Carpal tunnel: symptoms, tingling hands and options for relief
Author: Ondrej Stovicek
Tingling fingers, night-time hand pain or a weaker grip can be warning signs of carpal tunnel syndrome. The problems arise when the median nerve in the wrist is compressed and, left unaddressed, they can gradually get worse. How do you recognise the typical symptoms, what can you try at home and when is it time to see a doctor?
Quick guide to this article:
- What is the carpal tunnel?
- What are the symptoms?
- Who is most at risk?
- How do you spot early carpal tunnel?
- What can help?
- How exactly can Cannadorra products help?
- Simple exercises for carpal tunnel
- What does not help?
- Carpal tunnel examination and treatment
- Summary and sources
What is the carpal tunnel?
The carpal tunnel is a narrow space on the palm side of the wrist. The flexor tendons of the fingers and the median nerve pass through it. If the space inside the tunnel narrows or the surrounding tissues swell, the nerve starts to be compressed. The result can be tingling, numbness, pain and, later on, weakening of the hand.
Carpal tunnel syndrome usually develops gradually. At first the trouble appears only occasionally, often at night or during activities in which you hold a phone, a steering wheel or a book. Sometimes you feel the need to shake your hand to make the unpleasant sensations go away.
What are the symptoms of carpal tunnel?
Most often the thumb, index finger, middle finger and part of the ring finger are affected. The little finger typically stays free of symptoms, because it is supplied by a different nerve.
You may feel the following kinds of pain:
- tingling, pins and needles or a feeling of electric shocks in the fingers,
- numbness of the fingers or the palm,
- pain in the wrist and hand, which may radiate into the forearm,
- symptoms getting worse at night and waking you from sleep,
- a weaker grip, clumsiness of the hand or dropping objects,
- in a more advanced stage, a more lasting loss of sensation and wasting of the muscles at the base of the thumb.
Is every case of tingling hands carpal tunnel?
No. Tingling can also be related to overuse, compression of a different nerve, problems with the cervical spine, diabetic neuropathy or impaired blood flow. Sudden one-sided numbness or weakness of the hand, especially together with a drooping corner of the mouth, speech difficulties, a severe headache or dizziness, requires immediate medical help.
Why does carpal tunnel develop?
Often no single cause can be identified. The risk is increased by changes in anatomy after a wrist injury, arthritis and other inflammatory conditions, diabetes, thyroid disorders, obesity, pregnancy or menopause associated with fluid retention, and also by hereditary predisposition. Repeated bending of the wrist, a strong grip and work with vibrating tools can trigger or worsen the problems. Working at a keyboard on its own, however, is not automatically a cause of the syndrome.
Who does carpal tunnel affect most often?
The problems can appear in both women and men, but they are more common in women and usually show up in middle or older age. People who repeatedly work with the wrist in a bent position, use vibrating tools or grip work tools firmly for long periods are at increased risk. Hormonal changes and fluid retention can also contribute to the problems, which is why the syndrome sometimes appears during pregnancy or around menopause.
When working at a computer, the problem tends to be a prolonged unsuitable hand position and overuse rather than typing itself. A wrist resting on a sharp desk edge, a keyboard set too high or an unsuitable mouse can make existing problems worse.
How to spot early carpal tunnel
The first symptoms tend to be inconspicuous. The hand tingles only occasionally, for example after longer work, while driving or during sleep. After changing position or shaking the hand, the sensation usually subsides. Later on the problems appear more frequently and can repeatedly wake you up. The numbness may become more persistent and poorer fine motor skills are added – more difficult buttoning, handling coins or opening bottles.
Typically the problems are distributed across the thumb, index finger, middle finger and the adjacent half of the ring finger. If it is mainly the little finger and the other half of the ring finger that tingle, it is more likely to be irritation of the ulnar nerve. Pain that starts in the neck or shoulder and travels down the whole arm may in turn be related to the cervical spine. This distinction is only indicative; a reliable diagnosis is made by a doctor.
Can you test for carpal tunnel at home?
