# Carpal tunnel syndrome

- Web page: https://kainezitherapy.com/en/conditions/elbow-and-wrist/carpal-tunnel/
- Body area: [Elbow and wrist](https://kainezitherapy.com/en/conditions/elbow-and-wrist.md)
- Recommended treatment:
  - [Kinesitherapy for nerve pain (neuralgia)](https://kainezitherapy.com/en/services/kinesitherapy/kinesitherapy-for-neuralgia.md): €40.00, 60 min
  - [Ultrasound therapy](https://kainezitherapy.com/en/services/physiotherapy/ultrasound-therapy.md): €25.00, 15 min
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Carpal tunnel syndrome is a trapped nerve in the wrist. It causes numbness in the thumb, index and middle finger, often at night.

## At a glance

- **How it feels** Numb thumb, index and middle finger, worse at night
- **How long treatment takes** Usually 6–10 sessions over 3–5 weeks
- **Surgery** For a severe or persistent case; a surgeon decides

Carpal tunnel syndrome is pressure on the median nerve in the narrow channel of the wrist. The carpal tunnel itself is the channel between the wrist bones and the strong ligament above them. The syndrome causes numbness in the thumb, index finger and middle finger. It is more common in women, during pregnancy and in people whose work involves a lot of wrist bending. It usually starts in the hand you work with, but often affects both.

## Symptoms

- Numbness and tingling in the thumb, index finger, middle finger and half of the ring finger.
- Numbness that wakes you at night and eases when you shake your hand.
- Numbness when you hold a phone, a steering wheel or a book.
- Pain in the wrist that sometimes reaches the forearm.
- Clumsiness: you drop things and find buttons hard to do up.
- Difficulty feeling small objects, such as coins.
- In a more severe case, the muscle at the base of the thumb gets weaker.

At first the numbness comes only at night or during certain work. Over time it can become constant. The little finger is usually not numb: if it goes numb too, the cause is probably something else. Some people describe the hand as swollen, although no swelling can be seen from the outside.

## Why it happens

- Repeated wrist movements: keyboard work, work with tools, working at a till.
- Pregnancy and hormonal changes that make the body hold on to fluid.
- Diabetes, thyroid disease, rheumatoid arthritis.
- Old wrist injuries and fractures.
- Work with vibrating tools, for example a hammer drill or a chainsaw.

Numb fingers have other causes too, for example a trapped nerve in the neck. That is why Kaloyan checks the neck as well. In pregnancy the symptoms usually ease after the birth; in people who work with their hands, once the strain is reduced.

## How we treat it

Kaloyan checks the sensation and strength in your fingers, does specific tests for the wrist and examines your neck to rule out another cause. If you have had a nerve conduction test (EMG), bring it: it shows how badly the nerve is compressed. For a mild or moderate case, the main treatment is [kinesitherapy for nerve pain (neuralgia)](https://kainezitherapy.com/en/services/kinesitherapy/kinesitherapy-for-neuralgia/), which means exercise and manual therapy: techniques that help the nerve glide freely in the channel, manual therapy for the wrist and advice on your work. Kaloyan will ask what you do for a living, because small changes at work often reduce the numbness.

[Ultrasound therapy](https://kainezitherapy.com/en/services/physiotherapy/ultrasound-therapy/) on the wrist reduces the symptoms in some patients, and Kaloyan often combines it with the exercises. The course is usually 6–10 sessions. Doctors often recommend a night splint too, which keeps the wrist straight, and the two go well together. The night-time numbness usually eases first, then the numbness during the day. For a severe case, or if the muscle at the base of the thumb gets weaker, Kaloyan will refer you to a specialist to decide whether surgery is needed.

## What you can do yourself

- Keep your wrist straight when you type or hold a phone.
- Take short breaks during repetitive work with your hands.
- Don’t sleep with your wrists bent under the pillow.
- If numbness wakes you, shake your hand and rest it on a pillow with the wrist straight.
- Grip objects with your whole palm, not the tips of your fingers.
- If you work at a computer, try a wrist rest or a vertical mouse.

## When to see a doctor first

See a doctor first if:

- the muscle at the base of the thumb has wasted or got weaker;
- the numbness is constant, day and night;
- your legs go numb too, or the numbness spreads up the arm;
- the symptoms started after a wrist injury.

Performed by

## Kaloyan Zarkov, kinesitherapist

- Kinesitherapy degree, NSA “Vassil Levski”
- 10+ years of practice

[About us](https://kainezitherapy.com/en/about/)

## Frequently asked questions

### What are the symptoms of carpal tunnel syndrome?

Numbness in the thumb, index finger and middle finger, often at night, pain in the wrist and clumsiness in the hand.

### Why do my fingers go numb at night?

The most common cause is carpal tunnel syndrome: at night the wrist curls and presses on the nerve. Sometimes the cause is in the neck.

### Do I need surgery for carpal tunnel?

Not always. In a mild or moderate case a splint and kinesitherapy often help. Surgery is considered if the symptoms are severe or the muscle at the base of the thumb gets weaker.

### Does carpal tunnel syndrome go away after pregnancy?

In most women, yes, within weeks to months after the birth.

### Does a wrist splint help?

Yes, especially a night splint that keeps the wrist straight. It often reduces the night-time numbness.

## Other conditions in “Elbow and wrist”

[All about elbow and wrist](https://kainezitherapy.com/en/conditions/elbow-and-wrist/)

- [Tennis elbow](https://kainezitherapy.com/en/conditions/elbow-and-wrist/tennis-elbow/)
- [Golfer’s elbow](https://kainezitherapy.com/en/conditions/elbow-and-wrist/golfers-elbow/)
- [Broken wrist](https://kainezitherapy.com/en/conditions/elbow-and-wrist/wrist-fracture/)

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