How do I know if I have carpal tunnel syndrome?

Common carpal tunnel symptoms include:

• tingling or “pins and needles” in fingertips
• night pain in hand, waking up from sleep
• numbness in thumb, index and middle fingers
• hand weakness

In most cases, the diagnosis of carpal tunnel syndrome is based on symptoms, medical history, and physical examination. A steroid injection into the carpal tunnel (cortisone shot) can be used for treatment and to help make the diagnosis. An electrodiagnostic study (nerve conduction study or EMG) can be ordered to confirm the diagnosis in some cases, but it is not always required. Hand surgeons are experts in making the diagnosis of carpal tunnel syndrome and they can rule out other causes of symptoms.

Many patients with carpal tunnel syndrome (CTS) improve with use of a wrist brace at night or a cortisone injection. Surgery is recommended in cases of severe carpal tunnel syndrome if there are signs of nerve damage. Surgery is also recommended if conservative treatment is not successful.

Patients with carpal tunnel syndrome (CTS) feel “numbness” or “tingling” in the fingers. Some patients feel that the hands are “asleep” and have poor circulation from time to time. Symptoms are often worse at night and wake patients up from sleep. Patients tend to shake out their hands for relief. Dropping objects, clumsiness with the hands, or a weak grip are also possible complaints. Some patients also report burning, electric pain, or “pins and needles” pain in the wrist or fingers.

In severe CTS, the hand is constantly numb in the thumb, index and middle fingers, and there is atrophy or loss of muscle bulk in the thumb muscles. These are signs of nerve damage.