My hand hurts at night!

Carpal Tunnel Syndrome

If pain runs up the palm of your hand and into all of your fingers except the little finger, especially at night or when using your hand in certain positions, there is a good chance that you have carpal tunnel syndrome. Tapping on the middle of the undersurface of the wrist may cause pain to shoot into your fingers or forearm.

carpal_tunnel_syndromeThe pain may be felt in your palm, and extend into the thumb, index, middle and ring fingers. It may feel like an aching, burning, numbness or tingling. Most of the pain may be in the index and middle fingers where the large PainSpot is located in the picture. By clicking on a hand image at, and answering several questions, you may find out whether your pain is typical of carpal tunnel syndrome. Holding your wrist in a flexed down position may increase the pain. Carpal tunnel syndrome often is painful at night or driving a car. Pain may also go from your wrist up the forearm.

Why is it called the carpal tunnel anyway?

The palm surface where your wrist and hand connect together contains the ‘carpal tunnel’. Usually nine tendons and one nerve go through this tunnel-like area. It is bordered by the wrist bones on the back of your wrist, and a strap-like ligament on the undersurface of your wrist.

If these tendons swell up around the nerve, it can pinch the nerve and cause carpal tunnel syndrome. Injuries, tendonitis, tumors or some unusual diseases cause buildup of other fluid or tissue in the area and also cause carpal tunnel syndrome.

What causes carpal tunnel syndrome?

Any condition which puts unusual pressure on the nerve in the carpal tunnel may cause carpal tunnel syndrome. Usually this is due to swelling in the tendons, or swollen arthritic tissue in the area. Excessive or unusual use of your fingers may cause tendinitis and swelling resulting in compression of the nerve. Inflammation and swelling from arthritic diseases such as rheumatoid arthritis also will pinch or crowd the nerve. Sometimes conditions causing fluid to build up in the carpal tunnel such as injuries or pregnancy will compress the nerve.

How do you know for sure you have carpal tunnel syndrome?

Specialized nerve conduction velocity testing (NCV) may confirm the diagnosis. At the same time, electromyography (EMG) testing will determine if the muscles of the hand have been affected.

What kinds of treatment gives the best relief?

Treatment depends upon the cause and severity of your symptoms. If your hand is weak as well as painful, surgery may be considered. If left untreated, permanent weakness may result. Before that point, physical therapy and a change in activities or work conditions are important. Often a brace to keep your wrist straight, especially at night is recommended. Sometimes injections of a cortisone-like medication are used to reduce inflammation and swelling. If rheumatoid arthritis is causing carpal tunnel syndrome, specific treatment prescribed by a rheumatologist will reduce swelling in the wrist area and reduce the - Deal of the Month Medical Supply Depot

About Doug Roberts MD

Board certified practicing rheumatologist and founder of
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