Carpal tunnel syndrome (CTS) occurs when the median nerve becomes compressed as it travels through the carpal tunnel — a narrow passageway in the wrist. The median nerve supplies feeling to the thumb, index, middle finger, and part of the ring finger, and powers important thumb muscles.

When the nerve is compressed:

• Numbness and tingling develop in the fingers

• Symptoms often worsen at night

• In advanced cases, thumb muscles can weaken or waste away

Carpal tunnel syndrome is one of the most common problems treated by hand surgeons, and is seen more frequently in women.

How Carpal Tunnel Syndrome Is Diagnosed

Diagnosis is based on symptoms, patient history, and a focused physical exam by a hand specialist.

Additional tests may include:

Electrodiagnostic Testing (EMG/NCV)

• Measures how well the nerve conducts signals.

• Detects severity and rules out other causes of numbness (such as diabetic neuropathy or neck compression).

• Performed by a neurologist using small electrodes and fine stimulation needles.

Ultrasound

• A painless test to measure the size of the median nerve.

• Enlargement is strongly associated with CTS.

Diagnostic Steroid Injection

• If symptoms improve after injection, patients typically do well with surgery.

• Relief is temporary — symptoms often return weeks to months later.

Treatment Options for Carpal Tunnel Syndrome in Raleigh, NC

Non-Surgical Treatments

1. Night Splinting / Bracing

• Keeps the wrist in a neutral position to reduce pressure on the nerve.

• Especially helpful for nighttime numbness and tingling.

2. Exercises (Median Nerve Glides  (Video)/ Lumbrical Stretches)

• Can reduce symptoms in mild carpal tunnel.

• Often used together with bracing.

3. Steroid Injection

• Decreases inflammation and relieves symptoms for weeks to months.

• Best results in patients with recent onset of symptoms (<3 months).

• Not considered a permanent cure.

Surgical Treatment

If symptoms persist or nerve damage is present, carpal tunnel release surgery is recommended.
The goal is to increase space in the carpal tunnel and relieve pressure on the median nerve.

Two approaches are offered:

1. Mini-Open Carpal Tunnel Release

2. Endoscopic (small incision, faster recovery)- Click here to learn more about Endoscopic Carpal Tunnel Release

Surgery can be performed using:

• Local anesthesia (“wide-awake” surgery), or

• Local + light sedation (“twilight”)

Recovery After Carpal Tunnel Surgery

• Most patients notice immediate improvement in nighttime symptoms.

• Sensation returns gradually over weeks to months as the nerve heals.

• If numbness was present for a long time, some sensation may not fully return.

• Return to work depends on job demands.

  • Light duty / typing: 2–14 days

  • Heavy labor / tools: 4–6 weeks

Better outcomes occur when CTS is treated early.

FAQs

Can work cause carpal tunnel?
Repetitive gripping or vibrating tools may contribute, but typing alone has not been shown to cause CTS.

Carpal tunnel during pregnancy?
Hormonal changes and fluid retention can cause temporary CTS. Symptoms usually improve within one month after delivery.

What is “pillar pain”?
A temporary, aching pain at the base of the palm after surgery. Occurs in ~10% of patients. Improves with scar massage over weeks.

Other causes of hand numbness?

• Cubital tunnel syndrome (compression at the elbow)

• Cervical spine compression (pinched nerve in the neck)