Symptoms of Carpal Tunnel Syndrome vary from person to person.  But, the most common symptom is the feeling of pins and needles in the index and middle fingers of the affected hand.  This is usually the first sign of the condition.     

In the early stages, it is normal for symptoms to come and go, and they almost always affect the fingers and thumb.  Typical symptoms include:

  • Pain
  • Tingling
  • Itching
  • Dry skin

Carpal Tunnel Syndrome can also cause itching and numbness in the palm, although this is less common.

While the condition primarily affects the hands, it is also known to cause pain and aching in the wrist, arm, shoulder and neck. Some people also experience an uncomfortable burning sensation.

Living with Carpal Tunnel Syndrome

Over time, symptoms become more frequent and persistent.  They can also worsen, affecting day to day activities.

  • Impaired sensation and altered feeling in the fingers and thumb affecting fine finger movements making everyday activities more difficult, such as fastening buttons
  • Weakness in the affected hand making it harder to grip objects
  • Loss of coordination in the thumb creating challenges with everyday hand movements
  • Swollen sensation in the fingers causing clumsiness

Carpal Tunnel Syndrome symptoms at night

The symptoms of Carpal Tunnel Syndrome are often first noticed during the night because most people sleep with a flexed wrist, and disturbed sleep is a common complaint. It is also normal to experience them first thing in the morning, often feeling the need to ‘shake out’ the wrist to relieve symptoms.

While it isn’t unusual for symptoms to occur only during the night, in more severe cases, it can be uncomfortable throughout the day as well. The amount of pressure on the nerve affects the severity of the symptoms and daytime activities such as holding the telephone, and gripping objects can exacerbate pain, tingling or other unpleasant sensations. Many people find temporary relief from their symptoms by either hanging the hand down or raising it up.

How is Carpal Tunnel Syndrome diagnosed?

Diagnosis and treatment are vital to prevent irreversible and disabling damage. While symptoms can be bearable in the short term, longer-term damage can include muscle wasting in the affected hand.

A GP will perform several tests to rule out other conditions and make a diagnosis. Often, Carpal Tunnel Syndrome is easy to diagnose because the symptoms are typical of the condition. A physical examination assesses the hands, wrists, arms, shoulders and neck for discomfort associated with Carpal Tunnel Syndrome. In particular, fingers are checked for impaired sensation, and hand muscles are tested for strength and signs of muscle wasting.

Carpal Tunnel Syndrome tests

Two further tests which may be carried out during the physical examination are the Tinel test and Phalen’s manoeuvre. Both tests reproduce the symptoms of Carpal Tunnel Syndrome by placing pressure on the median nerve.  A positive response is an indication of the condition.

Occasionally a referral is made for further tests such as blood tests, ultrasound imaging or x-ray to check the size of the median nerve.

On rare occasions when the diagnosis is not definite, electrodiagnostic tests are used to confirm it.

Once Carpal Tunnel Syndrome is diagnosed, treatment options can be considered.

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