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Carpal Tunnel Syndrome Symptoms

Since the median nerve provides sensations to the palm side of the thumb, index, middle and ring fingers, and supplies the muscles that are responsible for thumb movement (see Figures 1 and 2), the carpal tunnel symptoms will affect those areas. The symptoms of carpal tunnel syndrome include:

  • Numbness or tingling in the thumb, index, middle, and half of the ring finger.
  • Pain in the hand and wrist that can radiate to forearm and sometimes arm or neck.
  • Weaker grip, occasional clumsiness, or a tendency to drop things.
  • Difficulty with grasp is usually seen in severe and chronic cases, where the muscles at the base of the thumb slowly shrink (thenar atrophy).

Carpal tunnel symptoms may first occur in one or both hands during the night. They start gradually, with burning, tingling or numbness in the palm of the hand and the fingers, which can become severe enough to wake the individual from sleep. Some patients notice finger swelling, even though little or no swelling is apparent. Carpal tunnel symptoms can be provoked by activities requiring prolonged wrist flexion/extension or prolonged forceful grasping. 

As carpal tunnel symptoms worsen, tingling may be felt during the day. Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. Some people are unable to tell between hot and cold by touch. Carpal tunnel syndrome is often characterized by periods of remission and exacerbation.

Figure 1. The carpal tunnel is found at the base of the palm. It is formed by the bones of the wrist and the transverse carpal ligament.

Figure 2. Aspects of median nerve function.

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