If you develop numbness and tingling in your thumb and fingers that won't go away, you may have carpal tunnel syndrome.

Carpal tunnel syndrome involves compression of the median nerve that passes through the carpal tunnel. The carpal tunnel, located at the base of your hand, runs across the inside of the wrist.

"Carpal tunnel is one of the most common upper extremity complaints," says Kai Yang, MD, Nebraska Medicine hand surgeon. "The longer you have carpal tunnel, the more sensation you will lose in your thumb and fingers as well as motor strength in the thumb."   

Common symptoms of carpal tunnel syndrome

Some of the most common symptoms of carpal tunnel syndrome include:

• Numbness and tingling in the thumb, index and middle fingers
• Waking up at night with numbness in the thumb and fingers
• Weakness in the muscles at the base of the thumb
• Weakness in your ability to grip things 
• Pain that radiates up your forearm

Risk factors for carpal tunnel syndrome

Often, there is no single cause of carpal tunnel syndrome. Instead, it is usually related to several risk factors, says Dr. Yang. Primary risk factors include:

• Anatomy – You may have a small carpal tunnel space. The size and shape of your carpal tunnel are hereditary. There may be a genetic factor if the condition appears to run in your family 
• Pregnancy – Pregnant women often experience inflammation and fluid retention that can increase the pressure in the carpal tunnel 
• Occupational – Positioning of the wrist that results in extreme flexion or extension and certain repetitive motions from work or hobbies can increase pressure in the carpal tunnel
• Obesity – Extra weight or fluids in the carpal tunnel can cause increased pressure on the median nerve 
• Diabetes – While the exact reason is unknown, individuals with diabetes are at greater risk. It may be due to small vessel disease common in diabetics
• Trauma – A wrist fracture can change the space in the carpal tunnel, leading to pressure on the median nerve
• Rheumatoid arthritis – Inflammation around the tendons in the wrist can compress the median nerve. It is typically not related to osteoarthritis.

Contrary to popular belief, no conclusive evidence has directly associated carpal tunnel syndrome with extensive computer use, says Dr. Yang. 

Carpal tunnel syndrome typically doesn't go away on its own, with the exception of pregnancy. After delivery or once you stop breastfeeding, you may experience a relief of your carpal tunnel, he says. 

Home remedies

If you suspect you may have carpal tunnel syndrome, you can try some measures on your own to reduce stress on the hands and wrists. These include: 

• Wear a wrist splint
• If your work involves the wrists and hands, take short, frequent breaks to relieve pressure, especially if the equipment you use involves vibration
• Reduce your grip and change positions or tasks occasionally
• Make sure your wrist is comfortable and in a neutral position when using a mouse

If you continue to have pain and tingling after two to three weeks of home remedies, you should seek medical advice, says Dr. Yang. 

"Diagnosing carpal tunnel syndrome requires a physical evaluation and interview," he says. "There isn't just one test that can diagnose it." 

Treatment for carpal tunnel syndrome

• Wearing a wrist splint
• Avoiding activities that make it worse
• "While steroid injections are a known possible treatment, use of steroids varies among hand surgeons," says Dr. Yang. "I reserve steroid injections for pregnancy related symptoms only." 
• Carpal tunnel release surgery 

Carpal tunnel release surgery

"If conservative measures don't alleviate the pain and tingling after a few weeks to months, you may be a candidate for surgery," Dr. Yang says. Carpal tunnel release surgery is a 10-minute outpatient procedure that involves making an incision to the ligament in the carpal tunnel to open the space in the area.

"Most patients get very good results with surgery and have quick relief of numbness and tingling within one to two weeks of surgery," Dr. Yang explains. "The hand and thumb will gradually get stronger over time. The nerve usually needs several months to recover. If you have waited a long time to seek treatment sometimes the nerves incur significant injury, resulting in some lingering pain and numbness."

Patients are advised to avoid heavy lifting for a month after surgery. A physical therapist will also work with you to learn nerve glide exercises. These exercises involve performing slow, controlled movements using the arm and wrist to improve blood flow and promote smooth and regular movement of the nerves. 

Once you've undergone surgery, carpal tunnel syndrome usually does not come back. "If it does return, it is usually due to a significant degree and duration of compression of the nerve prior to surgery," says Dr. Yang. "A revision surgery is possible but not always helpful. Discuss your options with your surgeon."