Carpal tunnel syndrome is a nerve problem that causes tingling, numbness, weakness, or pain in the fingers, thumb, or palm, and sometimes the forearm. These symptoms are caused by pressure on a nerve (median nerve) in the wrist (carpal tunnel).

This problem is often linked to hand and wrist motions that you do a lot. These are called repetitive motions.

Swelling or fluid retention in the wrist—which can happen during pregnancy or because of a health problem—also can cause carpal tunnel symptoms or make them worse.

Severe carpal tunnel syndrome that lasts a long time can lead to permanent damage to the median nerve. This can make it hard for you to use your hand.

You may have:

• Pain.
• Weak thumb muscles. This makes it hard for you to grip or hold objects.
• Loss of feeling and ability to use your fingers and hand well.

Surgery reduces the pressure on the median nerve in the wrist. The doctor cuts a ligament to relieve the pressure on the nerve.

The surgery is called carpal tunnel release. It can be done in different ways:

• Open surgery : Your doctor makes a small cut (incision) in the palm of your hand.
• Endoscopic surgery : Your doctor makes one small incision in the wrist, or one small incision in the wrist and one in the palm. Your doctor then puts a thin tube with a camera attached (endoscope) into the incision. Surgical tools are put in along with the scope.

You may decide to have surgery if you've had very bad symptoms for a long time and other treatments haven't helped.

Sometimes surgery is done to prevent lasting nerve damage. You will likely have a nerve test to see if you are at risk for nerve damage.

Most people who have surgery for carpal tunnel syndrome have less or no pain and numbness in their hand and better hand function after surgery.^{footnote 3} It's not clear how long you should try non-surgical treatment before considering surgery. But after people who have severe carpal tunnel syndrome have surgery, they typically have fewer symptoms and better hand function than people who continue using wrist splints or a combination of medicine and hand therapy.^{footnote 2}

Both types of surgery—open and endoscopic—work equally well to improve symptoms.^{footnote 4} Talk to your doctor about which surgery might be best for you.

Major problems from surgery can happen, but they are rare. About 1 person out of 100 has a major problem after surgery, such as nerve damage, while 99 out of 100 people don't.^{footnote 4}

You can try several home treatments to help relieve your symptoms. This may be all you need to do for mild symptoms of carpal tunnel syndrome. Doctors suggest that you try these treatments for several weeks to months before you think about having surgery.

You may try to:

• Rest your hand. Stop activities that hurt.
• Wear a wrist splint. It's usually worn at night, but you can wear it during the day.
• Put ice on the palm of your hand and wrist for 10 to 20 minutes at a time.
• Change the way you do certain hand motions.

Other choices

• You can work with a physiotherapist to learn how to do activities in a new way.
• If these home care treatments don't help, you may be able to take corticosteroid shots or pills to improve your symptoms.
• You can try yoga.
• Symptoms of carpal tunnel syndrome during pregnancy often go away after childbirth. Unless your symptoms are very bad, you may want to put off having surgery and see if your symptoms go away after you have the baby.

Rest, ice, and other home treatments may be all you need if you've had mild symptoms for a short time.

Your doctor may also suggest that you try wrist splints or corticosteroids to avoid or delay surgery.

• Splints are easy and inexpensive, and there is little risk to trying them.
• Corticosteroid shots and pills give short-term relief from symptoms.^{footnote 1}

Your doctor might recommend surgery if:

• You've had very bad symptoms for a long time, so you're at risk of having lasting nerve damage.
• Tests show that you have nerve damage.
• A wrist splint, medicines, and other treatments haven't helped your symptoms.