Carpal Tunnel Syndrome Explained to Africans

By: Rukhsar Jabbar. M.Sc. Physiotherapy. Freelance Health Writer and Datelinehealth Africa (DLHA) volunteer. Medically reviewed by A. Odutola. MB BS, PhD, FRCSEd.

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Displeased-Afro-girl holding onto the wrist of her flexed left arm. Credit source - Freepik

 

Key points

• Carpal Tunnel Syndrome (CTS) is a common hand condition that occurs when a major nerve in the wrist - the median nerve, is compressed as it passes through a tunnel in front of and over the bones of the wrist.
• CTS is often due to repetitive hand movements or poor wrist posture.
• Tingling, numbness, pain, in the thumb, index, middle, and part of the ring finger; often worse at night.
• Repetitive tasks, ergonomics, certain health conditions (like diabetes or thyroid issues), pregnancy, and genetics.
• Take regular breaks, maintain proper wrist posture, use ergonomic setups, and perform hand/wrist exercises.
• Options range from wrist splints and activity modification to medications, exercises, or surgery in severe cases.

 

Introduction

Carpal Tunnel Syndrome (CTS) happens when a nerve in your wrist, called the median nerve, gets squeezed in a narrow space known as the carpal tunnel. This usually happens when there’s extra pressure in the wrist. The first signs are often tingling, numbness, or pain in your thumb, index, and middle fingers, and the thumb side of your ring finger.

At first, these symptoms usually appear at night while you’re lying down and may feel better during the day. Over time, you might notice them during the day too, especially when doing activities like typing, drawing, or playing video games. In severe cases, symptoms may be constant. Jobs that involve repetitive hand movements or vibrating tools can increase the risk of CTS. Other factors include obesity, diabetes, thyroid problems, rheumatoid arthritis, pregnancy, and family history. [1]

This article will help you understand CTS, its causes, symptoms, and treatments. You’ll also learn simple lifestyle changes and exercises that can reduce pain and keep your hands healthy.

 

What is Carpal Tunnel Syndrome?

To understand carpal tunnel syndrome, you need to first learn about a space in the front of your wrist called the carpal tunnel. 

The carpal tunnel is a small passage in the front of your wrist. The opening is covered by a thick band of tissue called the transverse carpal ligament, and behind it are wrist bones. Through this narrow space pass nine tendons (cord-like structures) that help you bend your fingers, along with an important nerve called the median nerve, which controls some movement and sensations in your hand. 

Cartoon illustration of the front of wrist to show the carpal tunnel and its contents. Click on image to emlarge. Image credit: Freepik

 

Carpal Tunnel Syndrome (CTS) happens when this nerve gets pinched or irritated because of too much pressure, or injury, or poor blood flow [1]. The median nerve controls some muscles in your forearm and hand, and provides sensation to the palm side of your thumb, pointer finger, middle finger, and the thumb side of your ring finger. It also controls feeling in the back of the fingertips of your thumb and pointer finger, part of the ring finger on your palm, and even part of your inner forearm [2].

Cartoon illustration showing the nerves that process sensations from different areas of the front and back of the skin of the hand. The areas shaded in blue may feel numb, burning or tingly when you have Carpal Tunnel Syndrome. The abnormal sensations are due to compression of the median nerve in the wrist. 

 

Around the world, up to half of all people may experience muscle and bone pain each month, and CTS is one of the common reasons for this discomfort. It affects about 5 out of every 100 people worldwide and 12 out of every 100 people in Africa [3].]

 

Signs and Symptoms of Carpal Tunnel Syndrome

The signs of carpal tunnel syndrome include:

• soreness or discomfort in your fingers, hand, or arm
• loss of feeling in your hands
• a prickly sensation or feeling like your hand has "fallen asleep"
• weakness in your thumb or trouble holding things firmly

These signs typically begin gradually and may come and go. They tend to be more bothersome during nighttime hours. [4]

 

What Causes Carpal Tunnel Syndrome?

Infoposter: Causes of Carpal Tunnel Syndrome. Click on image to enlarge. Adapted from here.

 

Most carpal tunnel syndrome cases happen because of several reasons working together. Research shows that women and elderly people have a higher chance of getting this condition.

