It can result in a variety of problems, including pain, tingling, numbness, swelling, weakness or clumsiness of the fingers and thumb. Tendon swelling and tendinitis results from a person's own tendency to collect fluid around their tendons and joints. This may be aggravated by repetitive or strenuous activities, but there is no scientific evidence that such activities cause the problem. When the lining around the tendons swells, the pressure cuts off the blood supply to the nerve. Scar tissue may form around the nerve from repeated episodes of pressure.
Nerve damage is suspected when any symptoms occur regularly during the day.
Electrical nerve study evaluation is indicated in selected cases if there is a question of other nerve compression syndromes, metabolic neuropathy, or nerve damage. Otherwise, management options are based on history and physical examination. In mild cases with tolerable symptoms and no evidence of nerve damage, conservative management is indicated. Nonoperative options include antiinflammatory medication, vitamin B6, wrist splints while sleeping, and cortisone injection into the carpal tunnel. Risk Factors for failure of conservative management include age greater than 50, constant paresthesias, symptoms greater than 10 months, trigger digits, Phalen's test positive in less than 30 seconds, or any sign of nerve damage.