carpal tunnel syndrome - symptoms

In its early stages, most patients do not take the respective symptoms serious enough: what could be so bad about hands that numb at night? 

But the longer the nerve is jammed at the wrist the more likely it is to be irreversibly damaged. Quite frequently, the first symptoms of the carpal tunnel syndrome are sensory disturbances suffered from in thumb, fore- and middle finger, as these fingers are controlled by the Nervus medianus. These fingers then feel numb, ache and tingle as if they had gone to sleep.

Respective complaints are frequently experienced at night or when the limb is exposed to stress. They will in particular appear when the hand is bent, e.g. while holding the telephone or steering a car. This is also the reason for nocturnal pain because many people unwittingly slightly bend their hands when they sleep. While the carpal tunnel syndrome progresses, paraesthesia increases and becomes a permanent problem and the pain spreads across the arm. In advanced stages, the fingers numb and the thenar’s muscles atrophy, i.e. they become stunted.

Early stage symptoms

The symptom that most characteristically indicates the carpal tunnel syndrome is when your fingers numb at night. At first, shaking and relocating the affected hand will frequently help. However, if the condition is not treated the pain will increase. An additional symptom frequently is a tingling sensation on the palms - a certain sign for the median arm nerve (which controls the inner surfaces of thumb, fore- and middle finger as well as the fourth finger radially) to be compressed and jammed. Usually, at first one finger is affected by paraesthesia before it spreads across the other fingers. While the pain is first only suffered when the wrist has been exposed to strain, it will in later stages appear all of a sudden and without any obvious reason.

Symptoms in progressed stages

As time goes by, the pain will spread across the arm all the way up into the shoulder. The respective complaints go hand in hand with deteriorated tactile and touching skills of the fingers. In this stage, patients find it increasingly difficult to button up their clothes or pick up rather small items. The unpleasant feeling in the fingers will soon be replaced by their insensitivity. Step by step, a dent will appear on the thenar - this is so-called thenar atrophy.

Thenar atrophy is caused by the gradual regression of a thumb muscle that is innervated by the affected nerves. The muscular atrophy seriously affects the thumb’s functioning. Patients are, for instance, unable to splay it out, which makes it difficult to grasp things or hold a bottle. In this stage, the nerve has already suffered from severe damage. Frequently, it is now already too late to start with treatment because the nerval damage is irreversible. In consequence, the palms of the hand affected and the thumb might remain numb.

Symptoms in both hands?

If people suffer from carpal tunnel syndrome, they will usually experience respective symptoms in both hands - it is just that these symptoms are likely to first show on one hand. Months or even years may pass in between the carpal tunnel syndrome showing in one arm and first symptoms being experienced on the other side of the body, too. Usually, the right (i.e. the dominant) side is more prone to the problem with right-handed people, while it is just the other way round with left-handers. One reason why the carpal tunnel syndrome is more likely to show earlier on the dominant side is that this side’s hand is frequently used more intensely.

Take your symptoms serious and get treatment!

Just like with many other medical conditions, the course of carpal tunnel syndromes can vary significantly. Many patients suffer from slight complaints only for years and experience long periods without any symptoms. However, it is in particular those patients who are at a high risk - because if they don’t relate their early symptoms to the carpal tunnel syndrome, affected patients are likely to not see their doctor before their nerve has been damaged irreversibly.