How Doctors Diagnose and Treat Carpal Tunnel Syndrome

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Carpal tunnel syndrome causes pain, tingling, numbness and other strange sensations in the wrist. However, several other conditions can cause similar symptoms. So how can a doctor figure out when carpal tunnel syndrome is to blame?

Your doctor has many tools to use for diagnosing carpal tunnel syndrome. Carpal tunnel treatments can ease your symptoms and help prevent further nerve damage.

Diagnosing Carpal Tunnel Syndrome

To confirm or rule out a diagnosis of carpal tunnel syndrome, your doctor will:

  • Ask about your symptoms. Be prepared to describe your symptoms in detail, including what makes your symptoms worse and what improves them. Your doctor will also ask about your medical history. This will include questions about other health problems you may have. Some health problems can raise your risk of developing carpal tunnel syndrome.

  • Perform a physical exam. Your doctor will press, tap and move your wrists to see what is uncomfortable for you. Your doctor also will look for signs of carpal tunnel syndrome, such as smaller, weaker muscles in your fingers and hands.

  • Order tests. These tests will measure how well the nerves in your hands send and receive signals. They can show if there has been damage to the nerve in your wrist.

  • Image your wrist. Your doctor may request imaging tests to get a picture of the inside of your wrist. You might have X-rays, ultrasounds, and MRI (magnetic resonance imaging) of your wrist. These tests can help determine if there's damage to the nerve. That can be a sign of carpal tunnel syndrome. The tests also can spot other things that might be causing your symptoms. These can include fractures or a growth in your wrist.

Treating Carpal Tunnel Syndrome

Carpal tunnel treatment options can ease pain, numbness, and tingling symptoms and help prevent permanent nerve damage.

Your treatment may be fairly simple if you caught carpal tunnel syndrome early. The first steps of treatment are:

  • Changing your habits. You may need to change specific aspects of your work or other activities that make your condition worse.

  • Taking medications. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help. Examples are ibuprofen and naproxen. These drugs ease the pain and inflammation that cause symptoms. Putting ice on your wrists also helps with inflammation.

  • Wearing a brace. It helps to keep your wrist in a straight position. Wearing a brace at night or during the day, or both, relieves pressure in your wrist. This can help ease your pain.

  • Exercising. Your doctor can suggest exercises to stretch the muscles and ease pressure on the nerve in your wrist. Your doctor also may suggest that you work with a physical therapist.

  • Getting injections. Your doctor may inject a corticosteroid into the carpal tunnel. These drugs reduce inflammation and can ease your symptoms. However, the shots often work for only a short time. Your symptoms may come back.

Severe carpal tunnel syndrome may not improve with these steps. Some people need surgery.

There are two types of carpal tunnel surgery. The goal of both is to reduce the pressure on the nerve in your wrist. To do that, they create more room inside the "tunnel" where the nerve is. Another name for it is carpal tunnel release. You may have an option of either open surgery or minimally invasive surgery with an endoscope.

  • Endoscopic carpal tunnel surgery. Another name for it endoscopic carpal tunnel release. The doctor makes 1 or 2 very small cuts in your wrist or palm. The doctor places a tiny camera inside and uses it to guide a small, special knife to split the ligament in your hand.

  • Open carpal tunnel surgery. The doctor makes a small cut in the palm of your hand and splits the ligament in your hand.

Most people recover well from carpal tunnel syndrome surgery. It takes a few weeks to get back to normal activities. But, it's very rare for symptoms to come back after surgery.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Nov 2

  1. Carpal Tunnel Syndrome Fact Sheet. National Institute of Neurological Diseases and Stroke. http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm

  2. Carpal Tunnel Syndrome. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/basics/definition/con-20030332

  3. Carpal Tunnel Syndrome. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00005

  4. Carpal Tunnel Syndrome. American Academy of Family Physicians. http://familydoctor.org/familydoctor/en/diseases-conditions/carpal-tunnel-syndrome/treatment.html

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