Carpal tunnel syndrome (CTS) is pressure on a nerve in your wrist, known as the median nerve. The carpal tunnel is a narrow passageway surrounded by bones and ligaments on the palm side of your hand. The median nerve provides sensation (ability to feel) to your thumb, index and middle fingers, and part of the ring finger. It supplies the impulse to some of the muscles going to the thumb. 
Carpal tunnel syndrome can occur in one or both of your hands and is a common condition. When the median nerve is compressed, the symptoms of carpal tunnel syndrome include tingling in the thumb, index and middle fingers, often described as pins and needles, pain in the hand and wrist and sometimes shooting pain from the wrist to the fingers or from the wrist up the arm. Usually, the thumb and index finger, middle finger, or ring fingers are affected but not the little finger.
Carpal tunnel pain is caused by repetitive motion, poor positioning or excessive use of the hands and wrists; in some cases this is related to a person’s job. However, certain medical conditions, such as fractures or trauma to the wrist, or genetic factors including arthritis, diabetes and thyroid dysfunction can also put a person at greater risk for developing carpal tunnel. Carpal tunnel can often occur during pregnancy and usually settles after giving birth.
For more details on the causes, symptoms and diagnosis of CTS, see my page on Carpal Tunnel Syndrome for full information.
Can Carpal Tunnel cause shoulder pain?
Even thought carpal tunnel is a wrist problem patients often ask “can carpal tunnel cause shoulder pain”. In rare cases carpal tunnel can cause shoulder pain. Patients can experience referred pain shooting up the arm from the wrist to the shoulder and even to the neck. This pain can sometimes feel like an electric shock.
In other cases patients can have a condition known as double crush syndrome. This happens when a nerve root is pinched in the neck (trapped nerve) and the median nerve is being squashed down at the carpal tunnel. These patients can experience pain shooting down from the neck through the shoulder and into the wrist and hand and also pain shooting up from the hand into the shoulder and neck.
It is important for patients to have a thorough clinical examination and sometimes investigations are necessary to diagnose these conditions.
Treating Carpal Tunnel Syndrome
While surgery is often considered to be a viable option, not all carpal tunnel syndrome cases need an operation. Those with early mild symptoms can try avoidance techniques including taking regular breaks, wearing wrist splints at night, relaxing your grip or adjusting your position. You can order a carpal tunnel splint here (paid link). Warmth can help with pain and stiffness, as can stretching to improve blood flow. Avoiding sleeping on your arms or with your wrists bent can also help to prevent or ease carpal tunnel symptoms.
Try over-the-counter medications such as anti-inflammatory drugs like ibuprofen because they not only relieve any pain you may have, but they can also reduce inflammation around the nerve. If your symptoms are work-related, ask your employer to do a workplace assessment for ergonomics. Note that it is important that you moderate tasks that increase your risk of CTS.
In some cases an ultrasound guided steroid injection can help settle symptoms temporarily.
Ultimately if your symptoms are worsening, or if they are becoming constant you should seek advice on getting your carpal tunnel treated.
Carpal tunnel surgery options
Surgery may be necessary in severe or persistent carpal tunnel syndrome cases. The surgery for carpal tunnel syndrome is called a carpal tunnel decompression, it involves cutting the band of tissue, called the transverse carpal ligament, in the wrist that crosses the median nerve to lessen the pressure on your nerve, and the outcome is usually good.
Carpal tunnel syndrome surgery is usually performed as a day-case operation under local anaesthetic. The procedure usually takes about 15 minutes. Shoulder or neck pain coming from the carpal tunnel typically disappears immediately or almost immediately within a matter of days of carpal tunnel decompression surgery.
If you have any questions regarding carpal tunnel syndrome, or any other shoulder and elbow issues that you may be suffering from please email, call +44 207 164 6312 or book an appointment online.
