Carpal Tunnel Syndrome (CTS) is the most common cause of hand numbness and pain:

It is caused by compression of the Median Nerve as it goes through the wrist

• Specifically the Carpal Tunnel hence the name Carpal Tunnel Syndrome

 Usually the first three or four fingers are affected

• One finger may predominate since there are multiple branches of the nerve
• Pain or numbness at night is a typical symptom

People often report that it wakes them up at night

They often feel like they have to shake their hands to wake them up

Pain or Numbness while driving or riding a bicycle is also common

• This is due to the vibration and hand position

Women are more commonly affected than men

• The ratio is 5:1 and it is unknown why it is more common in women

Both hands are usually affected although one is usually worse than the other

• CTS is the most common cause of numbness that affects both hands
• Neck problems usually cause numbness in one hand or the other, not both

Special Tests for Carpal Tunnel Syndrome

• Tinel's Tapping
  • This test is positive for nerve irritation if tapping sends shock waves up or down the hand
• Phalen's Compression
  • This test is positive if compression of the nerve produces numbness and pain into the fingers

EMG Nerve Tests

• Using a special machine in the office, we can determine if there is any significant nerve damage

Grading CTS

• There are three grades depending on EMG results; Mild, Moderate and Severe
• These grades help us decide on the most appropriate treatment

Physical Therapy or Occupational Therapy

• This helps resolve any residual pain and promotes the natural healing process
• Ergonomic evaluation and bracing can also be beneficial

Surgical Decompression of the nerve is done if symptoms do not resolve

• Most common in patients where the EMG shows severe CTS