Carpal Tunnel Syndrome: What Causes Numbness in the Hands?

Carpal tunnel syndrome is a condition that occurs when the median nerve in the wrist is compressed within a narrow passageway, typically manifesting as numbness, tingling, and a loss of strength in the hand. Especially among desk workers who heavily use keyboards and mice, or those spending long hours on smartphones, the symptoms of this nerve compression are affecting more people every day. What begins as a dull ache that wakes you from sleep can eventually progress to a point where even the simplest daily tasks become a struggle.

At a Glance

• Caused by the compression of a nerve within a narrow canal in the wrist.
• The most distinct sign is a tingling and numbness that wakes you up at night.
• Usually concentrated in the thumb, index, and middle fingers.
• In the early stages, it can be managed with ergonomic adjustments and wrist splints.
• For advanced cases, a brief surgical procedure provides a permanent solution.

What is Carpal Tunnel Syndrome?

On the inner side of our wrist lies a narrow passageway surrounded by bones and connective tissues; this is called the carpal tunnel. The median nerve, which provides movement and sensation to our fingers, passes through this tunnel along with the tendons that bend our fingers. Swelling or thickening of the tissues inside the tunnel for various reasons creates pressure on the median nerve. Much like a blockage restricting water flow in a narrow pipe, this pressure on the nerve disrupts the signals travelling to your hand.

This condition is generally seen in adulthood, becoming more frequent after the age of thirty. Because the anatomical structure of the carpal tunnel in women's wrists is naturally narrower than in men's, women are three times more likely to develop this issue. As technology has settled into the centre of our lives, it is now common to see this picture in individuals of all ages who constantly repeat the same hand movements.

Causes and Risk Factors

Repetitive movements that require keeping the wrist continuously bent or tense are among the main triggers of the syndrome. Typing at a computer for hours without a break, resting your wrist on the desk while using a mouse, working with vibrating hand tools, or holding a phone for long periods increases the pressure inside the tunnel. However, the problem does not always stem solely from physical strain.

Systemic conditions such as diabetes, thyroid disorders, and rheumatoid arthritis raise the risk by causing nerve damage or inflammation around the joints. Water retention (edema) during pregnancy can also cause temporary nerve compression. Genetic predisposition plays a significant role too; if you have a naturally narrow wrist structure, your risk is higher. If there are similar joint or nerve diseases in your family, sharing this with your doctor as part of your familial health history will be highly beneficial for early diagnosis. Obesity is another factor that triggers pressure within the tunnel by increasing the body's overall inflammatory load.

Symptoms of Nerve Compression

The disease usually progresses slowly and insidiously. In the initial stages, you may experience numbness and a pins-and-needles sensation in your hand, especially while reading a book, talking on the phone, or gripping the steering wheel while navigating Istanbul traffic. This tingling is typically felt in the thumb, index finger, middle finger, and half of the ring finger; the little finger is usually unaffected because a different nerve serves that area.

As it moves to the intermediate stage, symptoms intensify at night. Patients often wake up from their sleep with a feeling of swelling, burning, or numbness in their hands, feeling the need to shake or massage their hands for relief. In advanced stages, wrist pain can radiate up to the elbow or even the shoulder. Severe cases bring about weakness in the hand muscles; tasks requiring fine motor skills, such as holding a traditional Turkish tea glass (çay bardağı), buttoning a shirt, or opening a jar lid, become difficult. Complaints of suddenly dropping objects are quite common at this stage.

Diagnosis: How is it Diagnosed at the Hospital?

When you visit the hospital with your complaints, your doctor will first perform a detailed physical examination. They will gently tap the inner part of your wrist to see if it creates an electric shock sensation along the nerve (Tinel's sign). You will also be asked to bend your wrists and press the backs of your hands together for about a minute (Phalen's test) to check if the numbness increases in this position. Loss of strength and decreased sensation in the hand muscles are also evaluated during the exam.

The gold standard for a definitive diagnosis is the Electromyography (EMG) test. During an EMG, the electrical activity of muscles and nerves is measured. Using small electrodes placed on the skin or very fine needles, the conduction speed in the nerve is determined. If the median nerve is trapped in the carpal tunnel, the passage of electrical signals through this area will be noticeably slower. When necessary, ultrasound or MRI (Magnetic Resonance Imaging) can also be used to check the thickness of the ligaments in the wrist or to rule out other masses like cysts or tumours.

Treatment Methods

The treatment plan is shaped according to the severity of the symptoms and the degree of nerve damage. For cases diagnosed early, non-surgical (conservative) methods are preferred. The first step is the use of night splints, which reduce pressure on the nerve by keeping the wrist in a neutral (straight) position. By preventing the wrist from bending during sleep, these splints largely stop nighttime awakenings. During the day, it is recommended to make ergonomic adjustments in your workspace, use mouse pads with wrist support, and frequently perform hand stretching exercises.

