Carpal tunnel syndrome is a nerve problem that causes tingling, numbness, weakness, or pain in the fingers, thumb, or palm, and sometimes the forearm. These symptoms are caused by pressure on a nerve (median nerve) in the wrist (carpal tunnel).

This problem is often linked to hand and wrist motions that you do a lot. These are called repetitive motions.

Swelling in the wrist—which can happen during pregnancy or because of a health problem—also can cause carpal tunnel symptoms or make them worse.

Severe carpal tunnel syndrome that lasts a long time can lead to permanent damage to the median nerve. This can make it hard for you to use your hand.

You may have:

• Pain.
• Weak thumb muscles. This makes it hard for you to grip or hold objects.
• Loss of feeling and ability to use your fingers and hand well.

Surgery reduces the pressure on the median nerve in the wrist. The doctor cuts a ligament to relieve the pressure on the nerve.

The surgery is called carpal tunnel release . It can be done in one of two ways:

• Open surgery : Your doctor makes a small cut (incision) in the palm of your hand.
• Endoscopic surgery : Your doctor makes one small incision in the wrist, or one small incision in the wrist and one in the palm. He or she puts a lighted tube—called an endoscope, or scope—into the incision. Surgical tools are put in along with the scope.

You may decide to have surgery if you've had very bad symptoms for a long time and other treatments haven't helped.

Sometimes surgery is needed to prevent lasting nerve damage. You will likely have a nerve test to see if you need surgery.

Most people who have surgery for carpal tunnel syndrome have less or no pain and numbness in their hand after surgery.¹ One analysis looked at studies of people with severe carpal tunnel syndrome. It was not clear that surgery was any better than other treatments in the first few months. But at about 6 months, the people who had surgery seemed to have better results than those who tried wrist splints or a combination of medicine and hand therapy.² For example, in one of the studies, after 6 months people who had surgery had fewer symptoms, fewer days of being unable to do their work, and less pain than people who tried a combination of medicine and hand therapy.³

Both types of surgery—open and endoscopic—work equally well to improve symptoms.⁴ Talk to your doctor about which surgery might be best for you.

Major problems from surgery can happen, but they are rare. About 1 person out of 100 has a major problem after surgery, such as nerve damage, while 99 out of 100 people don't.⁴

You can try several home treatments to help relieve your symptoms. This may be all you need to do for mild symptoms of carpal tunnel syndrome. Doctors suggest that you try these treatments for 3 to 12 months before you think about having surgery. It often helps to try several treatments at the same time.

You may try to:

• Rest your hand for 1 or 2 weeks. Stop activities that hurt.
• Put ice on the palm of your hand and wrist for 10 to 15 minutes at a time.
• Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen or ibuprofen, to help your pain. Talk to your doctor before taking NSAIDs. They can cause side effects.
• Change the way you do certain hand motions.
• Wear a wrist splint. It's usually worn at night, but you can wear it during the day.

Other choices

• You can work with a physical therapist to learn how to do activities in a new way.
• If these home care treatments don't help, you may be able to take corticosteroid shots or pills to improve your symptoms.
• You can try yoga.
• Symptoms of carpal tunnel syndrome in pregnant women often go away after childbirth. Unless your symptoms are very bad, you may want to put off having surgery and see if your symptoms go away after you have the baby.

Rest, ice, and other home treatments may be all you need if you've had mild symptoms for a short time.

Your doctor may also suggest that you try wrist splints or corticosteroids to avoid or delay surgery. Splints are easy and inexpensive, and there is little risk to trying them. Studies show that:¹

• If you have very bad symptoms, a splint may not help your pain as well as surgery could.
• Corticosteroid shots and pills give short-term relief from symptoms.

Your doctor might recommend surgery if:

• You've had very bad symptoms for a long time, so you're at risk of having lasting nerve damage.
• Test show that you have nerve damage.
• A wrist splint, medicines, and other treatments haven't helped your symptoms.