Carpal tunnel syndrome

Carpal tunnel syndrome happens when the median nerve is compressed at the wrist. Night numbness in the thumb, index, and middle fingers is one of the most recognizable patterns.

What it feels like

Tingling or numbness in the thumb, index, middle, and part of the ring finger often wakes people at night.

Shaking the hand may temporarily relieve symptoms. Daytime gripping, driving, or phone use can flare them.

Advanced cases bring hand weakness, dropping objects, or thenar muscle thinning.

What is going on

The median nerve shares a tight space at the wrist with flexor tendons under the transverse carpal ligament.

Swelling, repetitive load, pregnancy, diabetes, and thyroid disease can raise pressure in that tunnel.

Cervical radiculopathy can mimic hand numbness, so neck screening matters.

How we evaluate

History of night symptoms, sensory mapping, and provocative wrist tests guide the first visit.

We examine the neck and elbow nerve sites so a double-crush or alternative entrapment is not missed.

Nerve studies are used when the diagnosis is uncertain or when procedural or surgical timing depends on severity.

What we may offer

Night splinting, load changes, and therapy strategies help many mild to moderate cases.

Corticosteroid injection into the carpal tunnel can help selected patients and sometimes clarifies the diagnosis.

Progressive weakness, thenar atrophy, or failed nonoperative care prompts surgical release discussion.

Why are nights worse?

Wrist flexion during sleep can raise tunnel pressure and irritate the median nerve.

Is this the same as a pinched nerve in the neck?

Not necessarily. Neck radiculopathy can look similar. Exam and, when needed, nerve testing separate them.

Do I need surgery right away?

Many people improve with splinting and activity changes first. Weakness or advanced nerve findings change urgency.

Can an injection help?

A carefully placed carpal tunnel injection can reduce symptoms for selected patients and support the diagnostic picture.