Your hands and wrists are essential to nearly every task you perform — typing, gripping, lifting, writing, or even holding a coffee mug. When a condition like Carpal Tunnel Syndrome (CTS) develops, these once-simple actions can become painful and frustrating.
Carpal Tunnel Syndrome occurs when the median nerve, one of the major nerves that runs through your forearm into your hand, becomes compressed within the carpal tunnel — a narrow passageway of bones and ligaments located on the palm side of your wrist. This nerve provides sensation to your thumb and most fingers and controls some of the muscles that allow your hand to move.
When pressure builds up inside this confined space, it irritates the nerve, leading to tingling, numbness, weakness, and pain. At Dr. Burke Orthopedics, our team in Pearland, Houston, Friendswood, and Southeast Texas helps patients find answers through compassionate evaluation, accurate diagnosis, and comprehensive treatment.
The carpal tunnel is a tight, protective canal formed by the carpal bones at the bottom and a strong ligament — the transverse carpal ligament — forming the roof. Within this space run the median nerve and nine flexor tendons that control finger motion.
Because the tunnel is so narrow, even minor swelling or structural change can increase pressure and irritate the median nerve. This compression can develop from several factors, often working together rather than one single cause.
Common Causes and Risk Factors
- Repetitive wrist motion: Typing, assembly line work, or prolonged tool use can irritate the tendons in the wrist, leading to inflammation and swelling.
- Wrist injuries or fractures: Trauma may change the anatomy of the tunnel, creating less space for the nerve.
- Inflammatory conditions: Diseases such as rheumatoid arthritis cause swelling in soft tissues and tendons, compressing the nerve.
- Fluid retention: Hormonal changes during pregnancy or menopause can increase pressure within the tunnel.
- Chronic conditions: Diabetes, thyroid disease, and obesity can make nerves more susceptible to injury and inflammation.
- Genetics: Some individuals are born with smaller carpal tunnels, increasing their risk even with minimal strain.
Many people notice their first symptoms during work, driving, or at night — times when the wrist bends and pressure builds naturally.
Carpal Tunnel Syndrome develops gradually, often beginning as mild tingling or numbness that comes and goes. Over time, symptoms can become constant, affecting coordination, strength, and quality of life.
Common symptoms include:
- Numbness and tingling: Most often felt in the thumb, index, middle, and part of the ring finger. The little finger usually remains unaffected, helping differentiate CTS from other nerve conditions.
- Nighttime discomfort: Many patients wake up with burning or tingling sensations and may shake their hands to “wake them up.”
- Pain radiating up the forearm: Especially when performing repetitive motions or gripping objects.
- Weakness or clumsiness: Difficulty gripping tools, holding a phone, or performing fine movements like buttoning shirts.
- Swelling sensation: Some describe their fingers as feeling swollen even when they are not.
As the condition progresses, muscles at the base of the thumb (thenar muscles) may weaken or atrophy, leading to reduced hand function. Recognizing these signs early is key to preventing permanent nerve damage.
Diagnosing Carpal Tunnel Syndrome involves understanding both your symptoms and the anatomy of your wrist. At Dr. Burke Orthopedics, we combine clinical expertise with diagnostic technology to confirm the cause of your discomfort.
Evaluation typically includes:
- Comprehensive examination: Dr. Robert L. Burke reviews your medical history, work habits, and symptoms. He may perform gentle tests like Phalen’s maneuver (wrist flexion) or Tinel’s sign (tapping over the nerve) to reproduce sensations.
- Nerve conduction studies: Measures how quickly electrical impulses move through the median nerve to detect any delay or blockage.
- Electromyography (EMG): Evaluates muscle function to determine the severity of nerve compression.
- Ultrasound or MRI imaging: Helps visualize swelling, structural abnormalities, or surrounding inflammation.
This precise approach ensures the treatment plan targets the true source of pain rather than only addressing the symptoms.
Treatment depends on the severity of symptoms and how long the condition has been present. Early intervention can often prevent surgery, while advanced cases may require surgical decompression to restore nerve function.
Non-Surgical Treatments
Most mild to moderate cases can be successfully managed without surgery.
- Wrist splinting: Wearing a wrist brace, especially at night, keeps the joint in a neutral position and relieves pressure on the nerve.
- Activity modification: Avoiding repetitive or forceful wrist motions and adjusting ergonomic positioning at work can make a significant difference.
- Anti-inflammatory medications: NSAIDs can help reduce pain and swelling.
- Strengthening and flexibility exercises under professional guidance can improve posture, circulation, and joint mechanics.
- Corticosteroid or PRP injections: Targeted injections can calm inflammation around the nerve, often providing relief for several months.
Surgical Treatment
When conservative care does not provide relief, Carpal Tunnel Release Surgery may be recommended.
This outpatient procedure involves making a small incision in the wrist to gently cut the ligament covering the carpal tunnel, releasing pressure on the nerve. The incision is then closed, allowing the ligament to heal while creating more space for the nerve.
Dr. Burke performs these procedures with precision and care, utilizing advanced techniques that minimize downtime and support faster recovery.
Recovery time depends on symptom duration and treatment method. Many patients notice improvement within weeks after non-surgical therapy, while surgical recovery can take several months for full strength and sensation to return.
Tips for successful recovery:
- Keep the wrist straight while sleeping or resting
- Avoid excessive grip strength early in healing
- Engage in prescribed hand therapy to rebuild motion and dexterity
- Apply cold compresses to reduce swelling and discomfort
- Gradually return to work or activity as recommended by your orthopedic specialist
Preventing recurrence involves maintaining proper ergonomics, taking breaks during repetitive tasks, and keeping the wrist and forearm flexible and strong. Dr. Burke and his team guide patients through individualized recovery programs designed to protect nerve health and restore confidence in daily function.
Because wrist pain can come from multiple causes — such as tendonitis, arthritis, or nerve entrapment — it’s important to distinguish Carpal Tunnel Syndrome from other conditions.
Unlike tendon-related pain, CTS typically causes numbness and tingling rather than just soreness, and it follows a specific pattern in the thumb, index, and middle fingers.
Early evaluation by an orthopedic specialist ensures the correct condition is identified and properly treated.
Take the First Step Toward Relief
If tingling, numbness, or weakness in your hands is disrupting your work or sleep, now is the time to seek evaluation. Early diagnosis can prevent long-term nerve damage and restore full hand function.
At Dr. Burke Orthopedics, our goal is to help you understand the source of your symptoms and find the most effective, least invasive treatment. Our compassionate approach blends advanced orthopedic knowledge with personalized care to help patients across Pearland, Houston, Friendswood, and Southeast Texas return to a pain-free, active lifestyle.
Call (713) 436-3488 or Request an Appointment Online to schedule a consultation with Dr. Robert L. Burke,
board-certified orthopedic surgeon specializing in wrist and hand conditions.
