The following symptoms and complaints may collectively indicate carpal tunnel syndrome:
Leading symptom
- Hand falling asleep, especially at night, often associated with pain (brachialgia paraesthetica nocturna) [50-60% of cases involve both hands; risk of confusion with cervical spine syndrome, polyneuropathy, or cervical myelopathy-see under differential diagnoses].
Associated symptoms
- Painful paresthesias (paraesthetics) such as tingling, pins and needles, mainly in the middle finger, especially at night (brachialgia paraesthetica nocturna); later radiating to the arm [“shaking sign”: paresthesias disappear or improve when “shaking out” the hands!].
- Electrifying paraesthesia
- Increased pain with extreme bending or stretching in the wrist joint
- Numbness of the fingers (affecting the first three and a half fingers palmar (palm side) and the first two and a half fingers.
- Spontaneous pain with proximal (located toward the body) radiationdorsal/dorsal of the hand) [late symptom].
- Atrophy (tissue atrophy) of the thumb ball muscles of the M abductor pollicis brevis or M opponens pollicis and sensory disturbances (of the palm and fingers 1-3 including the radial side of the 4th finger) [late symptom].
- Skin/nail changes (rare).
