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Tingling, Burning, Pins & Needles... the signs of Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is the most common type of nerve compression within the adult population, with the occurrence rate for females twice as high than that of males. The carpal tunnel is located on the palm side of your wrist and is formed by the carpal bones and a thick transverse carpal ligament. This narrow passageway contains the median nerve and the flexor tendons that bend the fingers. The median nerve provides sensation to the palm of the hand, thumb, index, long and part of the ring finger and innervation to several muscles of the forearm and hand. Carpal tunnel syndrome is caused by the compression of the median nerve through the carpal canal at the wrist level.

Median nerve compression in the carpal canal can be caused by various reasons, but is most commonly seen with bad wrist positioning (ex: poor desk posture) or frequent extreme wrist movements (ex: sleeping with your fingers and wrist bent). Pregnant women tend to have an increase in swelling in the carpal canal which can lead to the development of carpal tunnel symptoms for the duration of pregnancy. Additionally, manual laborers who complete forceful and repetitive tasks also tend to experience carpal tunnel symptoms.

Carpal Tunnel Symptoms

Carpal tunnel symptoms usually start to present themselves at night. Most often, symptoms start as pain through the hand due to improper positioning of the wrists while sleeping and can lead to individuals waking up at night and shaking their hands to dissipate the symptoms. As the severity of the nerve compression increases, symptoms such as pins, needles, tingling, and numbness can occur more frequently during day. Severe cases of median nerve compression can also lead to weakness and muscle wasting within the palm of the hand. Every day tasks become more difficult especially those that require an increased level of dexterity.

Carpal Tunnel Treatment

Early treatment by a Certified Hand Therapist can help to settle the inflammation within the carpal canal and decrease symptoms. Treatment for carpal tunnel syndrome can include custom orthosis fabrication to obtain proper wrist position, median nerve and tendon gliding exercises, as well as activity and ergonomic modifications. Remember, the sooner you address your symptoms, the easier and quicker the treatment will be so we can help you get back to what matters most.



  1. Lawrence, M. Erickson, M. (2021) Therapists’ Management of Compression Neuropathies at the wrist. Rehabilitation of the Hand and Upper Extremity (7th edition, Volume 1, pages 732-744). Philadelphia: Elsevier, Inc.

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