Carpal Tunnel Syndrome is a common problem caused by compression of the median nerve in the wrist

Common symptoms include numbness and tingling in the hand. Many times the symptoms are worse at night, with driving and sometimes with repetitive hand activities. Tools that vibrate are especially suspicious for bothering our median nerves. It is common in both men and women.

Your primary care physician makes the diagnosis by history and physical exam. He/she might ask you to stretch your hands with the backs of your hands facing each other (in a reverse prayer position) or even just applying pressure with their thumbs on your wrist on the palm side. After Initital treatment can be icing your wrists, activity modification (stopping things that seem to make it worse), and wearing night splints to keep the wrists straight - especially at night.

Oral medications such as antiinflammatories may be used but are often not the best treatment. Icing can help: 10 minutes of ice to your wrist's palm sides for 10 minutes 3-4 times may help. Sometimes an injection of coritsone into the wrist may be helpful.

Diagnosis of carpal tunnel syndrome is usually done on the basis of examination and history. However, it is confirmed by a test called a nerve conduction study. This test involves attaching electrodes to your skin and stimulating the nerves with electric shocks. If we are searching for other nerve diseases we sometimes need to perform an EMG, this involves placing a needle electrode through your skin into your muscles. This is often not necessary when we are just testing for carpal tunnel syndrome, however.

If your nerve test show ''carpal tunnel'' and you are not responding to ice, splints, activity modification and perhaps injections you might be a candidate for surgery.

This is a discussion between you and a surgeon. Your primary care doctor or I can refer you for a surgical opinion.

If your main hand complaint is pain without numbness it is highly unlikely that you have carpal tunnel syndrome as your only problem.