Carpal Tunnel Syndrome (CTS) is the name for a group of problems that includes swelling, pain, tingling, and loss of strength in your wrist and hand. Your wrist is made of small bones that form a narrow groove or carpal tunnel. Tendons and a nerve called the median nerve must pass through this tunnel from your forearm into your hand. The median nerve controls the feelings and sensations in the palm side of your thumb and fingers. Sometimes swelling and irritation of the tendons can put pressure on the wrist nerve causing the symptoms of CTS. A person’s dominant hand is the one that is usually affected. However, nearly half of CTS sufferers have symptoms in both hands.

What are the symptoms of CTS?
Typically, CTS begins slowly with feelings of burning, tingling, and numbness in the wrist and hand. The areas most affected are the thumb, index and middle fingers. At first, symptoms may happen more often at night. Many CTS sufferers do not make the connection between a daytime activity that might be causing the CTS and the delayed symptoms. Also, many people sleep with their wrist bent, which may cause more pain and symptoms at night. As CTS gets worse, the tingling may be felt during the daytime too, along with pain moving from the wrist to your arm or down to your fingers. Pain is usually felt more on the palm side of the hand.

Another symptom of CTS is weakness of the hands that gets worse over time. Some people with CTS find it difficult to grasp an object, make a fist, or hold onto something small. The fingers may even feel like they are swollen even though they are not. Over time, this feeling will usually happen more often.

If left untreated, those with CTS can have a loss of feeling in some fingers and permanent weakness of the thumb. Thumb muscles can actually waste away over time. Eventually, CTS sufferers may have trouble telling the difference between hot and cold temperatures by touch.

What causes CTS and who is more likely to develop it?
Women are three times more likely to have CTS than men. Although there is limited research on why this is the case, scientists have several ideas. It may be that the wrist bones are naturally smaller in most women, creating a tighter space through which the nerves and tendons must pass. Other researchers are looking at genetic links that make it more likely for women to have musculoskeletal injuries such as CTS. Women also deal with strong hormonal changes during pregnancy and menopause that make them more likely to suffer from CTS. Generally, women are at higher risk of CTS between the ages of 45 and 54. Then, the risk increases for both men and women as they age.

There are other factors that can cause CTS, including certain health problems and, in some cases, the cause is unknown.

These are some of the things that might raise your chances of developing CTS:

o Genetic predisposition.
o Repetitive Movements. People who do the same movements with their wrists and hands over and over may be more likely to develop CTS. People with certain types of jobs are more likely to have CTS, including manufacturing and assembly line workers, grocery store checkers, violinists, and carpenters. Some hobbies and sports that use repetitive hand movements can also cause CTS, such as golfing, knitting, and gardening. Whether or not long-term typing or computer use causes CTS is still being debated. Limited research points to a weak link, but more research is needed.
o Injury or Trauma. A sprain or a fracture of the wrist can cause swelling and pressure on the nerve, increasing the risk of CTS. Forceful and stressful movements of the hand and wrist can also cause trauma, such as strong vibrations caused by heavy machinery or power tools.
o Pregnancy. Hormonal changes during pregnancy and build up of fluid can put pregnant women at greater risk of getting CTS, especially during the last few months. Most doctors treat CTS in pregnant women with wrist splits or rest, rather than surgery, as CTS almost always goes away following childbirth.
o Menopause. Hormonal changes during menopause can put women at greater risk of getting CTS. Also, in some postmenopausal women, the wrist structures become enlarged and can press on the wrist nerve.
o Breast Cancer. Some women who have a mastectomy get lymphedema, the build-up of fluids that go beyond the lymph system's ability to drain it. In mastectomy patients, this causes pain and swelling of the arm. Although rare, some of these women will get CTS due to pressure on the nerve from this swelling.
o Medical Conditions. People who have diabetes, hypothyroidism, lupus, obesity, and rheumatoid arthritis are more likely to get CTS. In some of these patients, the normal structures in the wrist can become enlarged and lead to CTS.

Also, smokers with CTS usually have worse symptoms and recover more slowly than nonsmokers.