Carpal Tunnel Symptoms
Nighttime pain or numbness in your hands results in loss of sleep, with the dominant hand being slightly more involved than the nondominant hand, occurring in about 7 out of 10 patients with carpal tunnel syndrome. Ultimately, both hands are typically affected - not necessarily simultaneously. This problem can be seen most often in people over the age of 30 (9 out of 10), but has been reported in children as young as two years of age. In my personal experience, my youngest patient presented at four years of age. Numbness and tingling in the thumb, index, and long fingers plus the thumb side of the ring finger; i.e. split down the middle - see diagram - (this tends to be noticed only in the most alert and sensitive people), with or without clumsiness.
In many patients, a feeling of swelling of their hand particularly in the mornings is noted. Some loss of dexterity with declining penmanship (writing intolerance and poor writing quality) as well as difficulty with handling small objects such as a needle or buttons are quite common. Women specifically will tend to complain of the difficulty with personal grooming and may burn themselves with loss of control of their curling iron, and they may complain of difficulty pulling up their nylons or fastening their bras or clasping their earrings. They often complain of a fear of dropping their infant and in older women, fear of dropping their grandchildren. Men are more likely to complain of having tools fly out of their hands.
Weakness is perceived by many, but measured weakness with use of a dynamometer or pinch strength weakness measured with a pinch meter actually only occur rarely due to carpal tunnel syndrome. This is because the median nerve at the level of the carpal tunnel at the wrist does not innervate much muscle.
It is mostly just the sensory nerve. Measurable weakness of grip and pinch is usually a sign of ulnar nerve dysfunction or some other very significant nerve disorder. It is these distinctions that make nerve conduction studies (NCS) very important and necessary in evaluation and treatment of patients so presenting.