helpful Life Hacks for Carpal Tunnel Pain

When you have the wrist or hand pain and tingling of carpal tunnel syndrome, it may seem like surgery is the only answer. But there are measures you can take to either avoid or postpone surgery and still have good quality of life.

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Carpal tunnel syndrome can cause pain, weakness, and numbness in the hand and wrist.
Read: Distinctive Carpal Tunnel Syndrome Symptoms

1. Give wrists a rest
One of the risk factors for carpal tunnel syndrome is repetitive or extreme wrist motion, so simply resting the wrists and keeping them in a neutral position as much as possible can ease pain and numbness.

See Causes and Risk Factors for Carpal Tunnel Syndrome

2. Use a wrist brace
Bracing the wrist is one of the most reliable ways to stabilize the wrist and ease carpal tunnel pain. When selecting a brace, choose a structured, firm option that will immobilize the wrist, as opposed a flexible one made of neoprene or elastic.

See Treatment Options for Carpal Tunnel Syndrome

3. Elevate hands, especially during sleep
Elevating the hands and wrists can help ease inflammation, particularly at night. This can be done by sleeping on your back and propping your wrists up on pillows. Since keeping your arms straight can also help, try wrapping a towel or ace bandage around your elbows.

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4. Make your work station ergonomic
Although repetitive wrist motion isn’t a proven cause of carpal tunnel syndrome, it can raise risk for the condition. So to maintain a good neutral position for your wrist despite using a computer all day, make sure your keyboard and mouse are at the right height to keep your wrists straight. You may also want to use wrist rests in front of your mousepad or keyboard.

5. Ask about job rotation
If your job involves activities such as repetitive assembly line work, talk with your employer about the possibility of rotating tasks to give your wrists and hands a rest.

6. Try ice therapy
One of the best ways to decrease carpal tunnel inflammation and dull pain signals is to use cold therapy on your wrist. Cold therapy sessions can last up to 15 to 20 minutes, and don’t forget to use a towel or cloth to protect your skin.

Watch: Video: How to Make 5 Quick and Easy Ice Packs

7. Do wrist exercises
Some people with carpal tunnel syndrome feel that it’s helpful to their symptoms to do wrist exercises. Here are a few examples of exercises you can try:

  1. Make a fist with your hand, then slowly straighten and fan out your fingers. Repeat 5 to 10 times.
  2. Hold your arm out straight, palm down. Bend your hand until your fingers are pointed downward. Use your other hand to exert a gentle pressure on the back of your hand for 20 seconds. Then switch hands.

8. Take NSAID medications
Anti-inflammatory pain medications like ibuprofen (Advil) or naproxen (Alieve) can help ease the pain of carpal tunnel syndrome. Take as directed, and ask your physician or pharmacist if you have questions about interactions or side effects.

See Acute Injury: Additional Treatment Considerations

9. Talk with your doctor
Physicians can offer a few nonsurgical medical treatments that have been proven to help carpal tunnel syndrome, including:

  • Oral corticosteroids such as prednisone
  • Cortisone (steroid) injections into the carpal tunnel

Ask your physician if one of these may be right for you.

10. Keep your hands warm
Cold conditions can lead to stiffness and exacerbate carpal tunnel syndrome pain. Keep your hands warm with fingerless gloves, particularly if you work in a cold environment.

11. Try acupuncture
Some studies have shown the acupuncture can help with the pain and symptoms of carpal tunnel syndrome. Look for a licensed acupuncturist with experience treating carpal tunnel syndrome.

If you try these self-care techniques but they fail to bring relief, keep in mind the surgical procedure for carpal tunnel syndrome, known as carpal tunnel release, has a high success rate.

Learn more:

What Is Carpal Tunnel Syndrome?

Diagnosing Carpal Tunnel Syndrome

Interview Transcript

Announcer: The Health Minute, produced by University of Utah Health.

Interviewer: If you have carpal tunnel syndrome, it might seem like surgery is the only means of relief from your symptoms. But what about simple splinting? Could that be an effective, non-invasive alternative? Dr. Douglas Hutchinson is a hand surgeon. Does splinting work for carpal tunnel syndrome?

Dr. Hutchinson: You know, it’s very effective actually, and splints alone are the mainstay of our treatment. And if a person can sleep at night and not wake up with numb fingers, they’re going to feel a lot better, they’re going to do better during the day, their hands are not going to hurt them, and/or go to sleep on them as much during the day as well, and they’re going to get several years out of that type of treatment before they may get to the point where despite splinting they’re still getting numbness, and that’s when they probably should talk about surgery.

Announcer: To find out more about this and other health and wellness topics, visit thescoperadio.com.

