Carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is a common medical condition characterized by compression of the median nerve at the wrist, in the area known as the carpal tunnel. This condition can cause a number of symptoms, including pain, numbness, tingling, and weakness in the hand and fingers.

Diagnosis of tunnel syndrome involves a comprehensive evaluation of the medical history, physical examination, and often specific diagnostic tests. Each of these aspects is detailed below:

The evaluation begins with a complete medical history, in which the doctor collects information about the symptoms, their duration, their severity, and any triggering factors. The patient's occupation and activities are also investigated, since certain jobs and repetitive movements may increase the risk of developing tunnel syndrome.

The doctor will perform a detailed physical examination of the affected hand and wrist. This may include tests to evaluate sensation, muscle strength, and ability to move. During the examination, the doctor may perform specific maneuvers, such as the Phalen test or the Tinel test, to provoke or reproduce the characteristic symptoms of tunnel syndrome.

To confirm the diagnosis and determine the severity of the condition, nerve conduction tests may be performed. Electromyography (EMG) and nerve conduction velocity are common tests that measure the speed and effectiveness of nerve signal transmission through the median nerve. These tests can help locate the location and severity of nerve compression.

In some cases, imaging studies, such as an ultrasound or magnetic resonance imaging may be performed to evaluate the anatomy of the wrist and rule out other causes of symptoms.

Tunnel syndrome can present a variety of phenotypes or clinical manifestations, varying in terms of severity and duration of symptoms. Common tunnel syndrome phenotypes include:

  • Mild Form: In mild cases, patients may experience occasional symptoms, such as tingling or numbness in the hand or fingers. These symptoms are usually intermittent and can be relieved with rest.
  • Moderate Form: In moderate cases, symptoms tend to be more frequent and persistent. Patients may experience pain, tingling, and weakness in the hand, which can affect their daily activities and sleep.
  • Severe Form: Severe cases of tunnel syndrome can involve intense and constant symptoms. Patients may experience significant hand weakness, loss of dexterity, and muscle atrophy. Quality of life is seriously affected in these situations.

It is important to note that tunnel syndrome is a progressive condition, and symptoms can worsen over time if not treated properly.


Medical treatment:

Medical treatment of tunnel syndrome is based on the severity of symptoms and may include several strategies:

  • Lifestyle Modifications: In mild cases, lifestyle changes and ergonomic adjustments may be recommended to reduce strain on the wrist and median nerve.
  • Physical therapy can be beneficial in improving muscle strength, mobility, and posture. Therapists can provide specific stretching and strengthening exercises.
  • Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and, in some cases, oral or injected corticosteroids may be used to relieve the pain and inflammation associated with tunnel syndrome.

Corticosteroid injections directly into the carpal tunnel may provide temporary symptom relief by reducing inflammation.

Occupational therapists can teach energy conservation techniques and strategies for performing everyday activities with less strain on the wrist.


Surgical Treatment:

When conservative treatments do not relieve symptoms or when tunnel syndrome is severe, carpal tunnel release surgery is considered an effective approach.

Carpal Tunnel Release Surgery: Carpal tunnel release is a commonly used surgical procedure. During surgery, the surgeon cuts the transverse carpal ligament that puts pressure on the median nerve. This relieves compression and allows the nerve to recover.


The prognosis after treatment for tunnel syndrome varies depending on the severity of the condition and how quickly it is treated. In general, most patients experience a significant improvement in symptoms after carpal tunnel release surgery.

The success of conservative treatment depends on the severity of the condition and the patient's individual response to therapies.

Early detection and timely treatment are essential to prevent long-term damage to the median nerve and improve the patient's quality of life.