Carpal tunnel syndrome


Carpal tunnel syndrome causes numbness, tingling and is mainly caused by repetitive strain-related injuries.

Carpal tunnel syndrome is a neuropathy resulting from the compression of the median nerve in the carpal canal, an anatomical structure located between the hand and forearm. Through this rigid tunnel, beside the median nerve, are the flexor tendons which are lined by the synovial tissue. Any situation that increases the pressure inside the canal causes compression of the median nerve and the carpal tunnel syndrome.


The main cause of carpal tunnel syndrome is R.S.I. (Repetitive Strain Injury), generated by repetitive movements such as typing or playing musical instruments. There are also traumatic causes (falls and fractures), inflammatory (rheumatoid arthritis), hormonal and drug. Tumors are also among the possible causes of the syndrome.


The main symptom is paresthesia, a sensation of tingling or numbness, which manifests itself more at night and occurs mainly in the area of innervation of the median nerve. The evolution of the syndrome makes it difficult to manipulate small structures and perform simple tasks such as buttoning a button, threading a needle, or even holding a cup.


Two tests help establish the diagnosis: the Phalen test and the Tinel test.

The first consists of bending the wrist and keeping it bent for one minute. As this position increases the intracarpal pressure, if there is nerve compression, the symptoms get worse.

The Tinel test consists of bending the median nerve. If it is compromised, there will be a sensation of shock and tingling.

In some cases, it is necessary to order an electromyography to confirm the diagnosis.


The treatment takes into account the degree of impairment of the disease. If it is mild, an orthosis is recommended to immobilize the wrist and the use of non-hormonal anti-inflammatory drugs. If there is no improvement, cortisone is applied inside the carpal canal. Once the possibilities of clinical treatment are exhausted, surgery is indicated.


– Try to avoid activities that involve flexion-extension wrist movements;

– Remember that changes in thyroid hormones and diseases such as diabetes can lead to compressive neuropathies. See your doctor if you have a tingling sensation in your hands;

– Women in or entering menopause are more prone to carpal tunnel syndrome because of decreased estrogen production;

– Sit up properly and support arms and fists when using the computer. Do not forget that its inappropriate use is a risk factor for L.E.R. and carpal tunnel syndrome.


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