Don’t delay treatment for carpal tunnel syndrome

Ignoring symptoms of this carpal tunnel syndrome can lead to permanent nerve damage.

Updated: November 8, 2019Published: October, 2017

First, you may notice tingling or numbness in your fingers that comes and goes. Over time, the sensations may get worse, lasting longer or even waking you up at night. Eventually the pain and numbness might even make it hard to grip things like a fork, a pen, or other objects.

If you’re having these symptoms, it could be carpal tunnel syndrome, which occurs when the median nerve — which runs down your arm and into your hand — is compressed by a ligament that crosses over it as it passes through a narrow space in the wrist known as the carpal tunnel.

“Carpal tunnel syndrome has classic symptoms, which include numbness and tingling in the thumb, index finger, middle finger, and half of the ring finger,” says Dr. Tamara Rozental, professor of orthopedic surgery at Harvard Medical School and chief of hand and upper extremity surgery at Beth Israel Deaconess Medical Center. Your little finger is typically not affected because a different nerve serves it.

Women at risk

Women tend to be more prone to carpal tunnel syndrome because of risk factors, such as pregnancy, that are specific to their sex. Other risk factors include:

  • diabetes
  • cysts that encroach on carpal tunnel passageway
  • drinking alcohol
  • being overweight
  • thyroid disease
  • arthritis affecting the wrist.

While it used to be thought that repetitive activities such as keyboarding could cause carpal tunnel syndrome, research has found that this is largely not the case, says Dr. Rozental. However, regular use of heavy or vibrating equipment, such as a jackhammer, may predispose you to the condition.

Diagnosis

Your doctor can usually diagnose carpal tunnel syndrome based on your symptoms and the findings on physical examination. But in some cases, you may need additional tests to ensure that those symptoms aren’t being caused by another condition, such as arthritis, a pinched nerve in your neck, or neuropathy (nerve disease that can be a complication of diabetes or other conditions), says Dr. Rozental.

One of the tests used to confirm carpal tunnel syndrome, a nerve conduction study and electromyogram (EMG), uses an electrical signal to determine how well the nerve is working. Another test uses ultrasound, which is less invasive than an EMG but requires an experienced technician and is not as widely available.

Treating carpal tunnel syndrome

For mild cases of carpal tunnel syndrome, resting your hand and wearing a splint at night might be all it takes to relieve symptoms. Symptoms of carpal tunnel syndrome often occur at night, causing people to wake up and shake or move their hand around until the numbness resolves and it feels better, says Dr. Rozental. Medications, such as aspirin and ibuprofen aren’t a cure, but can help relieve pain. Your doctor may also want to try giving you steroid injections to help relieve symptoms.

If these carpal tunnel treatments aren’t effective, however, it may be time to consider surgery to release the ligament that is placing pressure on the median nerve.

When to get surgery

“The mistake that people often make is waiting too long to get surgery,” says Dr. Rozental. “I see a lot of people who say that their numbness was gradually worsening and now their hand is completely numb and has been for a year.” If the nerve is compressed long enough, the muscle atrophies and the nerve damage becomes permanent, she says.

So, if your carpal tunnel symptoms aren’t responding to other treatments, take action quickly.

The surgery takes 10 minutes under a local anesthetic. Unless you do a job that involves manual labor, you can typically go right back to normal activities, says Dr. Rozental.

“I tell my patients all the time that a carpal tunnel release done at the right time for the correct diagnosis is very successful,” she says.

Image: © Daisy-Daisy/Getty Images

Disclaimer:
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Carpal tunnel syndrome

Carpal tunnel syndrome occurs when a nerve in the hand and forearm, known as the median nerve, gets pinched (compressed) within a passage called the carpal tunnel. The carpal tunnel is a narrow canal at the wrist through which the median nerve extends from the forearm to the hand and the first four fingers. It is surrounded by the wrist bones and connective tissues, which are tissues that support the body’s joints and organs.

Carpal tunnel syndrome is often described as idiopathic because its cause is frequently unknown but can be influenced by lifestyle factors. Little is known about the genetic contributions to this condition. Most of the genes that have been studied provide instructions for making proteins that are components of connective tissues. Other genes associated with the condition play roles in nerve cell function, the immune system, or metabolism. Additionally, the width of the carpal tunnel varies among individuals; people with narrower passages are more likely to have nerve compression than are people with wider passages.

In carpal tunnel syndrome, nerve compression can be caused by many factors including inflammation of connective tissues surrounding the carpal tunnel, accumulation of fluids (edema) in the lower arm, hormonal changes, stress and trauma to the wrist, or obstructions within the carpal tunnel, such as a cyst or tumor. Carpal tunnel syndrome occurs in 20 to 45 percent of pregnant women, likely due to edema or hormonal changes, and often goes away at the end of the pregnancy.

