February 24, 2026
Carpal tunnel syndrome is known to be caused by repetitive hand and wrist movements. But you don’t have to work in a factory or type all day long to develop it. Everyday tasks, such as driving, holding your phone or lifting a baby from their crib can lead to the pain and discomfort known as carpal tunnel syndrome (CTS).
So, what exactly is CTS?
It's a group of symptoms that occur when your median nerve — the main nerve running from your armpit into your hand — gets squeezed. The compression takes place — you guessed it — in the carpal tunnel, a narrow space between the bones in your wrist and the tendons keeping those bones in place.
"That small space houses several tendons along with the median nerve," says Julia Nuelle, MD, an MU Health Care orthopedic surgeon and hand specialist. "Any time fluid builds up, tissues become inflamed or there are changes to the wrist bones, it can put pressure on that nerve and cause it to dysfunction."
The median nerve supplies feeling to most of your fingers and thumb. So, when it's not working as it should, you'll know it — often by the tingling in your fingers.
CTS gets progressively worse without treatment and affects up to 5% of the general population, so it's a good idea to know the facts. Dr. Nuelle shares six critical things to know about CTS:
1. Carpal Tunnel Syndrome Can Cause Discomfort From Your Fingertips to Your Elbow
When the median nerve is compressed in the wrist area, you can feel the effects in either direction. The most common CTS symptoms are:
- Numbness and tingling in the fingers, specifically the thumb, index finger, long finger and half of the ring finger
- Feeling that your fingers are swollen even when they are not
- Difficulty completing fine motor tasks, like buttoning a shirt
- Pain felt at the base of your wrist
- Shock sensations that may travel down to your fingertips or up through your forearm
"You should be able to move your wrist through a full range of motion and hold it there for a reasonable amount of time without your fingers going to sleep," Dr. Nuelle says. "If your symptoms are happening often or are consistent with certain movement, it's not normal and should be evaluated."
Dr. Nuelle recommends seeing a doctor if:
- Numbness and tingling do not improve with position changes
- Pain and symptoms wake you from sleep
- The fleshy mound at the base of your thumb looks flat or hollow and causes difficulty using your thumb
2. ANY Repetitive Action Can Lead to Carpal Tunnel Syndrome
It doesn't take much to jumpstart the symptoms of CTS — just repetitive action that takes your wrist out of a neutral (straight) position and bends it forward or backward. Think about your wrist position when you blow-dry your hair, garden, strike certain yoga poses or text.
"When we put our wrists in flexed and extended positions repeatedly, it can put extra pressure on the median nerve," Dr. Nuelle says. She adds that some people are naturally at higher risk if they are born with a smaller or narrower carpal tunnel. "The nerve may be compressed just by the nature of the position."
To reduce your risk, pay attention to the position of your wrists and get them into neutral position whenever possible — it helps optimize blood flow to the median nerve. When you do spend time with your wrists bent, pause occasionally to move your fingers and wrists.
3. Hormone Changes, Injury and Inflammation Can All Cause Carpal Tunnel Syndrome
Repetitive movement is the most common cause of CTS, but it's not the only one. The narrow carpal tunnel is easily affected by:
- Fluid retention that may accompany thyroid issues or hormonal changes during pregnancy, perimenopause and menopause
- Inflammation occurring during pregnancy or due to health issues including rheumatoid arthritis, obesity and diabetes
- Swelling due to a ligament injury or broken bone
"The good news is that the symptoms of CTS often improve or go away completely once the underlying issue is resolved," Dr. Nuelle says.
4. Carpal Tunnel Syndrome Symptoms Tend to Worsen at Night
For many people with CTS, the symptoms can be worse at night — you may even be woken up by "pins-and-needles" in your fingers.
No one knows for sure why it happens, but experts suggest several explanations, which include:
- Blood pressure lowers at night, and CTS symptoms happen when the pressure in the carpal tunnel is higher than your blood pressure
- Fluid builds up with inactivity as you sleep
- You unknowingly sleep with your wrists bent or curled, which maintains pressure on the median nerve
"Whenever we are treating mild to moderate CTS, we ask patients to wear a neutral wrist splint at night," Dr. Nuelle says. "It helps keep their wrist in a neutral position while sleeping to lessen the pressure on the nerve."
5. CTS Symptoms Can Sometimes Indicate a More Serious Underlying Issue
If you have CTS symptoms, it's critical to rule out other disorders and issues, such as:
- Amyloidosis: This rare disorder causes abnormal proteins to deposit in organs and tissues. It can cause CTS, but its effect throughout your body requires acute care.
- Nerve compression elsewhere in the body: Nerve compression in the brachial plexus (near your shoulder) or cervical spine (your neck) can cause pain and tingling all the way down your arm and into your hand.
"We are always looking for other areas where the nerve can be compressed," Dr. Nuelle says. "Depending on specific symptoms and clinical findings, we may even conduct neurodiagnostic testing to record the activity of the nervous system to ensure we are focusing on the correct area and treatment plan."
6. There Is a Range of Treatment Options for CTS
Treatment is critical to slowing or stopping the progression of CTS. Depending on the severity of the compression and your symptoms, there are several treatment options. Up to 90% of mild-to-moderate CTS cases respond to conservative treatment measures.
"We use neurodiagnostic testing to grade the severity of your CTS and determine the best treatment at this time," Dr. Nuelle says. "CTS needs to be addressed before it progresses, and if you wait too long, there's no guarantee that even surgery can resolve the issue."
Treatment for CTS includes:
- Positioning with a brace: Nighttime neutral wrist splinting is the first line of treatment. It ensures adequate blood flow to the median nerve and can reduce symptoms.
- Steroid injections: This approach can provide quick relief if splinting isn't helping. However, a single injection may not lead to a long-term and lasting resolution — you may need more than one injection.
- Carpal tunnel release: This surgical procedure offers a permanent cure for CTS. Traditional carpal tunnel release requires general anesthesia and an incision from your palm to beyond your wrist crease. A mini open carpal tunnel release is a minimally invasive approach that uses a smaller incision and is performed as an outpatient procedure.
"For moderate to severe CTS, or mild CTS that hasn’t responded to nonsurgical measures, a mini open carpal tunnel release offers an outpatient option requiring very little recovery time," Dr. Nuelle says. "If you don't need surgery, keep the nerve as healthy as possible by consistently bracing your wrist at night and eating a diet rich in vitamins and minerals."
Next Steps and Useful Resources
- Want to discuss more with a doctor? Find one today.
- Want to learn more about carpal tunnel treatments, including outpatient procedures? See our services.