Other things that increase your risk of carpal tunnel syndrome include:

• Medical problems - Conditions like rheumatoid arthritis, diabetes, and thyroid problems are linked to carpal tunnel syndrome. 
• Being pregnant - Hormone changes during pregnancy can cause swelling that puts pressure on the nerve.
• Wrist injury, including fracture that causes swelling and inflammation of contents in the carpal tunnel thereby reducing the space.
• Family history - This is probably a major factor. Some people are born with a smaller carpal tunnel, or they may have body differences that leave less room for the nerve and these features can be passed down through families.
• Repetitive movements - Doing the same hand movements over and over - Repeating the same hand and wrist actions or tasks for long periods can irritate the stretchy cords in your wrist, causing them to swell up and press on the nerve.

 

How Carpal Tunnel Syndrome is Diagnosed

•  Medical History

Diagnosing Carpal Tunnel Syndrome (CTS) usually begins with a doctor or physiotherapist asking about your symptoms and daily habits. Most people with CTS notice numbness, tingling, or wrist pain at night that affects the fingers and hand. In more severe cases, people with CTS may complain of weakness in the muscles of the thumb. 

Talk with your healthcare provider early if you have these symptoms

• Physical Examination

During your checkup, your doctor will closely look at your hand and wrist and do several hands-on tasks. 

During these tasks, your doctor may:

• Press down or gently tap along the main nerve on the palm side of your wrist and hand to see if it causes tingling in your fingers (called Tinel's sign).
• Bend your wrists downward and hold them in that position to check if your hands feel numb or tingly.
• Test how well you can feel things by gently touching the skin of parts of your hand and fingers with cotton wool while you keep your eyes closed.
• Check if the muscles at the base of your thumb are weak or have gotten smaller.

In most cases, doctors can diagnose carpal tunnel syndrome just by asking about your medical history and doing a physical exam, without needing additional tests. Sometimes, you may need other tests. 

• Diagnostic tests

A. Electrodiagnostic tests 

Your doctor might request special electrodiagnostic nerve tests to check how well your main wrist nerve is functioning and help identify if there's too much pressure on the nerve.

These tests will also help your doctor find out:

• How serious your carpal tunnel syndrome is
• If the nerve is being squeezed in other places too
• If other nerves in your wrist are also having problems
• If you have another medical condition that's affecting your nerves along with carpal tunnel syndrome.)

The electrodiagnostic tests may include:

• Nerve conduction studies (NCS) - These tests check how well electrical signals move through the nerves in your hand and arm and can find out when a nerve isn't sending its signals properly. Nerve conduction studies can help your doctor understand how bad your problem is and decide on the best treatment.
• Electromyogram (EMG) - An EMG checks the electrical activity in your muscles at rest and on movement. EMG results can show if your muscle weakness or size reduction is due to nerve damage or direct muscle damage.

B. Medical imaging tests

Other tests that your doctor may ask for are grouped together as medical imaging tests. These include:

• Ultrasound - An ultrasound uses high-pitched sound waves to create pictures of bones and soft tissues. Your doctor might suggest an ultrasound of your wrist to look at the main nerve for signs that it's being squeezed.
• X-rays - X-rays take pictures of hard structures like bones. If you have trouble moving your wrist or wrist pain, your doctor may order X-rays to rule out other reasons for your symptoms, such as arthritis, injured ligaments, or a broken bone. 
• Computerised Tomographic imaging (CT) or Magnetic Resonance imaging (MRI) scans - CT and MRI scans provide better images of the body's soft and bony tissues than X-rays. Your doctor may order a CT scan to help determine other causes for your symptoms or to look for abnormal tissues that could be impacting the median nerve. An MRI especially can also help your doctor determine if there are problems with the nerve itself, such as a tumor or scarring from an injury. 

 

Treatment of Carpal Tunnel Syndrome

I. Nonsurgical treatments 

An African physiotherapist fits a black wrist brace on a male patient’s hand during treatment in a bright medical clinic, illustrating wrist pain care for Carpal Tunnel Syndrome. Credit: AI using OpenID’s DALL·E. Click on image to enlarge.

 

Bracing or splinting - Wearing a brace or splint at night will stop you from bending your wrist while you sleep. Keeping your wrist straight reduces pressure on the nerve in the carpal tunnel. You might also find it helpful to wear a splint during the day when doing things that make your symptoms worse.

Anti-inflammatory medicines (NSAIDs) - Pain-relieving medicines like ibuprofen and naproxen can help reduce pain and swelling.

Changing your activities - Symptoms often happen when your hand and wrist stay in the same position for too long — especially when your wrist is bent up or down. If your work or hobbies make your symptoms worse, changing or adjusting these activities can help slow down or stop the condition from getting worse. Sometimes this might mean making changes to your workspace or work setup.

