Complaints & connections · borters.ch
The median nerve has too little room at the wrist — numb fingers at night are the typical first sign.
Also known as: carpal tunnel syndrome · median nerve compression
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
The median nerve runs through a narrow tunnel at the wrist and gets compressed there. Characteristic: the hand falling asleep and tingling at night, affecting thumb, index and middle finger but sparing the little finger — many shake the hand to get rid of it. Later come pains radiating into the arm and loss of grip strength; fine objects slip from the hand. More common in women, in pregnancy, with an underactive thyroid, diabetes and rheumatic disease. Early on, a night splint and treating the underlying cause often help; with persistent symptoms or wasting of the thumb muscle, a small operation is very effective.
The carpal tunnel tingles and numbs the fingers at night. If the pain instead sits sharply over the thumb side and shoots on gripping, it is about the tendon sheath.
In sleep the wrist bends and the pressure in the tunnel rises. A splint that keeps the wrist straight improves things for many within weeks — and it is the cheapest measure there is.
Waking at night and having to shake the hand so the tingling eases describes the typical picture. That says more for the diagnosis than most tests in the consulting room.
The nerve measurement is done before an operation, with an unclear picture and when the neck or the elbow could also be the cause. For the first splint it is not needed.
Pregnancy, an underactive thyroid, diabetes, rheumatism and strongly vibrating tools favour the narrowing. In pregnancy it usually goes by itself after the birth.
Visible wasting of the ball of the thumb or a lasting numbness means the nerve has been under pressure for a while. Waiting is then no longer the best choice — lost fibres come back slowly or not at all.
Women are affected about three times as often. It typically starts at night, because the wrist bends during sleep — which is why a night splint alone often helps. In pregnancy it is common and usually disappears again afterwards.
A night splint keeps the wrist straight, because pressure in the tunnel is highest in bending and stretching — it works in about half within four to six weeks. A cortisone injection works in most people, but only for weeks to months. Vitamin B6 brought nothing in comparisons. No drug widens the tunnel; only cutting the ligament does. After surgery the night-time tingling usually goes within days, while strength and numbness take months.
Rest the forearm, bring the mouse closer, keep the joint straight — hours in a bent position raise the pressure in the tunnel. Night-time symptoms still need assessing.
Tingling and numbness that wake one from sleep, in thumb, index and middle finger — the little finger stays free. Shaking the hand helps. That is the core pattern.
Phoning, holding a newspaper, cycling, gripping the steering wheel, using a hairdryer: activities with the hand raised or bent bring on the tingling.
Cups slip, buttons and zips become difficult, fine work fails. That comes later than the tingling and shows that the strength is affected too.
A pull that travels up from the wrist into forearm and shoulder is often taken for a neck problem. The night-time start in the fingers tells the two apart.
Without B12 the insulating layer of the nerves is not maintained. A lack causes tingling, numbness and unsteadiness in the dark — and it is one of the few reasons for nerve trouble that can be fully undone if found early.
The nerves cover their energy needs through thiamine. It runs short with alcohol, after stomach operations, with long-lasting vomiting and under water tablets.
Here both count: a lack harms the nerves, and too high an intake over months harms them as well. Supplements therefore belong taken in a dose that has a reason.
Works together with B12. Given alone, folate can improve the blood count while the B12 deficiency goes on damaging the nerves — which is why both are looked at together.
Recommended for this since the 1970s; the controlled studies found no difference. The catch is the amount that became usual with it: above 50 mg a day over months it can itself cause nerve complaints — exactly the picture meant to be treated.
Not as treatment but to tell apart: a B12 deficiency causes tingling in both hands, carpal tunnel usually in one and only in the first three fingers. Where the picture does not fit, the value belongs measured.
In pregnancy clearly established against neural-tube defects, otherwise mainly with deficiency. Can mask a B12 deficiency — watch both.
An underactive thyroid stores fluid in the tissue and narrows the tunnel at the wrist. It is among the few causes where treating the underlying illness heals the hand.
In pregnancy the tissue swells and the complaints typically come at night. They usually vanish by themselves after the birth — which is why surgery is rarely done here.
A raised sugar changes tendons and connective tissue. That is why carpal tunnel, trigger finger and frozen shoulder occur more often and frequently together in diabetes.
The tunnel is narrow; any extra tissue presses. In pregnancy and in an underactive thyroid it is water retention that causes the trouble — and it usually recedes afterwards.
Nerve gliding exercises and a night splint improve mild to moderate cases. With lasting numbness or muscle wasting an operation belongs considered — waiting then costs substance.
Traditionally recommended. Controlled studies show no benefit for carpal tunnel itself — with a coexisting deficiency correction is worthwhile for other reasons.
The point lies exactly over the median nerve, three fingers above the wrist crease — not a coincidence but the same anatomy under two names.
Between thumb and index finger. One of the classic points for hand complaints; traditionally avoided in pregnancy.