The initial symptoms of compression of the median nerve include numbness, burning or aching pain and tingling. There may also be a decreased ability to feel with the fingers, but this may not be particularly noticeable. The pain is often worse at night, but may be worsened by activity, especially flexing of the wrist. Carpal tunnel syndrome is usually distinguished from other such disorders by a simple test wherein direct pressure is applied to the carpal tunnel to elicit pain. Medical imaging procedures can confirm the diagnosis even in cases with only slight median nerve pathology.
Treatment can begin with limiting the offending activity and occupational or physical therapy.
Elevation of the affected arm and the use of a splint at night may help. Injection of steroids directly into the carpal tunnel may help to alleviate the symptoms for some people, but this procedure is difficult and best left to a health care professional knowledgeable in the anatomy of the carpal tunnel, and trained and experienced in the procedure. Surgery is usually the treatment of last resort for carpal tunnel syndrome. However, it can be very effective. Like any surgery, carpal tunnel surgery carries a risk of not working and even making matters worse.