1. What is carpal tunnel syndrome? 
  2. How do I know if I have carpal tunnel syndrome? 
  3. I type often on a computer keyboard. Will this increase my risk of developing carpal tunnel syndrome? 
  4. How is carpal tunnel syndrome diagnosed? 
  5. How is carpal tunnel syndrome treated? 
  6. Will carpal tunnel syndrome come back after surgery?

1. What is carpal tunnel syndrome?
Carpal tunnel syndrome (CTS) occurs when the median nerve that runs from the forearm into the palm side of the hand is compressed as it passes through the narrow carpal tunnel in the wrist.

2. How do I know if I have carpal tunnel syndrome?
Patients with carpal tunnel syndrome may experience any one or all of the following symptoms:

  • Numbness in the hand and first three fingers
  • Tingling or burning sensation in the hand
  • Aching in the wrist and hand
  • Weakness in the thumb
  • An inability to distinguish between hot and cold temperatures
  • Aching of hands at night.

A neurologic test conducted by a physician or neurologist aids in diagnosing the condition.

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3. I type often on a computer keyboard. Will this increase my risk of developing carpal tunnel syndrome?
Studies have shown that use of a computer keyboard and mouse does not lead to, nor does it raise the risk of developing, carpal tunnel syndrome.

4. How is carpal tunnel syndrome diagnosed?
A medical history, physical exam and a neurologic exam with a physician or neurologist will help confirm or rule out carpal tunnel syndrome. There are several neurologic tests available to help in the diagnosis, including:

  • Tinel's test — During this test, the physician lightly taps the wrist near the median nerve, which may create tingling in the hand.

  • Phalen's test — The physician will ask the patient to flex (bend) the affected wrist, which may cause tingling within 60 seconds.

  • Pressure provocation test — During this test, the physician will press his or her thumb on the wrist over the carpal tunnel for 60 seconds, which may cause tingling or numbness.

  • Nerve conduction studies — These are the only way to definitively diagnose CTS. They also determine the level of severity of median nerve compromise (mild, moderate, severe) and can be helpful in determining other causes of hand numbness.

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5. How is carpal tunnel syndrome treated?
There are both conservative (non-surgical) and surgical treatments for carpal tunnel syndrome, depending upon its severity. In mild cases, non-surgical management is recommended first and includes a modification of activities with excessive vibration, repetitive motion, forceful gripping or excessive flexion and extension of the wrist. Wearing a wrist splint or brace during the day and at night can help keep the wrist straight and take pressure off the carpal tunnel. If symptoms are mild, steroid injections can be effective in treating carpal tunnel syndrome in the short term. 

Surgery for CTS is an outpatient procedure done under local anesthesia in which the transverse carpal ligament of the wrist is divided. This creates more room in the carpal tunnel and relieves pressure on the median nerve.

6. Will carpal tunnel syndrome come back after surgery?
Surgery to "release" the transverse carpal ligament that crosses the wrist resolves the problem in the majority of cases. Recurrence is less than 5 percent.

For information about treatment for CTS, contact the Virginia Mason Center for Hand Surgery at
(206) 341-3000.