Carpal tunnel syndrome comes from pressure on a nerve at the wrist, and it causes numbness, tingling and weakness in the hand. Without treatment it tends to worsen, and nerve damage can become permanent. Numbness with new or sudden weakness, slurred speech or trouble walking needs 911. Other symptoms can be looked at in Towson.
Hands That Wake You Up
You wake with a numb hand and shake it until the feeling comes back. Later it returns while you read or grip the steering wheel. Over time, buttons get harder and things start slipping out of your fingers.
Carpal tunnel is one of the problems we see at our Towson clinic. Not every sore thumb or numb finger is carpal tunnel, though, and a few look-alikes are worth knowing.
Inside the Carpal Tunnel
The carpal tunnel is a narrow passage in the wrist, about an inch wide, with small bones on three sides and a stiff ligament across the top. The median nerve and nine tendons share the space, and it can barely stretch. When things tighten or swell, the nerve gets squeezed.
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The space gets tighter
The tunnel narrows, or the tissue around the tendons swells.
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The nerve gets squeezed
Pressure on the median nerve also cuts into its blood supply.
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The hand reacts
Numbness, tingling, pain or weakness follow in the areas that nerve serves.
What raises the risk
- Being a woman, or being older
- A carpal tunnel that is naturally small, which can run in families
- Pregnancy and other times the body holds extra fluid
- Diabetes, rheumatoid arthritis, thyroid conditions or obesity
- A broken or dislocated wrist
Clues it may be something else
- Numbness in the little finger, which this nerve does not serve
- Pain mainly at the base of the thumb when you grip or pinch
- Numbness along the arm after a neck injury
- A nerve condition, such as neuropathy, that affects more than the wrist
Mayo Clinic's page on carpal tunnel syndrome notes that the little finger is usually not affected.
Many times there is no single cause, and sometimes the cause is never known.
When Thumb Pain Is Something Else
Carpal tunnel can affect the thumb, but two other problems start at its base and tend to feel different.
De Quervain tenosynovitis
The covering around two tendons on the thumb side of the wrist gets irritated. It hurts to turn the wrist, grip or make a fist, sometimes with swelling or a catching feeling. Gardening, golf and lifting a baby can make it worse.
Thumb arthritis
Cartilage wears away at the joint at the base of the thumb, which is common with aging. Pinching and grasping hurt, and doorknobs and jars get harder. See a healthcare professional if swelling, stiffness or pain there does not go away.
Mayo Clinic's overview of de Quervain tenosynovitis places the pain near the base of the thumb.
What Carpal Tunnel Feels Like
Symptoms usually begin slowly with no specific injury, and they often come and go at first.
- Numbness or tingling in the thumb and the index, middle or ring finger
- Burning or pain in those fingers
- A brief feeling like an electric shock in the fingers
- Symptoms that wake you from sleep
- Pain or tingling that travels up the forearm
- Clumsy hands and trouble with fine tasks such as buttons
- Dropping things
- Numbness that becomes constant
What Narrows the Tunnel
Wrist anatomy
Some people simply have less room for the nerve, and that trait can run in families. A wrist fracture or arthritis in the small wrist bones can also change the space.
Repeated hand and wrist motions
Doing the same motions for a long time may aggravate the wrist tendons, and the swelling presses on the nerve. Assembly lines and vibrating tools are common examples, though these have not been proved as direct causes.
Wrist position
Holding the wrist bent far forward or back for a long time raises the pressure on the nerve. Many people sleep this way.
Fluid and hormone changes
Hormone changes during pregnancy can bring on swelling. When the body holds extra fluid, the pressure inside the tunnel can rise.
Other health conditions
Diabetes can damage nerves. Rheumatoid arthritis and gout can swell the wrist tendons.
How We Treat Carpal Tunnel in Towson
How severe your symptoms are and how long they have lasted both matter, so those come first. Depending on your condition, our comprehensive evaluation may lead to a recommendation for one of these services.
Chiropractic
A personal consultation may lead to an individual chiropractic plan.
Class IV Laser Therapy
A noninvasive handheld device applies light, and this may be used for carpal tunnel syndrome.
Your chiropractor carefully evaluates each condition first, which determines whether gentle chiropractic treatment fits you. Orthopedic and neurologic testing is part of how numbness, tingling or weakness is carefully screened, to isolate the cause and the way your symptoms present.
Carpal Tunnel Options, From Splints to Surgery
Other paths exist, so this is not a full list. An orthopedic surgeon or your doctor can explain them.
| Option | What it involves | Who provides it |
|---|---|---|
| A splint or brace | Keeps the wrist straight, usually at night, to take pressure off the nerve. | You, with advice from your doctor |
| Changing activities | Adjusting tasks, your grip or your workstation so the wrist spends less time bent. | You, with advice from your doctor |
| Nerve gliding exercises | Movements that help the median nerve slide within the tunnel. | Your doctor or a hand therapist |
| Medicine | Ibuprofen or naproxen for pain and inflammation. | Your doctor or pharmacist |
| Chiropractic care | A personal consultation and an individual plan. | A chiropractor at this clinic, if recommended |
| Class IV laser therapy | Light from a handheld device. | This clinic, if recommended |
| Carpal tunnel release | The American Academy of Orthopaedic Surgeons describes this surgery as cutting the ligament over the tunnel to make more room for the nerve. | A surgeon |
When a Specialist Is the Right Call
Nerve conduction studies and electromyography, a test of electrical activity in the muscles, show how well the median nerve is working and whether another nerve is involved. A surgeon may get involved when symptoms are long-standing.
Ask your doctor about a specialist if
- The numbness has become constant
- The muscles at the base of your thumb look smaller or feel weak
- A splint or other simple care has not helped, or helped only for a while
- No one is sure what is causing your symptoms
The American Academy of Orthopaedic Surgeons' overview of carpal tunnel syndrome says surgery may be recommended in long-standing cases to prevent irreversible damage.
If the team cannot help with your hand, you may be referred to another provider.
When Numbness Is an Emergency
Go to a hospital or call 911 if numbness or tingling comes with new or sudden weakness, trouble moving, vision changes, slurred speech, confusion or trouble walking. Do the same if it starts right after an injury to your head, neck or back, or if you lose bladder or bowel control.
Carpal tunnel symptoms tend to start slowly, so a sudden change is a different problem.
See a healthcare professional if
- Symptoms get in the way of your usual activities or your sleep
- Numbness or tingling has no obvious cause
- You have pain in your neck, forearm or fingers
- Your hand is getting weaker over time
The MedlinePlus article on numbness and tingling lists when to go to a hospital or call 911 and when to contact a provider.
Without treatment, nerve and muscle damage can become permanent.
A Hand and Wrist Visit on E Joppa Rd
You may be asked about your general health and what your hands do all day. New patients may start with a detailed intake, and chiropractic care can be combined with treatment from your other doctors.
MTA Stops, Loch Raven Village and Knettishall
MTA CityLink GREEN and LocalLink 53 both stop at Goucher Blvd and Prince Rd, about 0.3 miles southwest. E Joppa Rd forms the north edge of Loch Raven Village, and Knettishall lies about 0.7 miles southeast.
Schedule a Carpal Tunnel Evaluation
Write down which fingers go numb, what time of day it happens and which tasks set it off. Mention any condition you see a doctor for, such as diabetes or a thyroid problem. Ask about insurance or cost when you call.