These 3 moves may signal you’ve got carpal tunnel syndrome

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Q: I have a dull ache and tingling in my hands. How do I know if it’s carpal tunnel syndrome? Could it be caused by typing or scrolling?

A: Carpal tunnel syndrome is a common condition affecting the median nerve, which is responsible for sensation in the thumb, index finger, middle finger and part of the ring finger. Symptoms include uncomfortable feelings in our hands and wrists – numbness, tingling and clumsiness doing everyday tasks such as holding a steering wheel or buttoning clothes.

It’s incredibly common: An estimated one in five clinic visits in the United States are for carpal tunnel syndrome, and a Finnish study found that about 3 percent of the population gets a surgical procedure to relieve it. The syndrome appears to affect more women than men, and, for reasons we don’t quite understand, Americans more than those in other countries.

If your symptoms seem like they could be due to carpal tunnel, your doctor may have you try a few simple maneuvers to figure it out. A positive result would be if you develop symptoms such as numbness, tingling or aching in the part of the hand innervated by the median nerve.

– Hand elevation test

Raise and hold your arms above your head, keeping your elbows and shoulders loose. About 3 of 4 people with carpal tunnel syndrome will develop symptoms within two minutes, and 98.5 percent of people without carpal tunnel do not develop symptoms performing this maneuver.

– Phalen’s test

Flex your hands downward at 90 degrees from your forearm and then press your two wrists together (your fingernails should now be touching). If you develop symptoms within one minute, it’s considered positive.

– Tinel’s sign

Tap the base of the wrist of the affected hand with two fingers repeatedly for up to 60 seconds. A positive Tinel’s sign would be if you feel tingling or even electric shocks.

Keep in mind these maneuvers are not perfect. They can point you in the right direction, but it’s important to see your doctor who will evaluate the sensation and muscles of your hands in more detail and rule out other potential conditions. In some cases, your doctor may recommend additional testing, such as a nerve conduction study, to confirm the diagnosis.

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What triggers carpal tunnel syndrome?

Certain repetitive tasks such as typing are associated with developing carpal tunnel syndrome, though the data is mixed whether activities like spending time on the computer truly cause it – some have found that carpal tunnel is more common among those who work in non-computer-related jobs.

Research is limited on the impact of smartphones, but in one Saudi Arabian study of nearly 300 people, those who used their smartphones between four and seven hours per day had higher odds of carpal tunnel syndrome than those who used their smartphones less than one hour per day.

Women may be more predisposed because the carpal tunnel tends to be narrower in women than in men. Many conditions including obesity, diabetes, and pregnancy raise the risk of carpal tunnel syndrome. In the case of pregnancy, symptoms often become worse in the third trimester but can resolve within a few weeks postpartum. The shape of the wrist bones seems to play a role, and this, along with other heritable conditions like rheumatoid arthritis associated with carpal tunnel, is possibly why it can run in families.

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What is carpal tunnel syndrome?

The carpal bones are eight small rocklike bones that comprise our wrists. A ligament drapes across them like a bracelet to form what’s called the carpal tunnel. Tendons and the median nerve of our hand pass through that narrow space.

It doesn’t take a lot for the space to get too tight. Normally in a neutral position, the pressure in the tunnel is around 2.5-5 mm Hg. When you flex your wrists, such as when using a computer mouse, that pressure rises. In some patients, that pressure can rise to as high as 100 mm Hg – at which point blood flow to the median nerve gets choked, and the nerve itself is compressed. This leads to the symptoms associated with carpal tunnel syndrome.

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How do you fix carpal tunnel syndrome?

Symptoms of carpal tunnel syndrome are often worse at night and can wake people from sleep. In these cases, wearing a wrist splint for a short period can help. Doctors may also consider a steroid injection to the carpal tunnel that can ease any inflammation raising the pressure. In a randomized controlled trial, oral nonsteroidal anti-inflammatory medications were not shown to be helpful.

People with more moderate to severe symptoms – such as being unable to perform household tasks from hand weakness – or serious abnormalities of their median nerve detected by specialized tests may need a surgery called carpal tunnel release. This surgery is often done with local anesthesia (meaning, you’re awake) and has a quick recovery time.

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What I want my patients to know

When people experience new hand symptoms, they can be quick to attribute it to carpal tunnel syndrome because it is a relatively well-known condition. But there are many other reasons you might experience symptoms including from arthritis, Raynaud’s disease and wrist strain or other neuropathies that aren’t related to the median nerve. It’s important to talk to your physician about your symptoms to help make the right diagnosis.