Several simple tests are often recommended on the internet. In Phalen's test the wrist is bent and the backs of the hands are pressed together. In Tinel's test you tap gently over the course of the median nerve at the wrist. Triggering the typical tingling can support the suspicion, but a negative result does not rule the syndrome out and a positive one does not confirm it on its own.
Treat home tests as indicative only. Too much pressure or staying in an uncomfortable position for a long time is not needed. If the problems keep coming back, it is better to have the hand examined by a professional than to keep repeating the tests.
What can bring relief
1. Keep the wrist in a neutral position
A night splint or brace holds the wrist straight and reduces pressure on the nerve. For mild and moderate problems it is usually one of the first recommended steps. Improvement may not come immediately; with regular wear it can take several weeks.
2. Cut down on activities that make the problems worse
Take short and frequent breaks, alternate activities and avoid a prolonged strong grip. When working at a computer, keep the wrist straight, adjust the height of the keyboard and use a mouse that does not force the hand into an unnatural position.
3. Exercise gently and without increasing the pain
A physiotherapist may recommend nerve and tendon gliding exercises. Their effect is not the same for everyone and they should not provoke more pronounced tingling or pain. If the problems get worse during exercise, stop and consult a professional.
4. Try cold or heat, depending on what suits you
If you feel swelling or irritation, brief cooling through a cloth can be pleasant. Other people prefer heat, which relaxes the surrounding muscles. Neither method, however, removes the nerve compression itself.
5. Topical care as a supplement
A gentle massage and a suitable gel or ointment can be used around the wrist. CBD cooling gel can be a pleasant choice when the wrist feels overworked, while CBD warming gel suits you better when heat helps. A topical product can complement the care of an overworked wrist, but it does not treat carpal tunnel syndrome and does not replace an examination or the recommended treatment.
CBD is being researched in connection with pain and unpleasant sensations in peripheral neuropathy. One small randomised study with 29 participants recorded an improvement in some neuropathic problems compared with placebo after four weeks of topical CBD application. The study, however, concerned peripheral neuropathy of the lower limbs, not carpal tunnel syndrome directly. Its results therefore cannot be used to claim that CBD treats carpal tunnel.
How can Cannadorra products help with carpal tunnel?
CBD cannot remove the cause of carpal tunnel syndrome itself – that is, the pressure on the median nerve in the wrist. Thanks to the way it acts on the endocannabinoid system, however, it can serve as a supplement to care focused on unpleasant sensations, pain and the overall comfort of the hand. Research on CBD in various types of pain has produced interesting results so far, but there is still little direct clinical evidence in carpal tunnel. We therefore see CBD not as a treatment, but as one of the options for supportive care.
For problems in a specific spot, a practical choice can be the CBD gels we mentioned above, which are applied gently to the wrist and forearm area. Another option is the very popular CBD patches, which allow gradual release of CBD and comfortable application during the day.
CBD taken internally
CBD oils or capsules act on the body as a whole, which is why people often choose them as a supplement to care for sleep, mental well-being or comfort during long-term problems. Even in this case, however, CBD will not release a mechanically compressed nerve.
Does PEA make sense too?
PEA, or palmitoylethanolamide, is a substance the body produces itself and it is studied mainly in connection with pain and nerve irritation. A smaller double-blind study has also been carried out in carpal tunnel. Taking 600 mg of PEA daily for 60 days, however, did not bring a clear improvement in pain or in nerve examination results compared with placebo. PEA can therefore be seen as a supplementary support for the nervous system and regeneration. In the Cannadorra range you will find it, for example, in PEA FIT capsules.
And what about medicinal mushrooms?
With medicinal mushrooms, such as lion's mane, their possible effect on the nervous system is being studied. So far, however, the results come mainly from laboratory and preclinical studies. There is no convincing clinical evidence that medicinal mushrooms would relieve carpal tunnel syndrome or release the pressure on the median nerve. But they can certainly be recommended as a suitable supplement to treatment.
A practical routine through the day
Morning
After waking up, gently open and close the hand several times. Move the wrist only within a comfortable range and without sharp stretching. If you use a warming or cooling gel, apply a small amount to unbroken skin and follow the manufacturer's instructions.
