Carpal Tunnel Symptoms

Do you lie awake at night unless your arm hangs off the bed?

Nighttime pain or numbness in your hands prevents sleep. The dominant hand is slightly more likely to be involved than the non-dominant hand, but in about 7 out of 10 patients both hands will ultimately become symptomatic. This problem is seen most often in people over the age of 30. It has been reported in children as young as 2 years of age. The youngest person treated for carpal tunnel syndrome at Nebraska Hand & Shoulder Institute was 4 years old. Dr. Ichtertz treats a few teenagers every year. Symptoms are typically different for the younger patients.

Why does your hand fall asleep?

Numbness and tingling in the thumb, index, and long fingers and half of the ring finger, occurs with or without clumsiness and dropping things. The separation of the ring finger sensibility into median and ulnar sides is only noticed by the most alert and sensitive people.

Often a person will think that the whole hand is "going to sleep" when it is only part of the hand. In the case where it is, in fact, the whole hand or the majority of it, it means that at least two of the three nerves innervating the hand are involved: the median and ulnar nerves. The third nerve (superficial radial) is rarely abnormal.

Have you noticed swelling in your hand, especially in the mornings? 

In many patients, a feeling of swelling in the hand, particularly in the mornings, is noted. Loss of dexterity with declining penmanship (poor writing quality or lack of stamina while writing) and difficulty with handling small objects, such as a needle or button, is quite common.

Carpal Tunnel Symptoms in Men vs. Women

Women specifically tend to complain of difficulty with personal grooming and may burn themselves with loss of control of a curling iron. Difficulty pulling up one's nylons, fastening a bra, or clasping earrings is also noted. It is not uncommon for women to seek care shortly before having a grandchild for fear of dropping the infant.

Men are more likely to complain of having tools slide out of their hands.

An unusual symptom is that of soreness akin to a sunburn-type of feeling and some people actually feel a burning sensation. These more unusual symptoms not only confuse the patient but sometimes confuse their doctor as well.

Do your hand's pinch or grip feel weak?

Weakness is perceived to be present by many people with carpal tunnel syndrome. Weakness measured with a dynamometer in the office will only rarely occur due to carpal tunnel syndrome. The median nerve at the level of the carpal tunnel at the wrist does not innervate much muscle. Therefore, it is rare for it to have any effect on grip or pinch. The median nerve is mostly a sensory nerve. A measurable weakness of pinch and grip is usually a sign of ulnar nerve dysfunction that frequently accompanies median nerve dysfunction. This is part of the reason why nerve conduction study and quantitative sensory examination are important and necessary in the evaluation and treatment of patients presenting with an unusual complaint.