CARPAL TUNNEL SYNDROME

Is it carpal tunnel? Here's how to know.

Carpal tunnel syndrome is one of the most common hand conditions in Canada. Understanding your symptoms is the first step toward relief.

WHAT IS CTS

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a common condition of the hand caused by dysfunction of the median nerve as it enters the hand from the forearm. The nerve passes through a narrow space called the carpal tunnel on its way to the fingers and thumb.

The median nerve gives sensation to the thumb, index, middle, and half of the ring finger on the palm side. It also controls some of the small muscles in the hand. When it becomes compressed, the result is numbness, tingling, burning, pain, and weakness.

Anything that causes the contents of the tunnel to swell or the tunnel to get smaller can lead to carpal tunnel syndrome. This includes tendon swelling from repetitive strain, arthritis, diabetes, and obesity.

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symptoms

What does carpal tunnel syndrome feel like?

Symptoms typically start gradually and worsen over time. Recognizing them early can prevent long-term nerve damage.

Pain, numbness, and tingling in the thumb, index, middle, and half of the ring finger. Often described as burning, pins and needles, or tingling. The pinky is usually not affected.

Weakness. The median nerve controls small muscles in the hand and thumb. Compression reduces the nerve signal those muscles receive, leading to weakness in grip and pinch.

Night waking and positional symptoms. Many patients wake at night and need to shake out their hands to find relief. Some only notice symptoms during specific activities such as driving, using a phone, or keyboarding.

Cramping, spasms, and atrophy. Muscles that do not receive adequate nerve input can cramp or spasm. If untreated over time, they can atrophy and become permanently weak.

Radiating pain up the arm. Some patients describe a shooting sensation that travels up the arm from the wrist. This is different from symptoms that originate at the neck or shoulder and radiate downward.

Difficulty with fine dexterity. Manipulating small objects like buttons or coins becomes difficult when you cannot feel your fingers and the small hand muscles are not functioning normally.

SYMPTOM CHECKER

Symptom Severity Scale for Carpal Tunnel Syndrome

Symptoms typically start gradually and worsen over time. Recognizing them early can prevent long-term nerve damage.

Symptom

0

None

1

Mild

2

Moderate

3

Severe

4

Very severe

Numbness / Tingling

None

Occasional; brief

Intermittent; several times per day

Frequent; most of the day

Constant; all the time

Pain / Discomfort

None

Mild ache; no medication needed

Moderate pain; may use over-the-counter meds

Severe pain; limits activities; may need prescription meds

Very severe pain; hard to do most activities

Weakness

None

Slight weakness; no impact

Some weakness; noticeable with certain tasks

Marked weakness; difficulty with many tasks

Severe weakness; hard to grip or hold objects

Night Symptoms

No night symptoms

Rarely wakes up; sleep not affected

Wakes up 1–2 times per night

Wakes up several times; trouble sleeping

Constant night symptoms; very little or no sleep

Functional Impact

No Impact

No limitation; able to do all activities

Some limitation; adjusting or taking breaks

Much limitation; avoids or needs help with activities

Unable to do most activities; needs assistance

causes

What causes carpal tunnel syndrome?

CTS develops when pressure builds up inside the carpal tunnel, compressing the median nerve.

Repetitive activities

Repetitive tasks, holding the hand in certain positions, and vibration are commonly associated with CTS development.

General health

Diabetes, thyroid disease, arthritis, and obesity can all contribute by causing swelling or thickening of the carpal tunnel contents.

Unknown origin

Often no definitive cause can be found. CTS can develop without obvious risk factors.

Pregnancy

Pregnancy commonly causes CTS due to fluid retention and swelling. Symptoms may resolve but sometimes persist or recur after the first or later pregnancies.

diagnosis

How is carpal tunnel syndrome diagnosed?

Any patient experiencing symptoms more than once or twice a week should be assessed by a qualified healthcare provider. A physician, physiotherapist, or nurse practitioner can perform an initial assessment.

Diagnosis typically involves a combination of physical examination, medical history, nerve conduction studies, and ultrasound. Ultrasound can show more detailed nerve anatomy and swelling, and is increasingly used alongside nerve conduction testing. Many conditions can mimic CTS, so a proper diagnosis is important before proceeding to treatment.

A recent nerve conduction study (EMG) confirming carpal tunnel syndrome is required before booking a procedure at Alloy Hand Surgery. We can connect you with EMG providers in Calgary to make this step as straightforward as possible.

Procedures

open vs endoscopic carpal tunnel release

Different Approach, Same Result

Scar & Healing Comparison

TREATMENT OPTIONS

From symptoms to surgery:  your pathway to relief.

Mild to moderate symptoms can often be managed non-surgically. Moderate to severe symptoms should be treated surgically to minimize the risk of permanent damage.

Non-Surgical Options

Splinting

Splints keep the wrist in a neutral position and reduce pressure on the nerve. Best used at night while sleeping. Should not be worn 24/7.

Activity and ergonomic changes

More frequent breaks, modified tasks, and ergonomic workspace adjustments can reduce tendon swelling and symptom frequency.

Lifestyle and disease management

Changes in diet, exercise, and management of conditions like diabetes can decrease inflammation and reduce symptoms.

Steroid injections

Corticosteroid injections can reduce swelling in the carpal tunnel and provide excellent temporary relief. Effects do not address the underlying cause.

Surgical Options

Both techniques are effective. The goal of surgery is to relieve pressure on the nerve by releasing the elastic roof of the carpal tunnel.

Open Release:

Incision: 3 to 4 cm palm incision
Sutures: 3 to 5 required
Anesthetic: Local only

Endoscopic Release
(Dr. Loiselle's technique):

Incision: ~1 cm wrist incision
Sutures: 1 dissolving suture
Anesthetic: Local only

Why Endoscopic:

Less pain — Smaller incision means less post-operative discomfort.
Faster return to activity — No palm incision means quicker return to work and sport.
Minimal scarring — Very small scar, difficult to see after 6 months.

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READY TO GET STARTED?

Back to your life, without the wait.

Book your same-day consultation and procedure today. Please note that a recent nerve conduction study (EMG) confirming carpal tunnel syndrome is required prior to booking.

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