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  • Chris Moore, OTR

Carpal Tunnel - Do you experience numbness and tingling in your hands?


There are several reasons you may have numbness or tingling in one or both hands during the night or when you wake up in the morning. Sometimes the symptoms are minimal or they can be severe. It feels like you want to shake your hands to wake them up. Your hands can also feel weak and swollen even when there is no visible swelling. If any of these signs occur in the thumb, the index finger, middle finger and the inside half of the ring finger, it may be an indication that you have Carpal Tunnel Syndrome. The dominant hand is usually affected first although it can be in both hands. Excessive demands on the hands and wrists make this a very common condition. 1 out of every 20 people in the US are diagnosed with Carpal Tunnel.

The Carpal Tunnel refers to an important part of the human anatomy. It is a narrow passage located at the base of the palm side of the hand. It is the home of the median nerve and the tendons that bend the fingers. If pressure builds in this area, it can result in weakness and pain in the wrists, thumb and fingers.

Below is a diagram of the median nerve shown in yellow. This is a narrow passage formed by a combination of soft tissue and bones. This passage houses the median nerve flexor tendons, blood vessels and provides support to the hand. This includes range of motion and strength.


When pressure is increased in this area, it can result in weakness and pain in the wrist along with decreased functional use.

The red area seen in the diagram is the carpal tunnel. It is not located in the wrist but rather in the proximal portion of the hand, known as the carpal tunnel. There are 27 bones in the wrist and hand. If pressure builds in this area, it can result in the development of weakness and pain in the wrist and hand. The Carpal Tunnel is about the size of a thumbnail although can vary between people. Your genes determine the size of this area.


There are several professions that can lead to carpal tunnel such as

  • Assembly line tasks

  • Packing jobs

  • Heavy machinery operation

  • Landscaping job

  • Computer work

  • Dental professionals

  • Sewing and other handwork activities

  • Sports

  • Specific musical instruments

  • Construction jobs

  • Gardening

Any repetitive job, holding or texting on cell phones, vibration from driving or using hand tools, electric toothbrushes, hair blower, vacuums, sprains, fractures, fluid retention during pregnancy or menopause, diabetes, development of a cyst or tumor in the canal or rheumatoid arthritis. In order for you to decrease the pain and weakness, it is important to have the condition evaluated to determine what is causing the symptoms.

Your physician can perform an assessment using specific tests, X rays, ultrasound, electrodiagnositcs or MRIs. Non-surgical treatment can begin with a referral to

Occupational Therapy. The therapist can provide you with a home program including pain management techniques, stretching and exercises, an appropriate splint and treatment to reduce the symptoms. They can also help with modifying how you perform your work or use your tools and instruct you in using adaptive equipment. If therapy does not relieve the pain, other options include injections to decrease the swelling and inflammation or surgery. It is important if you experience of any of these symptoms that you request an evaluation in order to protect and improve the health of median nerve and your hands.

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