Carpal Tunnel Syndrome

Taking Care of Your Wrists

What is Carpal Tunnel Syndrome (CTS)? Numbness and altered sensation in your hand/s and fingers; symptoms worsening at night and improving with vigorous hand shaking; difficulty grasping objects or doing up buttons. These are some of the most commonly reported symptoms of Carpal Tunnel Syndrome (CTS). So, why might someone experience this particular cluster of symptoms? To understand this, it’s important to first review the basic anatomy for this part of the hand.

The ‘Carpal Tunnel’ describes a location in the wrist that resembles the shape of a tunnel, made up of wrist bones (floor) and a flat ligament called the flexor retinaculum (roof). Inside the tunnel there are a number of different structures, including tendons, blood vessels, and an important nerve called the median nerve. The median nerve, like all nerves, is responsible for transmitting information responsible for the movement of certain muscles in the fingers and hand, in addition to pain, temperature, and touch in the first 3½ fingers.


In the case of CTS, the median nerve is compromised, or irritated. As such, we will see deficits to specific movements, dexterity, and sensation. This is usually a result of the following pathways: (1) The structure of the Carpal Tunnel itself gets smaller; and/or (2) The structures within the Carpal Tunnel take up too much space; and/or (3) trauma. It is also important to understand that these pathways can be influenced by both occupational and non-occupational factors such as (but not limited to) repetitive use, awkward body mechanics, vibration, aging, diabetes, or arthritis.

Symptoms and Care

While CTS typically takes time to develop, it is important to understand individual risk factors. It is also important to recognize the key symptoms and seek an appropriate healthcare practitioner earlier rather than later for diagnosis and management. Detected early enough, simple activity modifications, splinting, and hands-on therapy may be sufficient; conversely, later stage management may involve more invasive treatment options like corticosteroid injections and surgical release.


In summary, altered sensations through the first 3½ fingers, night time wakings, improvements with hand shaking, and loss of strength/dexterity are the main symptoms to consider in CTS. If this sounds like you or someone you know, make sure to check it out!

Article written by Mike Levine on February 8, 2023.