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Carpal Tunnel Numbness

Dr. Z • Apr 25, 2020

Carpal Tunnel Numbness

The term carpal tunnel numbness goes by many other popular names. Sometimes people call it dead hand or carpal tunnel hand. The proper medical term is paresthesia.


Whichever term you use, the feelings are about the same. Numbness is just one of the main symptoms of carpal tunnel syndrome. It's usually felt along with either pain or tingling. This article tells you:


  • What causes the numbness
  • Where the numbness is felt
  • How the numbness is best treated


The aim is to come away knowing the reason for your disorder and how to identify it. Most importantly, there are techniques outlined below so you can get a handle on how to eliminate carpal tunnel numbness and other symptoms for good.


FIND OUT: do you have carpal tunnel? No strings attached self-test.

What causes carpal tunnel numbness?

Whichever term yo use, the numbness or tingling sensation is a warning sign of carpal tunnel syndrome. Carpal tunnel syndrome (or just "carpal tunnel") is a type of peripheral entrapment neuropathy. Numbness is only one sensation you can feel. Usually, pain, tingling (pins & needles), burning and weakness are also felt.


The reason you have these feelings is because the median nerve becomes "entrapped" or crushed deep inside the wrist joint. This is a main nerve in the hand and carries sensations like pain, touch, and temperature. It relays these sensations from the palm side of the hand, thumb, and fingers (but not the little finger).


The nerve passes through a space in the wrist joint called the carpal tunnel. (Because of identical terms, many people confuse the condition with this anatomical space.) This space is actually a canal formed between wrist bones and a thick ligament. This transverse carpal tunnel ligament holds the wrist bones tightly together. The canal forms a passageway for the median nerve and flexor tendons of the hand to pass through.

carpal tunnel space

The flexor tendons lie right next to the median nerve. Carpal tunnel numbness, pain and tingling occur because the tendons inside the canal inflame and swell. In turn, the swelling squeezes down on the median nerve.


When it's crushed, the median nerve responds by sending scrambled signals to the brain. These signals are interpreted as pain, numbness, tingling -- and every other abnormal sensation due to carpal tunnel syndrome.


What causes the tendon swelling and inflammation in the first place? Nobody knows for sure. But it to be seems related to tendon stress, like straining your fingers repetitively and with force. That's why some doctors call carpal tunnel syndrome a repetitive stress injury.

numbness from carpal tunnel

Where carpal tunnel numbness is felt

Carpal tunnel numbness if felt differently in different people. You can have numbness alone. Or else it can be accompanied by pain, tingling, burning, and weakness in the hand or fingers.


Some people feel these symptoms almost to the elbow. Others feel symptoms like pain shoot up the hand, like electric shocks.


It’s extremely rare for symptoms of carpal tunnel to begin quickly. Instead, symptoms generally start so gradually that you don’t even notice them at first. Usually, the person feels hints of numbness or even itching in the palm or the fingertips.


Normally sensations are worse in the thumb, index and middle fingers. Sometimes the fingers feel swollen, even though they're not. These sensations can occur in one or both hands simultaneously.

where carpal tunnel numbness is felt

It’s especially common to first notice carpal tunnel numbness at night. Many people have to wake up and “shake out” their numb hands. If symptoms worsen, the numb sensation lasts into the day, generally along with pain and tingling.


As carpal tunnel numbness progress even more, it might also be accompanied by a loss of grip strength. It may be difficult to make a fist or grasp small objects. Patients also report finger clumsiness. That means difficulty tying a shoelace, picking up coins, or buttoning a shirt.


In severe carpal tunnel syndrome symptoms get more intense. Numbness is described as "crushing" or like having your hand in a vice. The carpal tunnel numbness (and other symptoms) become relentless. They last day and night with no rest. Severe carpal tunnel can also lead to losing sensations of hot or cold in the fingertips.


If the disorder goes untreated, the muscles at the base of the thumb waste away. That means the normally plump muscle below the thumb flattens out and wrinkles. This means catastrophic loss of hand function.

pins and needles feeling

How to treat carpal tunnel numbness

Before you start

Mild, moderate and severe cases of carpal tunnel numbness, pain, and tingling are treated by relieving pressure on the median nerve. That means decompressing the nerve as it passes through the carpal tunnel inside the wrist joint.


The decompression can be achieved by surgery or nonsurgical means. All have varying degrees of success. And no single treatment choice is right for every person. The factors to consider for treatment depend on:

 

  1. The severity of symptoms
  2. How long you’ve had symptoms, and
  3. To what extent symptoms affect your life.

 

No matter the severity, you must treat carpal tunnel symptoms as quickly as possible. That’s because, statistically the disorder will only worsen. So if pain or numbness are waking you up at night, it’s time to get treatment now.

severe pain

The next steps

An initial treatment generally involves resting the affected hand and wrist for at least 2 weeks. This means avoiding activities that may worsen symptoms.


