Carpal Tunnel Syndrome

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.