During work
Set up your workplace so that the wrist stays as straight as possible. Keep your elbows at roughly a right angle, the forearm supported and the shoulders relaxed. Every 30 to 60 minutes change position for a moment, shake out your hands and switch activity. Do not hold a phone in one hand for a long time and limit prolonged gripping of heavy objects.
Evening and night
If the problems wake you up, the main thing that helps is preventing the wrist from bending during sleep. A night splint should hold the hand straight, but it should not constrict or cause further tingling. Before sleep the wrist can be briefly cooled or warmed, depending on what subjectively brings you relief.
Simple exercises for the wrist and hand
For some people exercises can ease mild problems, but they work best as part of a wider routine. Exercise slowly, without jerking and never through sharp pain. If tingling or numbness gets worse, stop exercising.
Opening and closing the palm: spread your fingers, then close them loosely. Repeat five to ten times.
Gentle forearm stretch: stretch your arm out in front of you, palm facing down. With the other hand, gently pull the fingers towards your body. Hold only to the point of a mild pull.
Tendon gliding: start with the fingers straight, then gradually form a hook, a loose fist and open the palm again. The movement should be smooth and pain-free.
Releasing the shoulders and neck: several times, draw the shoulder blades slightly back and down and let the shoulders relax. Tension in the upper body can intensify the unpleasant sensations in the hand.
It is ideal to consult a physiotherapist about the exact technique and a suitable number of repetitions, especially if you already have a confirmed carpal tunnel syndrome or another hand condition.
What is usually bad for the carpal tunnel?
- prolonged bending of the wrist during sleep or work,
- a repeated strong grip without breaks,
- resting the wrist on a hard or sharp edge,
- intensive hand strengthening at a time when the problems are getting worse,
- putting off an examination when numbness is persistent or the hand is weakening.
How the examination works
The doctor asks which fingers tingle, when the problems appear and whether they affect sleep or everyday activities. They will check sensation, the strength of the thumb and the hand's reaction to certain positions or tapping. If the cause is not clear or the severity of the compression needs to be determined, an electromyography examination assessing nerve conduction may follow. Ultrasound is sometimes used as well, or further examinations to rule out another cause.
How carpal tunnel is treated
Treatment depends on how long the problems have lasted and how severe they are. The doctor usually starts from the description of the symptoms and an examination of the hand. If anything is unclear, they may recommend a nerve conduction study or an ultrasound. Alongside lifestyle measures and a splint, a corticosteroid injection can be considered in some patients. If the condition is getting worse, there is marked weakness or conservative treatment is not working, surgery to release the pressure in the carpal tunnel may be recommended.
When to see a doctor
Make an appointment with a doctor if the tingling or pain keeps coming back, wakes you from sleep, persists despite home measures or gets worse. Do not put off an examination in case of persistent numbness, weakening of the thumb, a worsening grip or dropping objects. Long-term compression can lead to damage to the nerve and muscles, so it is better to find the cause of the problems in time.
Frequently asked questions
Which fingers tingle with carpal tunnel?
Most often the thumb, index finger, middle finger and part of the ring finger. The little finger is usually not affected.
Why does carpal tunnel hurt mainly at night?
During sleep we often bend the wrist without realising it. This can increase the pressure in the carpal tunnel and irritate the nerve.
Does shaking the hand help?
It can bring short-term relief, but it does not address the cause of the problems.
Does CBD help with carpal tunnel?
CBD can only be seen as a supplement to care for unpleasant sensations and the overworked area around the wrist. Direct clinical evidence for treating carpal tunnel syndrome is insufficient.
Can carpal tunnel go away on its own?
Sometimes yes, especially if it is related to pregnancy or temporary overuse. Persistent, worsening or severe problems, however, belong with a doctor.
Summary
Tingling hands, night-time pain and a weakening grip can be the first signs of carpal tunnel syndrome. The basis of relief is to spare the wrist, keep it in a neutral position and address persistent problems with a doctor in good time. A splint, ergonomics, suitable exercise and topical care can help manage the problems, but they do not replace a diagnosis or treatment of the cause.
Sources
Mayo Clinic: Carpal tunnel syndrome – Symptoms and causes
AAOS: Management of Carpal Tunnel Syndrome Clinical Practice Guideline