Carpal Tunnel Syndrome Treatment Overview
First steps to consider
- Mild to moderate carpal tunnel syndrome can sometimes be treated at home.
- Try changing activities that are contributing to it, wearing a wrist splint, and taking OTC pain medications.
When you may need a provider
- You still have symptoms after 6 weeks of home treatment.
- You have serious symptoms like weakness in the hand and fingers, wasting of the thumb muscles in the palm of the hand, or difficulty with fine motor tasks
- You may need to see a provider in person for a physical exam.
Call 911 or go to the ER if you have any of the following symptoms:
- Severe pain and swelling
- Numbness and tingling in the fingers
- Weakness of the fingers (especially after a fall or other trauma to the hand and wrist)
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When to see a healthcare provider
You should see a healthcare provider if your carpal tunnel syndrome symptoms like finger numbness, wrist pain, and hand weakness are not getting better after about 2 weeks of home treatments.
Carpal tunnel syndrome should be treated as soon as possible because pressure on the nerve over time can lead to permanent muscle loss, chronic symptoms, and may make surgery (if needed) less successful.
Carpal tunnel syndrome symptoms can mimic more serious conditions like pinched nerves in the neck or certain neurological conditions. So it’s important to see a healthcare provider if you’re not sure you have carpal tunnel syndrome.
Getting diagnosed for carpal tunnel syndrome
Many people with carpal tunnel syndrome symptoms can be treated without getting a definite diagnosis. But if treatments aren’t helping, your doctor may recommend seeing a hand/upper and extremity specialist.
- The doctor may use special tools to test the sensation in your fingers.
- In some cases, a nerve test called an electromyogram (EMG) may be necessary if the cause of your symptoms is not clear. This test can help figure out if your pain and numbness/tingling are from nerve pressure in your wrist or from a different location such as your neck.
What to expect from your visit
Your visit will start with a thorough history and physical exam. The doctor will discuss your current treatments and any OTC medications you’re taking.
- They may recommend prescription-strength NSAID medications to reduce pain and swelling in your wrist and hand.
- In some cases, your doctor may do a cortisone injection. After numbing the skin, a small needle is used to inject cortisone into the wrist. You should feel relief within a few days and the treatment lasts on average 4–6 weeks.
- You may be given a splint to wear at night.
- Your doctor may recommend physical therapy or special hand therapy. Therapy may include exercises to stretch the wrist, ultrasound treatments, hot wax treatment, and iontophoresis (electrical current).
- If your carpal tunnel was caused by repetitive movements, you may be referred to an occupational therapist.
What are the treatments for severe carpal tunnel?
Surgery may be needed if other treatments don’t help your symptoms.
The most common procedure is a carpal tunnel release (CTR). The surgeon will cut the tissue in the underside of your wrist that puts pressure on the median nerve. This surgery may be done through a regular incision or through tiny incisions using special instruments (endoscopic carpal tunnel release).
Symptoms will gradually go away as it heals. Depending on what you do for a living, you can expect to resume everyday job duties in 1–6 weeks. You can expect pinch strength to return within 6 weeks and grip strength in 3 months.
Prescription NSAID medications
- Meloxicam (Mobic)
- Nabumetone (Relafen)
- Naproxen (Naprosyn)
- Ibuprofen (Motrin)
- Celecoxib (Celebrex)
- Etodolac (Lodine)
Types of carpal tunnel syndrome providers
- A primary care provider can treat mild to moderate symptoms.
- An upper extremity or hand specialist may be required for more advanced symptoms or symptoms that don’t respond to an initial course of treatment. These specialists are orthopedic surgeons or plastic surgeons who have had additional training to treat disorders of the hand, wrist, and elbow.
How to treat carpal tunnel syndrome at home
If you have symptoms of carpal tunnel—wrist or finger pain, numbness, and tingling in the fingers—you can often treat it at home. You may need to change activities that are making it worse and take frequent breaks if you do a lot of work with your hands.
- Wearing a night splint on your wrist can help keep the wrist from being in positions that place pressure on the carpal tunnel nerve while you sleep.
- Most people with carpal tunnel syndrome take OTC anti-inflammatory medications (NSAIDs) to help symptoms by reducing inflammation around the nerve that runs in the carpal tunnel.
- It can take at least 1–2 weeks of wearing a splint, modifying your activities, and taking NSAIDs to notice improvement in carpal tunnel symptoms. But it can take about 6 weeks to feel better.
OTC treatments for carpal tunnel syndrome
- Ibuprofen (Motrin, Advil)
- Naproxen (Aleve)
- Wrist splint
Home remedies for carpal tunnel
- Avoid repetitive wrist motions and take frequent breaks while active.
- Wear a wrist splint at night.
- Try to keep your wrist straight when doing activities like typing, sewing, or carpentry.
- Perform simple wrist stretches to prevent muscle tightness and fatigue.
- Apply ice to your wrist whenever you have symptoms to help reduce swelling and inflammation.
- Take NSAIDs regularly for 2–3 weeks. This is more effective than just taking them as needed.