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Quick answer: Carpal tunnel syndrome is pressure on the median nerve at the wrist. It causes numbness, tingling and burning in the thumb, index, middle and part of the ring finger, often worse at night. It is most common in women between about 40 and 60. Mild to moderate cases usually start with a wrist splint worn at night and activity changes. Steroid injections can help short term, but the evidence does not show they beat night splinting after six months. Surgery is considered when symptoms persist or there is nerve damage, such as constant numbness or thumb weakness.
What carpal tunnel syndrome is
The carpal tunnel is a narrow passage at the base of the palm, formed by wrist bones and a tough band of tissue. The median nerve and nine tendons run through it. When swelling or tissue thickening narrows the space, the nerve is squeezed, which produces the classic symptoms. It is the most common nerve compression problem in the hand. Estimates of how many adults have it vary with how it is defined, with reviews placing it at roughly 1 to 6% of the general adult population.
Who gets it, and why it peaks after 40
Carpal tunnel is more common in women than men, and one population study found the incidence in women rose with age to a peak between 50 and 59 before declining. Other factors raise risk:
- Diabetes, thyroid disease (see hypothyroidism after 50) and rheumatoid arthritis
- Pregnancy and menopause-related fluid shifts
- Obesity
- Past wrist injury or fracture
- Repetitive wrist and hand work or vibrating tools
- Family history
The link with keyboards and mice is weaker than many people assume. Tasks that combine force, repetition and awkward wrist positions seem to matter more than typing alone.
Symptoms
- Tingling, numbness or burning in the thumb, index, middle and half of the ring finger. The little finger is usually spared, which helps separate it from other problems.
- Waking at night with a “dead” hand that improves when you shake it
- Numbness while driving, holding a phone or gripping a book
- Dropping objects or clumsiness with buttons
- In advanced cases, weakness of the thumb and wasting of the muscle at its base
Our article on sudden stiffness in your hands covers conditions that cause stiffness instead, and our guide to peripheral neuropathy covers numbness that begins in both feet and hands.
Other causes that can look the same
Neck problems that pinch nerve roots, ulnar nerve compression at the elbow, thumb-base arthritis and generalized neuropathy can cause hand numbness. A pinched nerve in the neck often brings neck pain and symptoms that change with head position. Numbness in the little finger points to the ulnar nerve. Sudden numbness with face droop, slurred speech or weakness on one side is an emergency, not carpal tunnel.
How it is diagnosed
A clinician examines your hand, tests sensation and strength, and may tap over the nerve or hold your wrist bent to reproduce symptoms. Nerve conduction studies can confirm the diagnosis and show severity, and they are especially useful when surgery is being considered or the picture is unclear. Blood tests for diabetes or thyroid problems may be ordered if an underlying cause is suspected.
Treatment: what the evidence says
Night splinting
Guidance from the American Academy of Orthopaedic Surgeons supports a splint or a steroid injection as early non-surgical options for most people before surgery. A splint holds the wrist in a neutral position, which reduces pressure on the nerve, and it is worn at night when many people curl their wrists without realizing it. Choose one that keeps the wrist straight rather than bent, and give it several weeks. A night wrist splint for carpal tunnel is inexpensive, but fit matters, so check sizing and which hand you need. If symptoms do not improve in a few weeks, speak to your clinician rather than simply continuing.
Activity changes and ergonomics
Take breaks from repetitive tasks, keep your wrist neutral while typing, avoid prolonged gripping, and reduce vibration exposure. Simple adjustments such as a keyboard that keeps your wrists straight help some people. Gentle nerve gliding and stretching exercises are commonly suggested, though the research on them is limited.
Steroid injections
A corticosteroid injection into the carpal tunnel can calm symptoms quickly. However, a 2025 summary of the AAOS guidance reported high-quality evidence that these injections do not provide long-term improvement compared with night splinting at six months to five years. Risks include local pain and swelling and, rarely, nerve injury. They may suit someone who needs relief while a decision is made, with the limits understood.
Surgery
Carpal tunnel release cuts the band that forms the roof of the tunnel to relieve pressure. It is usually done as an outpatient procedure under local anesthesia. A meta-analysis found surgery relieves symptoms better than splinting, and it is the recommended option when there is nerve damage, constant numbness, weakness or wasting of the thumb muscles, or when conservative care fails. Recovery varies, with many people resuming light activity within days and full grip strength returning over weeks to months.
Supplements and alternative claims
Many products claim to treat carpal tunnel. Evidence for vitamin B6 and most supplements is limited or mixed, and very high doses of B6 can themselves damage nerves. Tell your clinician before taking any supplement, and be skeptical of promised cures.
Protecting your hands day to day
- Avoid sleeping with wrists tightly flexed; a splint helps
- Keep wrists neutral with tools and phones, and vary grips
- Manage conditions such as diabetes and thyroid disease
- Maintain general strength; see grip strength and longevity
- Do not ignore constant numbness, because prolonged compression can cause lasting nerve damage
When to see a doctor
- Symptoms last more than a few weeks or wake you most nights
- Numbness becomes constant or you notice weakness or muscle wasting at the thumb base
- You drop things or lose fine hand control
- Numbness is in both hands and feet, or comes with neck pain
- Sudden numbness with face droop or slurred speech: call emergency services
The bottom line
Carpal tunnel is common after 40, especially in women, and it is treatable. Start with a neutral night splint and activity changes, see a clinician if symptoms persist or the thumb weakens, and consider surgery when nerve damage is present or other treatments fail. This article is general information and not a substitute for medical advice.
Sources: AAOS guideline on carpal tunnel syndrome and its 2025 AAFP summary; population studies of carpal tunnel incidence by age and sex; meta-analysis of surgery versus non-surgical treatment.
Frequently asked questions
What are the first signs of carpal tunnel syndrome?
Tingling, numbness or burning in the thumb, index, middle and part of the ring finger, often at night or when gripping. Shaking the hand usually eases it briefly.
Does a wrist splint really help carpal tunnel?
AAOS guidance supports a splint or a steroid injection as early options. A night splint keeps the wrist neutral and reduces pressure on the nerve. If symptoms do not improve within a few weeks, see your clinician.
Do steroid injections cure carpal tunnel?
They can reduce symptoms in the short term, but a 2025 summary of AAOS guidance reported that they do not provide long-term improvement over night splinting at six months to five years.
When is surgery needed for carpal tunnel?
Surgery is considered when symptoms persist despite non-surgical treatment, or when there is constant numbness, weakness or wasting of the thumb muscles, which signal nerve damage.
Is carpal tunnel more common in women?
Yes. It is more common in women than men, with incidence in one population study peaking between ages 50 and 59 in women.
Practical help in the kitchen: jar openers for weak hands.
If a weak grip makes cutlery slip from your hand, read our guide to adaptive utensils for a weak grip, arthritis or tremor.