Median nerve dysfunction; Median nerve entrapment; Median neuropathy
The median nerve provides feeling and movement to the thumb side of the hand. This includes the palm, thumb, index finger, middle finger, and thumb side of the ring finger.
The area in your wrist where the nerve enters the hand is called the carpal tunnel. This tunnel is normally narrow. Any swelling can pinch the nerve and cause pain, numbness, tingling or weakness. This is called carpal tunnel syndrome.
Some people who develop carpal tunnel syndrome were born with a small carpal tunnel.
Carpal tunnel syndrome can also be caused by making the same hand and wrist motion over and over. Using hand tools that vibrate may also lead to carpal tunnel syndrome.
Studies have not proved that carpal tunnel is caused by typing on a computer, using a mouse, or repeating movements while working, playing a musical instrument, or playing sports. But, these activities may cause tendinitis or bursitis in the hand, which can narrow the carpal tunnel and lead to symptoms.
Carpal tunnel syndrome occurs most often in people ages 30 to 60. It is more common in women than men.
Other factors that may lead to carpal tunnel syndrome include:
Carpal tunnel syndrome is a condition in which there is excessive pressure on the median nerve. This is the nerve in the wrist that allows feeling and movement to parts of the hand. Carpal tunnel syndrome can lead to numbness, tingling, weakness, or muscle damage in the hand and fingers.
During a physical exam, your health care provider may find:
Tests that may be ordered include:
Symptoms often improve without surgery. But more than half of cases eventually need surgery. Even if surgery is successful, full healing can take months.
If the condition is treated properly, there are usually no complications. If untreated, the nerve can be damaged, causing permanent weakness, numbness, and tingling.
Use tools and equipment that are properly designed to reduce the risk of wrist injury.
Ergonomic aids, such as split keyboards, keyboard trays, typing pads, and wrist braces, may be used to improve wrist posture during typing. Take frequent breaks when typing and always stop if you feel tingling or pain.
Symptoms may include any of the following:
Your provider may suggest the following:
Changes you can make in your workplace to reduce the stress on your wrist include:
Medicines used to treat carpal tunnel syndrome include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen. Corticosteroid injections given into the carpal tunnel area may relieve symptoms for a period of time.
Carpal tunnel release is a surgical procedure that cuts into the ligament that is pressing on the nerve. Surgery is successful most of the time, but depends on how long you've had the nerve compression and its severity.
Call for an appointment with your provider if:
Calandruccio JH. Carpal tunnel syndrome, ulnar tunnel syndrome, and stenosing tenosynovitis. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 76.
Zhao M, Burke DT. Median neuropathy (carpal tunnel syndrome). In: Frontera, WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 36.
Review Date: 4/18/2017
Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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