Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Carpal tunnel syndrome is an irritation of the median nerve in the wrist that leads to numbness, tingling, pain, and weakness in the hand. The syndrome typically affects the thumb, index, and middle fingers and is often particularly troublesome at night. The median nerve travels down the forearm and enters the hand after passing through the wrist tunnel (carpal tunnel) that is located in the central part of the wrist.
Carpal tunnel syndrome affects almost 5% of the population and is most common in middle-aged women. Any condition that causes increased direct pressure on the median nerve in the wrist can lead to carpal tunnel syndrome. Many people with carpal tunnel syndrome have no identifiable cause. Carpal tunnel syndrome is diagnosed based on the complaints of the individual combined with physical tests and often electrical tests. No single test is definitive for diagnosis of carpal tunnel syndrome. Rather, the person's complaints and test findings together lead to its diagnosis.
Carpal Tunnel Syndrome Causes
The following are risk factors associated with the development of carpal tunnel syndrome:
The relationship between work and carpal tunnel syndrome is unclear. Positions of extreme wrist flexion and extension are known to increase pressures within the carpal canal and apply pressure on the nerve. This is particularly true with repetitive strain injury to the wrist. Intensity, frequency, and duration of work activity and their relationship to carpal tunnel syndrome are unclear.
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Carpal tunnel syndrome can cause tingling, numbness, weakness, or pain in the fingers or hand. Some people may have pain in their arm between their hand and their elbow.
Symptoms most often occur in the thumb, index finger, middle finger, and half of the ring finger. If you have problems with your other fingers but your little finger is fine, this may be a sign that you have carpal tunnel syndrome. A different nerve gives feeling to the little finger.
You may first notice symptoms at night. You may be able to get relief by shaking your hand.
