The carpal tunnel is a narrow passageway between the bones and the ligaments in your wrist. The median nerve, which controls sensation in the fingers and some muscles in the hand, passes through this tunnel along with some of the finger tendons.

• Numbness or tingling in the fingers of one or both hands, except for the little finger.
• Numbness or pain in your hand or wrist that wakes you up at night.
• Numbness or pain that gets worse when your use your hand or wrist, especially when you grip an object or bend (flex) your wrist. Examples could be driving an automobile, or holding a telephone up to your ear.
• Occasional aching pain in your arm from your hand to your elbow (occasionally to the shoulder).
• A weak grip.

Prevention

• Stop any activity that you think might be causing finger, hand, or wrist numbness or pain. If your symptoms improve when you stop an activity, resume that activity gradually and with greater efforts to keep your wrist straight or only slightly bent.
• Use your whole hand (not just your fingers and thumb) to grasp objects.
• Reduce the speed and force of repetitive hand movements such as typing.
• Switch hands and change positions often when you are doing repeated motions.
• Take frequent breaks and rest your hands.
• If you are not able to change positions or equipment at work often enough to prevent numbness or pain, wear a wrist splint that will reduce stress on your fingers, hand, or wrist. Obviously your employer should be told if you are having problems.
• Pay attention to your posture, when you are typing. Make sure your fingers are lower than your wrists (using a keyboard wrist support may help). When your forearms are hanging by your sides, keep your shoulders relaxed.
• Keeping your arm, hand, and finger muscles strong and flexible and maintaining good overall fitness will also help to prevent the symptoms of carpal tunnel syndrome.
• Avoid using too much salt if you tend to retain fluid.
• Make sure that your computer table and chair and mouse are kept at the proper heights to prevent too much extension or flexion at your wrist.

Home treatment

• Follow the prevention tips above.
• Use non-steroidal drugs such as aspirin, ibuprofen, or naproxin to relieve pain and reduce swelling. Please be aware that these can have significant side effects and drug interactions. Tylenol can be taken to relieve pain, but it does not reduce swelling. Tylenol is a much safer drug if you’ve had any problems with your esophagus or stomach or if you are on other medications that can interact with non-steroidal drugs. Non-steroidals should not be taken if you’re hypertensive, have kidney or heart problems.
• Apply ice or a cold pack to the palm side of your wrist.
• Avoid sleeping on your hands. Wear a wrist splint at night to relieve pressure on your wrist.
• Do simple range-of-motion exercises with your fingers and your wrist to prevent stiffening. Stop if you have pain.
• Other lifestyle changes such as losing weight, quitting smoking, reducing the amount of alcohol that you drink, and controlling diabetes may help relieve symptoms of CTS that are related to swelling.
• Vitamin B-6 has not been shown to be effective treatment for carpal tunnel syndrome. Vitamin B-6 can also in some patients cause peripheral neuropathy symptoms such as tingling or numbness in the fingers or toes.

When to call a healthcare professional

• If tingling, numbness, weakness, or pain in your fingers and hand has not gone away after two weeks of home treatment. Please remember if these symptoms go on for a prolonged period of time, there can be permanent damage to the median nerve that may not be able to return to normal even after surgery is done.
• If you have little or no feeling in some of your fingers or hand.
• If you cannot do simple hand movements or you accidentally drop things more frequently.
• If you cannot pinch your thumb and first finger together or your pinch is weak.
• If you cannot use your thumb (no thumb strength).
• If you have problems at work because of pain in your fingers or hand.