What is Carpal tunnel syndrome?
The carpal tunnel is a narrow passage at the wrist formed by the wrist bones and a strong ligament. The median nerve and the tendons that bend the fingers pass through it. When the space becomes tighter — because of swelling of the tendons, fluid retention or changes in the wrist — the nerve is compressed.
Risk factors
- Repetitive hand and wrist use, vibrating tools, prolonged wrist bending
- Pregnancy and menopause
- Diabetes and thyroid disorders
- Rheumatoid arthritis and other inflammatory joint diseases
- Obesity
- Previous wrist fractures
- Kidney failure and dialysis
- Family history — some people have a naturally narrower tunnel
Carpal tunnel syndrome is more common in women and in people aged 40–60. It often affects both hands, although usually one more than the other.
How the condition develops
In the early stages, symptoms come and go, mainly at night or during certain activities. Over time, if the pressure continues, numbness becomes constant and the nerve fibres that control the thumb muscles are damaged, leading to weakness and wasting. EMG can detect these changes before they become permanent, which is why early testing is valuable.
Symptoms of Carpal tunnel syndrome
- Numbness and tingling in the thumb, index, middle and half of the ring finger
- Waking at night with a numb or painful hand, relieved by shaking the hand
- Symptoms when holding a phone, driving or reading
- Pain that may spread to the forearm or shoulder
- Clumsiness and dropping objects
- Weakness when opening jars or buttoning
- Wasting of the muscle at the base of the thumb in advanced cases
When should you see a neurologist?
- Night-time numbness of the hand
- Numbness persisting during the day
- Weakness or wasting of the thumb muscles
- Symptoms not improving with a splint
- Before carpal tunnel surgery
- Persistent or recurrent symptoms after surgery
How is Carpal tunnel syndrome diagnosed?
The diagnosis is suspected from the typical symptoms and examination, including tests that provoke symptoms by tapping or bending the wrist, and assessment of sensation and thumb strength.
- Nerve conduction studies and EMG: confirm the diagnosis, grade the severity (mild, moderate, severe) and exclude other causes such as a pinched nerve in the neck or polyneuropathy
- Ultrasound of the wrist: can show swelling of the nerve and structural causes
- Blood tests: blood sugar, thyroid function and others if an underlying condition is suspected
Conditions that can mimic carpal tunnel syndrome
- Cervical radiculopathy: a pinched nerve in the neck causing numbness in the hand and arm
- Polyneuropathy: numbness in both hands and feet
- Ulnar nerve compression: numbness in the little and ring fingers
- Thoracic outlet syndrome and rarer conditions
How is Carpal tunnel syndrome treated?
Mild to moderate cases
- Wrist splint at night keeping the wrist straight
- Avoiding prolonged wrist bending and repetitive strain
- Workplace adjustments and breaks
- Treatment of underlying conditions such as diabetes or thyroid disease
- Corticosteroid injection into the carpal tunnel for temporary relief
- Nerve and tendon gliding exercises
Severe cases and surgery
When EMG shows severe compression, there is muscle wasting or weakness, or symptoms persist despite conservative treatment, carpal tunnel release surgery is recommended. This is a short procedure in which the ligament is divided to make more space for the nerve. Referral is made to an experienced hand surgeon.
Practical tips for daily life
- Keep the wrist in a neutral position when typing or using a mouse
- Avoid sleeping with the wrists bent or under the pillow
- Use tools with thicker handles and reduce gripping force
- Take regular short breaks and stretch the hands and wrists
- Keep the hands warm in cold environments
Treatment timeline and your stay in Istanbul
The consultation and EMG take about one hour in total, and the results are explained immediately. Follow-up is planned according to the severity and treatment chosen.
For international patients, the diagnosis and treatment plan can be completed in one day in Istanbul.
Follow-up after treatment
- Wear the splint at night as recommended
- Take regular breaks from repetitive hand work
- Report increasing numbness or weakness
- A repeat EMG may be suggested to monitor the nerve or after surgery if symptoms persist
After surgery
After carpal tunnel release, the hand is usually used for light activities within days. Stitches are removed after about two weeks. Grip strength returns gradually over weeks. If numbness was severe or long-standing before surgery, recovery may be slower and occasionally incomplete, which is another reason not to delay treatment.
Risks and what to watch for
Untreated severe carpal tunnel syndrome can cause permanent numbness and weakness of the hand. Steroid injections may rarely cause skin changes, temporary pain or, very rarely, nerve injury. Surgery carries small risks such as infection, scar tenderness and incomplete relief, which are discussed with the surgeon.
Frequently asked questions about Carpal tunnel syndrome
Why is carpal tunnel syndrome worse at night?
Many people sleep with their wrists bent, which increases pressure in the carpal tunnel. Fluid also redistributes when lying down.
Is EMG necessary before surgery?
Yes. EMG confirms the diagnosis, grades severity and excludes other causes, which helps to avoid unnecessary surgery.
Can carpal tunnel syndrome heal on its own?
Mild cases, for example during pregnancy, may improve with splints or after the trigger resolves. Moderate and severe cases usually need treatment.
Does computer use cause carpal tunnel syndrome?
The evidence is mixed. Prolonged wrist bending and repetitive work may contribute, so ergonomic adjustments are recommended.
Is carpal tunnel syndrome common in pregnancy?
Yes, due to fluid retention. It usually improves after delivery; night splints are often enough.
How long does recovery take after surgery?
Night-time symptoms often improve quickly. Numbness and strength may take weeks to months to recover, depending on how severe the compression was.
Can both hands be affected?
Yes. Carpal tunnel syndrome often affects both hands, usually one more than the other.
What if symptoms continue after surgery?
Persistent or recurrent symptoms should be assessed with EMG to determine whether the nerve is still compressed, recovering slowly or whether there is another cause.
Can a steroid injection cure it?
An injection often gives relief for weeks to months, particularly in mild to moderate cases. In severe cases, symptoms often return and surgery is usually more effective.
Can carpal tunnel syndrome come back after surgery?
Recurrence is uncommon. If symptoms return, EMG is used to compare with previous results and identify the cause.
Can I continue working with carpal tunnel syndrome?
Usually yes, with adjustments such as splints, breaks and ergonomic changes. Your work activities are considered in the treatment plan.
Is ultrasound an alternative to EMG?
Ultrasound can show swelling of the nerve and structural causes, but EMG shows how well the nerve works and how severe the damage is. The two tests complement each other.
Can diabetes make carpal tunnel syndrome worse?
Yes. Diabetes makes nerves more vulnerable to compression, and people with diabetes may also have neuropathy. EMG helps to distinguish the two and plan the right treatment.
Should I wear the splint during the day?
Night use is usually the most important. Daytime use during activities that trigger symptoms may also help, but the splint should not limit normal hand use all day.
This page is for general information only and does not replace a medical consultation. Please consult a physician for diagnosis and treatment. Results vary from person to person.
