Symptoms of carpal tunnel syndrome

Introduction

The patients’ symptoms (clinic) depend on the cause, extent and duration of the damage. The carpal tunnel syndrome often begins with the so-called falling asleep and “formication” (= tingling) on the tip of the middle finger. The symptoms are triggered by a one-sided position of the wrist when using the telephone, riding a bicycle, working with strongly vibrating tools or in office activities with frequent PC work. A short time later the patient has the feeling of a swollen hand.

Characteristic features

However, the most characteristic feature of carpal tunnel syndrome is nocturnal or morning sleep of the hand and radiating hand-/arm pain (Brachialgia paraesthetica nocturna). The pain and paresthesia disturb the patient’s sleep at night. Frequently, an attempt is made to dispel the sensory disturbance by rubbing or shaking the hand.

Nocturnal complaints such as “falling asleep” of the palm and thumb, index finger and middle finger Pain in the early stages after exertion In the late stages spontaneous or even permanent Paresthesias: numbness, “falling asleep” of the hand Tingling, “ant walking” in fingers and palm Stiff and swollen fingers in the morning Hypaesthesia: deterioration of the sense of touch and loss of sensitivity Ball-of-thumb atrophy: muscular atrophy of the thumb

  • Night-time complaints such as “falling asleep” of the palm and thumb, index and middle finger
  • Pain in early stage after exertion In late stage spontaneous or even permanent
  • In the early stages after stress
  • In the late stage spontaneously or even permanently
  • Paresthesias: numbness, “falling asleep” of the hand tingling, “ant walking” in fingers and palm
  • Tingling, “ant walking” in fingers and palm
  • Stiff and swollen fingers in the morning
  • Hypaesthesia: deterioration of sense of touch and loss of sensitivity
  • Bunion atrophy of the thumb: Muscular atrophy of the thumb
  • In the early stages after stress
  • In the late stage spontaneously or even permanently
  • Tingling, “ant walking” in fingers and palm

Nocturnal pain and sensation disorders of the fingers and palm are the typical early symptoms of carpal tunnel syndrome. Particularly affected are the thumb, index finger and middle finger as well as the palm of the hand. Often, the patients wake up due to the nightly pain and sensations.

Typically, the symptoms are improved by shaking and massaging the hand. The night-time pain is perceived as extremely disturbing and has a negative effect on sleep patterns. If those affected often wake up from nightly pain, daytime tiredness and lack of concentration are to be expected the next day.

The characteristic symptoms of carpal tunnel syndrome, tingling and numbness, are so-called paraesthesias, i.e. sensations in the skin. The tingling is a sensation on the surface of the body, which is perceived by those affected as extremely disturbing and unpleasant. Those affected also describe the tingling sensation as a feeling of “ants running” on the skin or touching a nettle.

A numbness is accompanied by a significantly reduced sensation of touch. The affected body parts feel numb to the sufferer. At the same time, many affected persons feel that the affected areas have fallen asleep.

Touch, temperature and pain sensations are enormously reduced. The discomfort, tingling and numbness, often starts in the fingers, especially the middle finger, index finger and thumb. The paresthesias can affect the palm and radiate into the forearm.

Thumb ball atrophy refers to muscle atrophy in the area of the ball of the thumb. It is a classic late symptom of carpal tunnel syndrome if left untreated. The thumb ball muscles, Musculus abductor pollicis brevis and Musculus opponens policis, lose muscle mass. The muscle atrophy is most noticeable when grasping a bottle or opening and closing it. These movements are clearly hindered due to atrophy of the ball of the thumb.