Shoulder, arm & hand
Carpal tunnel syndrome
Hand tingling that often wakes you at night
What it means
Carpal tunnel syndrome involves compression of the median nerve at the wrist. It often affects the thumb, index, middle, and part of the ring finger. The timing, finger distribution, and exam help distinguish it from problems elsewhere along the nerve. [1, 2]
What I check in the clinic
I ask which fingers tingle, whether you shake the hand to settle it, and what happens with work or driving. I may compare the wrist and neck exams to see which findings match. Increasing weakness or persistent numbness deserves medical follow-up.
What the evidence says about care
A night splint is sometimes tried, although evidence about the magnitude of benefit is uncertain. A Cochrane review found surgery probably produced more clinical improvement than splinting at longer follow-up in the studied populations. Your exam and symptom severity help guide that discussion. [3, 4]
Common questions
Why do I wake up with tingling but feel fine using my hand at breakfast?
Tell me which fingers you notice and what helps the feeling settle. I’d use that pattern alongside the wrist and neck exam to decide what to check next.
How can I tell whether the night symptoms are changing?
Notice which nights it wakes you and how long it takes to settle. A simple note gives us something more concrete to compare than how your hand feels at the appointment.
Why does holding my phone bring on tingling when typing feels fine?
I’d ask which fingers are involved and what your wrist and arm are doing in each position. We can compare a small change in support and see how it fits the rest of the exam.
What if the tingling changes hands?
Tell me whether it’s the same fingers and what you were doing each time. That can change where I look and what other assessment we discuss.
When should I ask about a hand specialist?
If numbness persists or you notice increasing weakness or loss of thumb function, contact your clinician to discuss further assessment. [1]
What should I bring to an evaluation?
Bring one example of a movement or activity you want back, along with any relevant imaging or treatment notes you already have.