What is carpal tunnel syndrome?

Carpal tunnel syndrome usually creates pain and tingling in your hand because of pressure on the median nerve in your wrist. The median nerve and several tendons run from your forearm to your hand through a small space in your wrist called the carpal tunnel. The median nerve controls movement and feeling in your thumb and first three fingers.

What causes carpal tunnel syndrome?

The pain associated with carpal tunnel syndrome is caused by pressure on the median nerve, which in turn occurs from swelling or anything that makes the carpal tunnel smaller. Conditions or activities that can lead to carpal tunnel syndrome include: Wrist injuries and bone spurs, making the same hand movements repeatedly (especially if the wrist is bent down), obesity, pregnancy, illnesses such as hypothyroidism, rheumatoid arthritis, diabetes, and, last but not least, smoking, because it can reduce the blood flow to the median nerve.

What are the symptoms?

Carpal tunnel syndrome can cause tingling, numbness, weakness, or pain in the fingers or hand. Sometimes the pain encompasses the entire arm between your hand and your elbow.

Symptoms most often occur in the thumb, index finger, middle finger, and half of the ring finger. If you have problems with your other fingers but your little finger is fine, this may be a sign that you have carpal tunnel syndrome. A different nerve gives feeling to the little finger. The first symptoms are often initially noticed at night and you may be able to obtain temporary relief by shaking out your hand.

How is carpal tunnel syndrome diagnosed?

Dr. Alex will do a physical exam and ask about your health and activities. He’ll inquire about health problems such as arthritis and diabetes and ask if you are pregnant. He’ll also ask about recent injuries to your arm, wrist, or neck and or recent repetitive activities that could have hurt your wrist.

He will ask if you recently hurt your wrist, arm, or neck and he’ll want to know about your daily routine and any recent activities that could have hurt your wrist. He’ll check the feeling and strength in your neck, shoulders, hands, wrists, and arms.

How is it treated?

Mild symptoms usually can be treated with home care. For example, by stopping activities that cause numbness and pain, resting your wrist longer between activities, taking non-steroidal anti-inflammatory drugs, icing your wrists for 10-15 minutes every hour, or wearing a wrist splint at night to keep your wrist in a neutral position, you maybe be able to reduce mild pain and inflammation.

For long term improvement and maintenance at all times, practice keeping your wrists in a neutral position, switch hands often when performing repeat movements, and use your entire hand – not just your fingers – to pick up and hold objects. And, perhaps most importantly, keep your wrists straight with your hands higher than your wrists when using a keyboard.


If you’ve come to see Dr. Alex, the chances are very good that your symptoms are not mild and/or that you’ve tried home remedies that have not given you relief. Depending on your condition and the probable cause of your carpal tunnel syndrome, Dr. Alex may treat you with chiropractic manipulation, acupuncture, and/or ultrasound, or a combination of these treatments.

If, after a regimen of treatments, you experience little or no improvement, Dr. Alex may suggest blood tests to check for specific health problems and nerve tests to determine if the median nerve is working properly. As with many health problems, surgery is an option that should be exercised only when your symptoms are so painful that you can’t perform your normal work, leisure, or daily activities even after 3 to 12 months of non-invasive treatments.