What Are the Warning Signs of Carpal Tunnel Syndrome?

9 Early warning signs of carpal tunnel syndrome include burning sensations, pain in the thumb, shock-like, hand weakness, and more.

Carpal tunnel syndrome is a condition that occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes compressed at the wrist. This can result in pain, numbness, and weakness in the fingers, hands, and wrists, and sometimes the arms. It is a type of entrapment neuropathy, in which a peripheral nerve is pressed or squeezed.

People are most likely to notice symptoms first thing in the morning and at night. You may feel like your thumb and first few fingers feel useless and you may experience a pins-and-needles sensation.

11 Early warning signs of carpal tunnel syndrome include: 

1. Burning or tingling sensations in the thumb and the index, middle, and ring fingers
2. Symptoms are usually worse at night 
3. Symptoms often affect both hands, but one hand might be worse 
4. Pain in the thumb and the index, middle, and ring fingers
5. Shock-like sensations
6. Hand weakness/difficulty grasping items
7. Itchy palms
8. Stiff fingers
9. Inability to make a fist
10. Changes in hand temperature (colder or warmer)
11. Changes in skin color of the affected hand

Other 5 symptoms of carpal tunnel syndrome include: 

1. Pain and tingling that extends to the whole hand or up to the wrist and forearm
2. Fingers feel swollen even though little or no swelling is apparent
3. Untreated, the muscles at the base of the thumb may waste away
4. Inability to determine between hot and cold by touch (in severe cases)
5. Pain and tingling that extends past the elbow to the shoulder (rare)

Carpal tunnel syndrome is caused by factors that increase pressure on the median nerve and tendons in the carpal tunnel, such as: 

• Trauma or injury to the wrist that causes swelling, such as a sprain or fracture
• Overactive pituitary gland
• Underactive thyroid gland
• Rheumatoid arthritis
• Mechanical problems in the wrist joint
• Repeated use of vibrating hand tools
• Fluid retention during pregnancy or menopause
• A cyst or tumor developing in the canal

Risk factors associated with developing carpal tunnel syndrome include:

• Obesity
• Being female
• Pregnancy
• Diabetes
• Rheumatoid arthritis
• Osteoarthritis of the hand
• Preexisting median mononeuropathy
• Connective tissue diseases
• Low thyroid hormone (hypothyroidism)
• Genetic predisposition
• Aromatase inhibitor use
• Workplace factors
• Repetitive hand and wrist use
• Forceful hand and wrist use
• Working with vibrating tools
• Sustained wrist or palm pressure
• Prolonged wrist extension and flexion
• Use of hands in cold temperatures

Factors that may aggravate carpal tunnel syndrome symptoms include: 

• Typing
• Holding a phone
• Driving
• Reading

Carpal tunnel syndrome is often diagnosed with a history and physical exam, in which a doctor may tap on or press on the wrist, or ask you to hold your hands in ways that can make carpal tunnel syndrome symptoms worse.

Tests that may be used to help diagnose carpal tunnel syndrome include: 

• Nerve conduction studies 
• Electromyography (EMG)

Treatments for carpal tunnel syndrome include:

• Wrist splints to keep hands in a "neutral position" 
• Avoiding activities that may provoke symptoms
• Resting the hand and wrist
• Ice 
• Over-the-counter (OTC) medications like nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen (Advil, Motrin) may provide short-term pain relief
• Steroid shots or pills (such as prednisone) to help control inflammation and swelling
• Injections of lidocaine, an anesthetic 
• Yoga has been shown to reduce pain and improve grip strength 
• Carpal bone mobilization is a treatment in which a physical or occupational therapist moves the bones in the wrist around in a special way. The evidence for this treatment’s effectiveness is limited. 
• Alternative therapies such as acupuncture and chiropractic care may help some people but their effectiveness is unproven. 
• Surgery for carpal tunnel syndrome involves cutting the ligament that stretches across the wrist to form the tunnel

Complications of carpal tunnel syndrome include:

• Median nerve damage that can lead to permanent impairment and disability
• Chronic wrist and hand pain

If carpal tunnel syndrome is caused by workplace-related factors, it may be able to be prevented by: 

• On-the-job conditioning
• Stretching exercises
• Frequent rest breaks
• Use of correct posture and wrist position
• Wearing fingerless gloves to keep hands warm and flexible