Under a doctor's supervision, non-steroidal anti-inflammatory drugs may be used to reduce pain and inflammation. In more resistant cases, corticosteroid injections are administered directly into the carpal tunnel to quickly reduce swelling and relieve the nerve. However, if there is no improvement despite months of treatment, or if severe nerve damage is detected in the EMG results, surgical intervention comes to the forefront. In carpal tunnel release surgery, which takes about 15-20 minutes under local anaesthesia, the connective tissue pressing on the nerve is cut to widen the canal. While you can return to normal daily tasks within a few weeks after surgery, regaining full grip strength may take a few months.

Complications and Risk Groups

Untreated nerve compressions can lead to permanent damage over time. Prolonged pressure on the nerve causes the muscles at the base of the thumb to waste away (atrophy). This means a permanent weakening of the hand's gripping and pinching functions. Permanent loss of sensation can also develop; this increases the risk of injury when holding a hot pot or working with sharp tools, as the person cannot fully feel pain or heat.

Risk groups include not only desk workers but also musicians, dentists, hairdressers, textile workers, and assembly line workers who use their hands extensively. Diabetic patients are at a special risk because their nerves are more prone to damage. Complaints that arise during pregnancy usually regress spontaneously within a few months after birth, but may require intervention if they become permanent.

When to See a Doctor?

If the numbness or pain in your hands has started to affect your daily life, you should see a specialist without delay. A medical evaluation is absolutely necessary if you have the following symptoms:

• You wake up at night due to numbness and pain,
• You frequently drop objects because of weakness in your hand,
• You notice a visible shrinking or thinning in the muscles at the base of your thumb,
• Your complaints have not passed for weeks despite rest and simple painkillers.

On the other hand, numbness in the hand may not always originate from the wrist. If the numbness in your hand or arm starts suddenly and severely, and is accompanied by facial drooping, weakness in the leg, speech impairment, or confusion, this could be a sign of a stroke, not carpal tunnel. In such a situation, you must call 112 immediately without losing any time or go to the nearest emergency room.

The Process at BHT CLINIC

At our hospital, hand and wrist problems are meticulously evaluated by our experienced specialist team. When you present with your complaints, an accurate diagnosis is quickly established thanks to the multidisciplinary approach of our Hand Surgery and Microsurgery and Neurology departments. The degree of nerve damage is clearly determined with our advanced technology EMG devices, and the most appropriate treatment plan is presented to you.

When necessary, surgical procedures are performed in our modern operating rooms using microsurgical techniques to cause minimal damage to surrounding tissues. Bringing your previous EMG results, a list of your medications, and reports regarding your chronic illnesses with you when coming to the hospital will speed up the process. For possible sudden wrist traumas or severe pain, our emergency department provides uninterrupted service 24 hours a day, 7 days a week. You can book an appointment to start your treatment process and regain your health with our expert physicians.

Frequently Asked Questions

Does carpal tunnel syndrome go away on its own?

In the early stages, especially with rest and the cessation of straining movements, symptoms may ease. Cases developing due to temporary conditions like pregnancy can resolve spontaneously after birth. However, if the syndrome develops due to repetitive movements or chronic diseases, it usually progresses over time if left untreated.

Is numbness in the hand only caused by nerve compression?

No, nerve pressure in the wrist is not the only cause of hand numbness. A cervical slipped disc (neck hernia), diabetic neuropathy, Vitamin B12 deficiency, or nerve compression in the elbow (cubital tunnel syndrome) can also cause similar complaints. The exact cause must be determined by a physician's examination and an EMG.

Is there a risk of recurrence after surgery?

The risk of the disease recurring after carpal tunnel surgery is quite low. Because the connective tissue is completely cut and the canal is widened during surgery, the pressure on the nerve is permanently eliminated. However, in very rare cases, mild complaints may appear years later due to excessive scar tissue formation during wound healing.

Is wearing a wristband alone enough for treatment?

In mild cases, using a night splint prevents the wrist from bending during sleep and largely relieves the complaints. However, if there is advanced nerve damage or if muscle wasting has begun, using a wristband alone is not enough; physical therapy, injections, or surgical intervention may be required.

When can I return to work after surgery?

Desk workers can usually return to their jobs a few days to a week after surgery, provided they do not overstrain their hands. However, for those working in heavy manual labour or constantly using vibrating tools, returning to work at full capacity can take 4 to 6 weeks.

We wish you healthy days. For detailed information and examinations, you can book an appointment or reach our 24/7 call centre at 0850 811 34 00.

This article is for informational purposes only; please consult your doctor for diagnosis and treatment.