Also, it’s helpful to immobilize the wrist in a brace while sleeping. This allows your hand to rest at night because it prevents further damage from unconscious twisting or bending while you sleep.


If simple rest doesn’t do the trick, then it’s time for more aggressive action. You can effectively treat carpal tunnel numbness and pain in one of two ways: non-surgically or surgically.


The American Academy of Orthopedic Surgeons (AAOS) says that 90% of the time, patients can successfully treat symptoms without surgery.


In fact, the National Institutes of Health fully endorses non-surgical therapy for at least 6 months before doing anything else. They advise these treatments for carpal tunnel numbness and pain work best if:

 

  1. Patients under 50 years old.
  2. Symptoms are mild to moderate and not constant.
  3. The symptoms began less than 10 months ago.

 

Studies show that non-surgical remedies also work best if the patient commits to treatment. No treatment (surgery or non-surgical) is a short term, instant remedy. They require dedication and daily attention for one to several months (and up to a year for surgery).

The most effective remedies

Braces

carpal tunnel night brace

Braces (splints) are the most commonly used non-drug treatments for carpal tunnel numbness and pain. For most people, the position of the wrist is vital to controlling symptoms. Therefore, the more the wrist is bent, the more pressure is exerted on the median nerve.


You should use braces only while sleeping, not during the day. Also, do not use generic braces, but only a certified carpal tunnel brace. Generic braces sold in pharmacies are usually not for carpal tunnel because they contain a palmar spine. A palmar spine will exert excess pressure on the wrist joint.

Physical therapy massage

myofascial release massage

Physical therapy massage is highly effective, especially when the carpal tunnel numbness and pain are mild to moderate. The best technique to use is called myofascial release massage. This is the therapy of choice for physical therapists, massage therapists and chiropractors.


The massage uses a kneading and twisting motion. Such motion breaks up adhesions on your tendons that cause restrictions and pain. It also promotes blood flow and fluid drainage from deep within the carpal tunnel space. 


All of these processes reduce tendon inflammation. As a result, the median nerve is freed from entrapment and returns to normal again. That's when symptoms disappear.

Exercises

stretching exercises for the hand

Exercises can be highly beneficial in relieving carpal tunnel numbness and pain. That’s especially true when used in combination with other non-surgical treatments like night bracing and massage. 


Doctors designed special stretching exercises for the fingers and hand to use multiple times a day. They’re specifically designed to be quick and easy to do so they don’t hinder your daily activities. 


The best carpal tunnel exercises focus on working the flexor tendons. Don't waste time working extensor tendons.

Drugs

carpal tunnel steroid shot

Drugs are not a good treatment choice for carpal tunnel numbness. However, they do provide a little better relief from carpal tunnel pain. Therefore, if you have pain along with numbness, then non-steroidal anti-inflammatory drugs like aspirin, Advil, Motrin, and Aleve can help ease the symptoms. But they are not a long term solution due to drug toxicity.


Also, doctors can give you corticosteroid shots directly into the wrist to relieve pressure on the median nerve. Usually they provide immediate (although temporary) relief of mild or moderate symptoms, even numbness. But steroid shots must be used sparingly due to their harmful side effects. And prolonged use of corticosteroids in diabetics can make it difficult to regulate insulin levels.

Surgery

Doctors generally recommend surgery if carpal tunnel numbness lasts for 6 months or more. With only about a 50% satisfaction rate among patients, carpal tunnel surgery is a last resort. Doctors recommend it only after every non-surgical remedy failed.


The surgery involves severing the band of tissue (transverse carpal ligament) inside the wrist. This reduces pressure on the median nerve. The following are the most common types carpal tunnel release surgeries:

 

  • Open carpal tunnel release surgery is the traditional procedure used to relieve carpal tunnel numbness and pain. This consists of making an incision up to 2-3 inches long in the palm. Then the doctor cuts the carpal ligament. When cut, the ligament lets the wrist bones snap apart to enlarge the carpal tunnel space.

  • Endoscopic carpal tunnel release surgery is far less traumatic and allows for faster recovery and less postoperative pain and discomfort. The surgeon makes either one or two small incisions (single or double portal surgery, respectively) in the wrist and palm. Then the doctor inserts a camera and surgical instruments through the incisions. The surgeon then cuts the transverse carpal ligament to enlarge the carpal tunnel space.
carpal tunnel release surgery

Conclusion

Carpal tunnel numbness is just one sign of carpal tunnel syndrome. Usually pain and tingling also occur in the fingers and hand. However, you don’t have to suffer. There are plenty of good non-surgical remedies that can eliminate symptoms for good. But the worst thing you can do is ignore symptoms. That’s because they almost always worsen if left untreated. And they’re much harder to treat when the condition advances to the severe stage.

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