What to Know About Wrist Pain & Carpal Tunnel

You wake up with numb fingers and can’t spend more than 30 minutes on the computer without shaking out the pain in your wrists and hands.

Could you have carpal tunnel syndrome?

If it’s not carpal tunnel syndrome, what’s causing your wrist pain?

While wrist pain and carpal tunnel syndrome are often conflated, one is not always associated with the other.

To get the relief you need, it’s crucial to understand carpal tunnel syndrome — its causes, symptoms, and treatments — and how it differs from regular wrist pain.

What Is Carpal Tunnel?

Located in the wrist, the carpal tunnel is a small passageway through which the median nerve and the flexor tendons travel.

The median nerve controls muscles situated at the base of the thumb and is responsible for providing feeling to the thumb and fingers.

The flexor tendons work to bend the thumb and fingers.

“Carpal tunnel syndrome occurs when there is increased compression on the carpal tunnel caused by a tight ligament, swelling in the wrist, or excessive wrist motion,” says Sara Mikulsky, PT, DPT, FNS, CEAS, owner of Wellness Physical Therapy in New York City.

“This compression puts stress on the median nerve, which can lead to pain and weakness,” she explains.

The most common carpal tunnel syndrome symptoms are pain and numbness in the palm and hands.

And while the carpal tunnel is located in the wrist, wrist pain is not typically a symptom of carpal tunnel syndrome, says Mikulsky.

“Pain is not usually in the wrist unless there is also underlying wrist arthritis,” she adds. “Wrist pain alone can be a sign of wrist sprain, fractures, or tendonitis.”

Carpal tunnel syndrome can usually be diagnosed with two simple, non-invasive tests:

• Tinel’s sign
• Phalen’s maneuver

“The Tinel sign is completed by tapping on the median nerve at the wrist joint. If tingling or numbness is felt in the fingers, it is a positive sign,” Mikulsky says.

“The Phalen’s maneuver is completed by flexing the wrist fully and placing the back of the wrist together. This position is held for about a minute. A positive test occurs when numbness and tingling are felt in the hands,” she adds.

How Do You Get Carpal Tunnel?

Narrowing of the carpal tunnel and compression of the median nerve, which leads to carpal tunnel syndrome, can be caused by a variety of factors, including:

• inflammation and swelling due to arthritis
• autoimmune disease
• pregnancy

Any of these conditions may cause narrowing of the carpal tunnel.

“This narrowing can also occur if a fracture of the wrist bones occurs and changes the shape of the bony structures,” Mikulsky says.

Obesity may also contribute to carpal tunnel syndrome, as adipose tissue can compress and narrow the carpal tunnel.

Repetitive movements of the hands and wrists may also lead to carpal tunnel syndrome, says Dr. Jordan Duncan, DC, owner of Silverdale Sport & Spine in Silverdale, Washington.

“Work that involves repeated wrist flexion and extension, particularly to the extremes of the range of motion, especially when combined with forceful pinching or gripping, can cause carpal tunnel syndrome,” he says.

For example, the repeated action of pouring from a full carafe of water could lead to a restaurant server developing carpal tunnel syndrome.

How Do You Relieve Wrist Pain?

Once a medical professional diagnoses carpal tunnel syndrome, it can often be treated with physical therapy.

Mikulsky says the focus will be to improve the space of the carpal tunnel by:

• Completing forearm stretches to elongate muscle
• Strengthening exercises to improve scapular muscles to decrease stress over the forearm muscles
• Education in maintaining neutral wrist position during activity to decrease stress on the carpal tunnel

Ice, massage, and joint mobilization may also be used to reduce inflammation.

However, in severe or prolonged cases of carpal tunnel syndrome, surgery may be required.

For wrist pain that is not associated with carpal tunnel, a doctor may recommend activities to provide relief, including:

• rest
• gentle mobilization exercises
• nighttime splinting

And, if you spend most of your day in front of a computer, it’s a good idea to reevaluate your workstation, as improper ergonomics can aggravate wrist pain and carpal tunnel syndrome.

“You want to orient the height of the desk so that your forearms are roughly parallel to the floor. This may be lower than usual for most people, but the goal is to allow for a more neutral wrist position when typing,” says Duncan.

Keeping your work centered in front of you will keep your hands and wrists in line with your forearms.

Duncan adds, “Avoid putting pressure on the heel of your hand and wrist, as this can increase pressure on carpal tunnel and median nerve.”