The first signs of carpal tunnel syndrome will appear in your fingers, hand and sometimes in your wrist. The main signs include pain, numbness, tingling and weakness. But there are variations of these symptoms; so much that many people confuse carpal tunnel syndrome with wrist tendonitis or even arthritis.

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

Carpal tunnel syndrome (most just call it "carpal tunnel" for short) is a common hand disorder. In fact, after sprains and arthritis, it's the most common hand disorder doctors see. It affects over 5 million Americans.

Technically speaking, carpal tunnel is actually a type of neurological disorder of the median nerve. This nerve is a main sensory nerve in the hand and fingers. With carpal tunnel, the nerve becomes crushed and "trapped" inside a narrow space in the interior of the wrist joint. 

Nerves don't like being crushed. As a result, they transmit signals to the brain that are interpreted as uncomfortable symptoms in the fingers, hand and wrist. These are they very first signs of carpal tunnel syndrome and include:

• pain
• numbness
• tingling (pins & needles)
• burning
• soreness
• puffy feeling
• itching
• shooting electric shocks
• hand weakness
• finger or hand clumsiness
• loss of finger dexterity

Hand weakness occurs because the median nerve can no longer efficiently transmit signals to the muscles of the hand. Likewise finger dexterity suffers, and the person feels like their hand or fingers are awkward or clumsy.

Usually the signs first begin on the thumb and first finger. Note that the little (pinky) finger is never involved in carpal tunnel syndrome because the median nerve doesn't travel to it. 

If you have any of theses signs or symptoms in your little finger, then you may have tendonitis instead. You can determine if you have carpal tunnel syndrome or tendonitis by performing these self tests.

Even though the signs of carpal tunnel syndrome are very clear, nobody is really certain how it happens in the first place. Most doctors classify carpal tunnel syndrome as a type of repetitive stress injury or RSI. That means when your hand and fingers undergo repetitive and forceful motions for long periods of time, injury can result to your tendons. 

Tendons are the ropy structures that make muscles move. In the arm, they run from the middle of the forearm (where the muscle is) to your fingertips. 

Injury to tendons causes them to inflame and swell. Almost everybody knows that swelling cases pain. So when tendons become injured and swell, any muscle movement (like moving a finger) can be very painful. 

But the scenario is a little more complicated with carpal tunnel syndrome. Sure, rapid and forceful finger movements cause tendon injury and swelling. But if the tendon swelling happens inside the narrow wrist joint, another problem occurs. The swollen tendons push against one of the main nerves to the hand, the median nerve. 

Think of the swelling like a fist full of drinking straws. The most center straw is the median nerve. And the surrounding straws are the tendons. As the straws expand and swell (as injured tendons do), they press into the central straw (the median nerve). Eventually, the center position is crushed down. 

Therefore, carpal tunnel syndrome is caused when the tendons passing through the wrist joint swell and push against the median nerve until it's crushed. When it's crushed, the nerve reacts by transmitting the uncomfortable sensations like pain or numbness which constitute the first signs of carpal tunnel syndrome. 

First and foremost, anybody can get carpal tunnel syndrome. However, the any signs of carpal tunnel are most likely to appear in people who are at high risk for getting the disorder. These are:

• people with a family history of carpal tunnel
• pregnancy
• being female
• working in jobs that repetitively stress hands
• if you have rheumatoid arthritis
• have broken or sprained your wrist
• diabetes
• high blood pressure
• smoking
• a sedentary lifestyle
• a thin body frame
• overweight or obese
• emotionally stressed

Also, employees of certain jobs more often report having signs of carpal tunnel syndrome. They have a higher incidence of developing the disorder because they all have one thing in common: they require rapid, forceful or extensive grip-and-release hand movements. The occupations at highest risk are:

• hairdressers
• accountants
• dental hygienists
• programmers 
• graphic designers
• cashiers
• artists
• construction & carpentry
• musicians
• secretarial
• gamers
• golfers
• knitters
• assembly line workers

• First, recognize if you're at risk for developing carpal tunnel (see section above).
  
  
• Next, recognize if you're in a high risk occupation (see section above).
  
  
• Take note on how many hours you stress your hand and fingers during the day.
  
  
• Determine whether your hand merely feels "tired" as opposed to having real symptoms.
  
  
• Do you feel pain, numbness, tingling, burning, soreness, itchiness, weakness or swollen feelings in your hand or fingers?
  
  
• Do you feel shooting electric shocks going up your hand, especially when gripping something like a phone?
  
  
• Is your hand clumsy and do you drop things often?
  
  
• Are you having difficulty picking up small objects like coins or keys?
  
  
• Is is hard to tie a shoelace or button a shirt?
  
  
• Are any of these symptoms especially noticeable when you're trying to sleep or when you wake up in the morning?
  

Usually, this neurological disorder progresses if there's not attempt at treatment. That means any signs of carpal tunnel you have now will become more intense as weeks and months pass if you don't take action immediately. 

Generally speaking, patients advance from "barely noticeable" to "severe" symptoms within about 6 months. However, this time frame is highly variable. For instance, some patients may feel minor pain or tingling for a year or two until symptoms start to worsen. Others may see symptoms escalate within a month of first noticing them.

Also, the rate of progression is variable from person to person. Usually symptoms worsen more and more with each passing week or month. Other times pain or numbness may be at a low level for a year or two, and then escalate quickly and drastically. 

On rare occasion, severe pain and numbness are felt at the very beginning. In other words, in a few patients intense pain and numbness are the very first signs of carpal tunnel syndrome.

Night bracing is crucial but many people overlook it's importance. Whether you have advanced symptoms or merely the faintest first signs of carpal tunnel syndrome, night bracing is very important. 

However, you should NEVER EVER wear a wrist brace during the day as you work with your hand. Doing so will make your hand fight the brace, further stressing the tendons in your wrist. This makes the carpal tunnel much worse.

Furthermore, NEVER EVER wear a generic wrist brace at night (the kind sold at your local pharmacy). These braces are generally made for sprains, and usually contain a metal spine on the palm's surface. Such a feature will also make your carpal tunnel symptoms worse. Click here to find out why, and to see how to choose a certified carpal tunnel night brace.