Carpal Tunnel Syndrome (CTS): All You Need to Know

Carpal Tunnel Syndrome happens when there’s compression of or pressure on the median nerve at the wrist. The median nerve extends from the forearm into the hand’s palm. The carpal tunnel is the thin, inflexible passage of bones and ligaments at the base of the hand. It houses the tendons and median nerve, making it possible to bend the fingers.

The median nerve supplies sensation to the thumb side of the palm and the other fingers, but not the little finger. It also controls some muscles at the thumb’s base.

Sometimes, compression of the median nerve occurs when the lining of irritated tendons thickens. Swelling may also narrow the tunnel, compressing the median nerve. The result is numbness, hand and wrist pain, as well as weakness extending to the arm and forearm.

CTS is also one of the most common causes of entrapment neuropathies. It happens when pressure or a squeezing force is on the body’s peripheral nerves.

Symptoms of Carpal Tunnel Syndrome

The symptoms of CTS usually begin gradually and include:

  • Tingling and numbness in the hand or fingers, the small finger excluded.
  • The fingers get a burning sensation like that of an electric shock.
  • Weakness in the hand that causes you to drop objects due to the numbness.
  • A feeling of swelling in the fingers, although none is apparent.

Causes of CTS

The condition occurs because of factors that increase pressure on the median nerve and tendons. The nerve is often without any other underlying problems. Some contributing factors include:

  • Trauma or injury to the wrist that causes swelling, such as sprain or fracture
  • Health conditions like rheumatoid arthritis, diabetes, as well as thyroid gland imbalance
  • Heredity factors that cause anatomic differences in the carpal tunnel structure
  • Overactive or underactive pituitary gland
  • Constant and frequent use of vibrating hand tools
  • Pregnancy or menopause leading to fluid retention
  • Tumors or cysts take up space in the carpal tunnel or the surrounding area.

Risk Factors for Carpal Tunnel Syndrome

Studies show that women and the elderly are more likely to develop CTS. In fact, females are 3 times more likely to get CTS. Adults are also at a higher risk of the condition than children. Other risk factors include:

  • Diabetes and other medical conditions like kidney failure
  • Workplace hazards
  • Anatomic factors like smaller carpal tunnels
  • Nerve-damaging conditions
  • Inflammatory conditions that put pressure on the median nerve
  • Obesity
  • Body fluid changes

How to Test for Carpal Tunnel Syndrome

During the CTS evaluation, your doctor will conduct the following tests:

  • Phalen’s test, where the doctor passively flexes your wrists maximally to observe the reaction.
  • Tinel test, which entails tapping on the inside of your wrist over the median nerve to check for nerve damage.
  • Nerve conduction study involves a variation of electromyography where you tape two electrodes to your skin. They then pass a small shock through the median nerve to assess the electrical impulses.

Treatment Options

Your doctor may also prescribe one or more of the following treatment options:

  • Medications like anti-inflammatories to relieve pressure on the median nerve.
  • Physical therapy to mobilize the median nerve via neurodynamic treatment.
  • Splinting: Wearing a splint or brace at night prevents you from bending the wrist as you sleep. It helps reduce pressure on the nerves in the carpal tunnel.
  • Surgery might be possible as a last resort if the non-surgical options don’t relieve the symptoms. Surgery aims at increasing the size of the tunnel to reduce pressure on the nerve.

What Else Could Look Like Carpal Tunnel Syndrome?

A few conditions can mimic CTS, including:

  • Cervical Radiculopathy (C6)
  • Tenosynovitis
  • Raynaud’s
  • Median nerve compression at the elbow
  • Arthritis

If you’ve had carpal tunnel syndrome and seek treatment or would like to know about it, Cawley Physical Therapy and Rehabilitation is the place to go. Please email us at or call 570-208-2787 for more information.