Carpal tunnel syndrome is the most common nerve compression disorder in the upper extremity. It occurs when the median nerve, which runs from the forearm into the hand through a narrow passageway at the wrist called the carpal tunnel, becomes compressed. The condition affects millions of people each year.
The carpal tunnel is formed by the wrist bones on three sides and a tough band of tissue called the transverse carpal ligament on top. When the contents of this tunnel swell or the space narrows, pressure builds on the median nerve, producing the characteristic symptoms of numbness, tingling, and hand weakness.
Recognizing the Symptoms
Carpal tunnel syndrome typically develops gradually. Early symptoms are often mild and intermittent but tend to worsen over time without treatment.
- Numbness and tingling in the thumb, index, middle, and ring fingers
- Symptoms that wake you from sleep or are worse at night
- Pain or burning sensation in the hand and wrist
- Weakness in grip strength, especially when grasping small objects
- Tendency to drop things due to impaired sensation or weakness
- Symptoms triggered by sustained hand positions such as holding a phone or steering wheel
- In advanced cases, visible wasting of the thumb muscles
When to See a Neurosurgeon
Many people manage early carpal tunnel syndrome with wrist splinting and activity modification. A neurosurgical evaluation is appropriate when symptoms persist despite conservative measures, when nerve conduction testing shows significant compression, or when weakness or muscle wasting is developing. Dr. Waldron performs carpal tunnel release, a brief outpatient procedure under local anesthesia that permanently relieves the pressure on the median nerve.