Nerve movement exercises - Some patients may benefit from exercises that help the main nerve move more easily within the carpal tunnel space. Your doctor or physical therapist may suggest specific exercises for you.

Steroid shots - Corticosteroid, or cortisone, is a strong anti-swelling medicine that can be injected into the carpal tunnel. These shots often help relieve painful symptoms or calm down a flare-up of symptoms. However, they usually only provide short-term relief and don't offer long-lasting benefits. A cortisone injection may also be used by your doctor to help diagnose your carpal tunnel syndrome.  

Platelet Rich Plasma (PRP) Injections - PRP comes from a patient's own blood and is given as a shot to treat various muscle and bone problems. While some studies show short-term improvement from PRP shots in people with carpal tunnel syndrome, this treatment likely doesn't provide long-lasting benefits.

II. Surgical treatments

If non-surgical treatments don't help your symptoms or only work for a short time, or your tests show significant nerve problems, your doctor may suggest surgery. The decision about whether to recommend surgery depends on:

• How bad your symptoms are
• What the doctor finds during your physical exam
• How well you responded to non-surgical treatments
• Your test results

Surgical Procedure for carpal tunnel syndrome

The surgery for carpal tunnel syndrome is called carpal tunnel release.

Most doctors do this surgery in one of two ways, but both aim to take pressure off your main wrist nerve by cutting the thick band of tissue that covers the tunnel. 

• Open surgery: The doctor makes a small cut in the skin of your palm and looks inside through this opening. They then cut the thick band covering the tunnel, which makes more room and takes pressure off the nerve. After surgery, this band may slowly grow back together but over a longer time, leaving more space in the tunnel.
• Endoscopic surgery: The doctor makes one or two smaller cuts and uses a tiny camera to see inside your hand and wrist. They use a special knife to cut the same thick band.

Both types of surgery work equally well. Each has good points and possible risks. Your doctor will discuss which one is better for you.

The surgery is usually done as a same-day procedure, so you go home the same day. You can be put to sleep completely or just have your hand and arm numbed. Sometimes with numbing medicine, you'll also get mild relaxing medicine through your vein (Intravenous, or IV)

Post-surgery expectations

Right after surgery, you'll be told to keep your hand raised above your heart level and wiggle your fingers to reduce swelling and stop your hand from getting stiff.

You should expect some pain, swelling, and stiffness after the procedure. You may have mild soreness in your palm that could last from several weeks to several months.

 

Is Carpal tunnel syndrome preventable?

Carpal tunnel syndrome can be preventable if you keep follow these preventive tips:

• Take frequent breaks from tasks that require constant hand or wrist movement.
• Use an ergonomic workstation with a comfortable chair, proper desk height, and wrist support.
• Sit with good posture to reduce strain on your hands, shoulders, and neck.
• Do simple hand and wrist exercises each day to keep your joints flexible and strong.
• Vary your movements when performing repetitive tasks like typing or sewing.
• Keep your hands warm, as cold conditions can make your wrists stiff and painful. 

 

Conclusion 

Carpal tunnel syndrome is a common global condition caused by pressure on the median nerve in your wrist, leading to pain, numbness, and weakness in your hand. While it commonly affects women and older adults, it can develop from various factors including repetitive hand use, family history, and certain health conditions. The good news is that most cases can be successfully treated, starting with simple approaches like braces, anti-inflammatory medicines, and activity changes, and progressing to surgery if needed. Early recognition and proper treatment typically lead to significant symptom improvement, allowing people to return to their normal activities and quality of life.

 

References: 

1. Sevy JO, Sina RE, Varacallo MA. Carpal tunnel syndrome. [Updated 2023 Oct 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [Cited 2025 Aug 29]. Available from here

2. Murphy KA, Morrisonponce D. Anatomy, shoulder and upper limb, median nerve. [Updated 2023 Aug 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2025 Sep 10]. Available from here

3. Yesuf T, Borsamo A, Aragie H, Asmare Y. Prevalence of carpal tunnel syndrome and its associated factors among patients with musculoskeletal complaints: a single-center experience from Eastern Ethiopia. BMC Musculoskelet Disord [Internet]. 2025 Jul 9;26:667. Available from here

4. NHS UK. Carpal tunnel syndrome. [Internet]. Last reviewed April 17, 2024. [Cited 2025 Sep 21]. Available from here

 

 

Published: October 28, 2025

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