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If your fingertips feel tingly or numb, you might have carpal tunnel syndrome (CTS). CTS refers to the signs and symptoms of the median nerve not working well at your wrist. The tingling can sometimes become so intense that it is painful. You can wear a splint to help you sleep, but eventually, you’ll likely need surgery to avoid permanent loss of feeling. Some doctors might suggest steroid injections, but it's not clear how much they help.
One of the important nerves in your arm is called the median nerve. It travels from your neck to your fingertips.
This nerve helps you feel things with the tips of your thumb, index, middle, and part of your ring finger. It also helps you make specific thumb movements. The nerve travels through a tunnel in your wrist made by wrist bones – the carpal tunnel. There's a band forming the top of this tunnel.
The nerve can stop working well at this tunnel. The signs and symptoms of the nerve not working well is called carpal tunnel syndrome (CTS).
CTS is caused by a nerve in your wrist not working well. If you are born with a narrower tunnel, you have a higher chance of experiencing CTS.
Risk factors for carpal tunnel issues include:
Problems in the median nerve are present in about a third of people by age 65, although levels of symptoms vary.
Early signs include tingling in the fingertips, especially at night. Later signs include loss of feeling in the fingertips.
When you lose feeling, you may have difficulty handling buttons and small objects.
If your symptoms only bother you at night, you can try wearing a splint to keep your wrist straight. If your hand goes numb regularly even with the splint on, it takes a while for the numbness to go away, or the numbness becomes constant, surgery is recommended.
Doctors diagnose problems with your nerve by talking to you and examining your hand. They might suggest a test called a nerve conduction study to determine how well your nerve is working. Some doctors also use ultrasound to look at your nerve.
If you only experience symptoms at night, wearing a splint or brace can help you sleep. Some doctors may inject steroids into the carpal tunnel, but studies show this may only provide temporary relief.
If your median nerve isn’t working well or if a brace no longer helps, surgery might be an option. During surgery, the surgeon will cut the ligament that is at the top of the carpal tunnel and squeezing your nerve. Your wrist and fingers will keep working normally afterward.
This procedure can be done in an office, surgery center, or hospital. There are different ways to do the surgery, including open and minimally invasive options, such as endoscopic (with a camera) and ultrasound guided. Many people have local anesthesia, which provides pain relief directly at the surgical site, and don’t go to sleep for the surgery. Our plastic surgery hand team uses the most advanced and innovative techniques to help you recover as fast as possible.
Using a brace or having surgery can quickly relieve nighttime tingling. If you have constant numbness or weakness in your thumb, those changes could be permanent. Your nerve can continue to improve for two to three years after surgery.
With some of the ways of doing surgery, you can resume your activities as soon as the next day. It's important to keep using your hand for everyday activities right after surgery to prevent stiffness and speed up your recovery. You may have some soreness in your palm for a couple months, which is normal.
If your carpal tunnel syndrome was severe, the nerve might not fully recover, and you could still have some numbness or weakness. Talk about this possibility with your doctor.
UPMC Brachial Plexus and Peripheral Nerve Disorder Center
UPMC Mercy Professional Building
1350 Locust St., Suite G-103
Pittsburgh, PA 15219
412-232-5616
By UPMC Editorial Staff. Last reviewed on 2024-07-29 by Teun Teunis, MD, PhD.