Particular activities, often related to certain occupations, may increase a person’s risk of developing carpal tunnel syndrome. Repeated use of tools that vibrate or require forceful movements can put stress on the wrist, causing swelling or inflammation around the carpal tunnel. Whether repeated tensing of the hand and wrist, caused by frequent computer use, increases the risk of carpal tunnel syndrome is unclear; the evidence is conflicting. It is likely that the impact of computer use on the development of carpal tunnel syndrome is minor.

While carpal tunnel syndrome can be a feature of many disorders, including obesity, alcohol use disorder, rheumatoid arthritis, type 1 diabetes, type 2 diabetes, hypothyroidism, kidney (renal) failure, transthyretin amyloidosis, and hereditary neuropathy with liability to pressure palsies, it usually occurs in people with no related health conditions.

Carpal Tunnel Release

What is carpal tunnel release surgery?

Carpal tunnel release is a surgery used to treat and potentially heal the painful condition known as carpal tunnel syndrome. Doctors used to think that carpal tunnel syndrome was caused by an overuse injury or a repetitive motion performed by the wrist or hand, often at work. They now know that it’s most likely a congenital predisposition (something that runs in families) – some people simply have smaller carpal tunnels than others. Carpal tunnel syndrome can also be caused by injury, such as a sprain or fracture, or repetitive use of a vibrating tool. It’s also been linked to pregnancy, diabetes, thyroid disease, and rheumatoid arthritis.

The median nerve and tendons that allow your fingers to move pass through a narrow passageway in the wrist called the carpal tunnel. The carpal tunnel is formed by the wrist bones on the bottom and the transverse carpal ligament across the top (or inside) of the wrist. When this part of the body is injured or tight, swelling of the tissues within the tunnel can press on the median nerve. This causes numbness and tingling of the hand, pain, and loss of function if not treated. Symptoms usually start slowly, and may get worse over time. They tend to be worse on the thumb side of the hand.

During a carpal tunnel release, a surgeon cuts through the ligament that is pressing down on the carpal tunnel. This makes more room for the median nerve and tendons passing through the tunnel, and usually improves pain and function.

Why might I need carpal tunnel surgery?

A diagnosis of carpal tunnel syndrome is about the only reason to have a carpal tunnel surgery. And even then, your doctor will likely want you to try nonsurgical treatments first. These may include over-the-counter pain medicines, physical therapy, changes to the equipment you use at work, wrist splints, or shots of steroids in the wrist to help relieve swelling and pain.

The reasons that a doctor would recommend a carpal tunnel release surgery may include:

  • The nonsurgical interventions for carpal tunnel syndrome don’t relieve the pain.
  • The doctor performs an electromyography test of the median nerve and determines that you have carpal tunnel syndrome.
  • The muscles of the hands or wrists are weak and actually getting smaller because of the severe pinching of the median nerve.
  • The symptoms of carpal tunnel syndrome have lasted 6 months or longer with no relief.

What are the risks of carpal tunnel surgery?

As with most surgeries, carpal tunnel release is not without its risks. Your wrist will be made numb and you may be given medicine to make you sleepy and not feel pain (called local anesthesia) for the procedure. In some cases general anesthesia is used, this when drugs are used to put you into a deep sleep during surgery. Anesthesia poses risks for some people. Other potential risks of a carpal tunnel release surgery include:

  • Bleeding
  • Infection
  • Injury to the median nerve or nerves that branch out from it
  • Injuries to nearby blood vessels
  • A sensitive scar

The recovery from carpal tunnel surgery takes time – anywhere from several weeks to several months. If the nerve has been compressed for a long period of time, recovery may take even longer. Recovery involves splinting your wrist and getting physical therapy to strengthen and heal the wrist and hand.

There may be other risks, depending on your specific medical condition. Be sure to discuss any concerns with your doctor before the procedure.

How do I get ready for carpal tunnel surgery?

  • Tell your doctor about all medicines you are currently taking, including over-the-counter drugs, vitamins, herbs, and supplements. You will probably need to stop taking any medicines that make it harder for the blood to clot, such as ibuprofen, aspirin, or naproxen.
  • If you’re a smoker, try to quit before to the surgery. Smoking can delay healing.
  • You may need to get blood tests or an electrocardiogram (ECG) before surgery.
  • You will usually be asked not to eat or drink anything for 6 to 12 hours before the surgery.

Based on your medical condition, your doctor may request other specific preparations.

What happens during carpal tunnel surgery?

Carpal tunnel release is usually an outpatient procedure, which means that you can go home the same day as the surgery if all goes well. There are 2 types of carpal tunnel release surgery. The traditional method is the open release, in which the surgeon cuts open the wrist to do the surgery.

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