Conditions · Nerves & muscles

Carpal Tunnel Syndrome

Numbness, tingling and weakness in the hand from pressure on the median nerve at the wrist.

The short answer

Carpal tunnel syndrome is numbness, tingling and weakness in the hand caused by pressure on the median nerve as it passes through a narrow tunnel in the wrist. It usually affects the thumb, index, middle and part of the ring finger, and often worsens at night. Dr. Patel confirms it with an exam and nerve testing, then treats it with splinting, therapy, activity changes and, when needed, a guided injection.

Where it isNerves & muscles
Treatment options03
Who you seeAnup H. Patel, D.O.
First visitExam and imaging review

01 · In plain words

Carpal Tunnel Syndrome

The carpal tunnel is a narrow passage in the wrist, formed by the small wrist bones and a tough band of tissue across the top called the transverse carpal ligament. The median nerve runs through it from the forearm to the hand, along with nine tendons that bend the fingers. The median nerve gives feeling to the thumb and first three fingers and controls muscles at the base of the thumb.

When the tunnel gets tighter, or the tissue inside swells, the nerve gets squeezed. The result is tingling, numbness and sometimes electric shock-like feelings in the thumb and fingers. Symptoms often show up while holding a phone, a newspaper or a steering wheel, and they commonly wake people at night. Many people shake the hand to make the feeling go away.

Carpal tunnel syndrome often comes from a mix of factors rather than one cause. Repetitive wrist bending, vibrating tools, wrist fractures and arthritis can all play a part, as can diabetes, thyroid disease, kidney failure, rheumatoid arthritis, pregnancy and a naturally smaller tunnel. If pressure continues over time, numbness can become constant and the thumb muscles can weaken.

Dr. Patel examines the hand, wrist and neck, because a pinched nerve in the neck can cause similar symptoms. EMG and nerve conduction studies show whether the median nerve is slowed at the wrist and how severe the problem is. Most people start with a night splint, activity changes and therapy. A guided injection may help when symptoms persist. Severe cases with muscle weakness may need surgical release, and he will refer you when that is the right step.

02 · What it feels like

What it feels like · Why it happens

Symptoms · Tap what sounds like you

Nothing ticked yet

Mention these at your first visit. It saves time and helps focus the exam.

Common causes

Prolonged or repetitive bending of the wrist at work or at home
Work with vibrating tools
Wrist fractures and dislocations
Arthritis of the wrist, and inflammatory conditions such as rheumatoid arthritis that affect the wrist tendons
A naturally smaller carpal tunnel from birth
Diabetes and other chronic illnesses that damage nerves
Fluid retention from pregnancy, kidney failure or lymphedema
Thyroid disorders
Obesity

03 · How the source is found

How Dr. Patel finds the source

Treatment only works when it is aimed at the right thing. This is how the source is confirmed.

Step 01
A history of which fingers are affected, when symptoms happen and what work you do
Step 02
Tapping over the nerve at the wrist (Tinel’s sign) and holding the wrist bent (Phalen’s test) to see if symptoms appear
Step 03
Testing sensation, grip and thumb strength, and checking for muscle thinning
Step 04
Examining the neck and elbow, since nerve problems there can cause similar symptoms
Step 05
EMG and nerve conduction studies to confirm the diagnosis and grade severity
Step 06
Ultrasound to look at the median nerve
Step 07
X-rays or MRI when a fracture, arthritis or another cause is suspected
Step 08
Blood tests for diabetes or thyroid disease when appropriate

04 · Your path to relief

Your path to relief

Care moves one step at a time, from the least invasive option up, and only as far as you need.

First-line care

A wrist splint that keeps the wrist straight, mainly worn at night
A relaxed grip during activities that involve repetitive wrist bending
Short breaks to stretch and bend the hands and wrists between tasks
Avoiding bending the wrist all the way up or down for long periods
Keeping the keyboard at elbow height and the wrists in a neutral position
Keeping the hands warm while working
Hand therapy, including nerve and tendon gliding exercises
Anti-inflammatory medication for short periods, when safe for you
Managing related conditions such as diabetes or thyroid disease

Targeted treatment

Joint Injections EMG and Nerve Conduction Studies Epidural Steroid Injections

Back to function

As a rehabilitation physician, Dr. Patel pairs every treatment with a plan to rebuild strength, movement and daily activity, so relief lasts.

Physical medicine & rehabilitation

Joint Injections

Medicine placed in or around a painful knee, hip, shoulder or other joint to ease pain and inflammation.

Learn more

EMG and Nerve Conduction Studies

Tests of nerve and muscle function that find the source of numbness, tingling or weakness.

Learn more

Epidural Steroid Injections

A steroid injection near irritated spinal nerves to calm pain that travels into the arm or leg.

Learn more

05 · When to call

When to call

When to see a specialist

Numbness or tingling in the hand keeps coming back
Symptoms wake you at night
You drop things or have trouble with buttons and fine tasks
Numbness has become constant
Symptoms are in both hands, or come with neck pain
Splinting and activity changes have not helped after a few weeks

Go to the emergency room if

Sudden numbness or weakness in one arm or hand with facial droop, trouble speaking or confusion; call 911
Severe pain, swelling or deformity of the wrist after a fall

06 · Questions

Questions

Do I need a nerve test?

Not everyone does, but EMG and nerve conduction studies are the standard way to confirm carpal tunnel syndrome and grade its severity. They also show whether the problem is at the wrist, the elbow or the neck. Testing is especially useful before an injection or surgery.

Does a wrist injection help carpal tunnel syndrome?

A corticosteroid injection into the carpal tunnel can reduce swelling around the nerve and ease symptoms. Many people get relief for weeks to months, and for some it lasts longer. Imaging guidance such as ultrasound helps keep the needle away from the nerve. Relief tends to be shorter when the nerve is severely compressed.

Will I need surgery?

Many people with mild to moderate carpal tunnel syndrome improve with splinting, activity changes and sometimes an injection. Surgery to release the ligament is usually considered when symptoms are severe, the thumb muscles are wasting, or nerve testing shows significant damage. Dr. Patel will refer you to a hand surgeon if that is the case.

Can a pinched nerve in the neck feel like carpal tunnel?

Yes. A pinched nerve root in the neck, especially at the C6 level, can cause tingling in the thumb and index finger. Some people have pressure in both places at once. Dr. Patel examines the neck and uses nerve testing to tell the difference.

Is carpal tunnel syndrome caused by typing?

Typing alone is a weaker risk factor than many people think. Forceful gripping, repetitive wrist bending and vibrating tools carry more risk. Even so, a neutral wrist position and regular breaks often ease symptoms.

This page explains a condition or treatment in general. It is not a diagnosis or medical advice for you. Dr. Patel will explain what applies to you at your visit.