This diagram indicates where ALL carpal tunnel signs occur. They follow where the Median Nerve is (darker areas indicated on the hand).

In its early stages, carpal tunnel syndrome doesn't bother you during the day while working. In fact, symptoms become noticeable when your hand is quiet and relaxed, as when you're asleep. That's why it's common to have numb hands while sleeping instead of working.

Usually, the fingertips go numb first. The thumb is also most commonly involved. Then your palm becomes numb. 

The numbness can be so bad that it wakes you up. Upon waking, you might feel the need to shake out the numbness. Some people find relief by hanging their hand off the bedside.

As carpal tunnel syndrome progresses, the numbness will last into the daytime. This is a sure sign that the condition has become more severe.

Pain in the areas indicated in the above diagram is another common sign of carpal tunnel syndrome. In the beginning of the disorder, the pain will also likely be present only at night. It might wake you up with the need to rub your hand to relieve the pain. 

As the disorder progresses, the pain (like numbness) will show up during the daytime. Whether during the night or day, the pain can have one or more of these qualities:

• Sharp, dull, aching, or throbbing
• Burning
• Shooting electrical shocks

Tingling, prickling or pins & needles is another key sign of carpal tunnel syndrome. It also occurs in the areas indicated in the hand illustration above. 

When you have carpal tunnel, usually tingling is accompanied by numbness. But this is not always the case.

Once again, at first, the tingling occurs at night while sleeping. As carpal tunnel advances, it starts to show during the daytime.

There are several conditions that can casue burning hands. Carpal tunnel certainly is one of them.

Itching and burning can even appear before you feel pain or numbness in your hands while sleeping. Other symptoms will almost certainly catch up later.

The itchiness and burning is usually confined to the palm and ends of your fingers (see illustration above). As with other symptoms, these symptoms will begin while sleeping. But as carpal tunnel advances, they will appear during the daytime.

Note that any benefit from applying a "carpal tunnel cream" such as "Icy Hot" is only a placebo. That's because the problem is not on your skin (or even below it) but in the nerve inside your wrist joint. 

Like having burning hands and figners, swollen fingers can have many causes. Carpal tunnel is one of them.

Having the feeling of puffiness or swelling is usually just that - a "feeling". That's because your skin feels that way, but looks perfectly normal. And usually the skin is not discolored.

It's rarer for carpal tunnel to cause actual swelling. When it does, usually it's confined to the fingers only. The skin is also not usually discolored.

It's rare for the initial symptoms of carpal tunnel syndrome to appear as hand or finger weakness. While not a rule, it's usually a sign of more advanced carpal tunnel. 

Losing hand strength is a sure sign you have this condition. It starts by having difficulty opening doors or jars. 

More advanced stages of carpal tunnel syndrome can see progressive and catastrophic loss of hand strength. That means people often drop things like phones, cups, keys, and kitchen utensils. 

Like weakness, hand clumsiness usually occurs as carpal tunnel advances further. It's rarer for clumsiness to be a first sign of this condition.  

The clumsiness means loss of dexterity. Carpal tunnel patients often find it difficult to write with a pen, pick up coins or keys, or turn a door knob. Tying a shoelace, buttoning a shirt, or combing your hair feels awkward. Dropping things like dishes, cups, and books is a daily occurrence. Care must be taken when holding infants.

Keeping your hand in the neutral (flat) position helps reduce pressure inside your wrist joint. If you bend your wrist unconsciously when you sleep, pressure rises inside your wrist joint. This compresses (crushes) the median nerve, making your carpal tunnel syndrome much worse. 

In contrast, bracing your hand in the neutral position eases pressure on the median nerve. This also keeps you from over-bending your wrist, further damaging the median nerve. The result is that the brace promotes healing while you sleep.

2 IMPORTANT BRACING CAUTIONS

1. Generic (pharmacy) braces commonly sold at Walgreens, Walmart, CVS, etc. are harmful if you have carpal tunnel syndrome. Why? They usually contain a palmar spine. This pushes into your wrist joint causing increased pressure. Therefore, only wear a certified carpal tunnel brace. 

2. Do not wear ANY wrist brace while you're working. Your hand and wrist are already damaged with carpal tunnel syndrome. So why force your hand to fight a brace when it's trying to do its regular work? That only stresses your wrist joint even more. 

Rest is the remedy for most ailments. And rest is also exceptionally good for carpal tunnel syndrome. But you don't have to lie in bed to rest your hand. Just be mindful that you should take short breaks if your hand is involved in any of these activities:

• Repetitive and rapid motion (like using a mouse or keyboard)
• Pinching repeatedly and forcefully (like sewing or knitting)
• Bending the hand with force (like playing tennis)
• Grasping and releasing repeatedly (like using a hair brush)
• Gripping and releasing forcefully and repeatedly (like hammering)
• Maintaining a bent wrist (like lifting weights)
• Twisting the hand and wrist (like using a screwdriver)

Taking short (10-20 second) breaks to rest your hand is important when the hand activity is stressful or harmful. Also, try to lessen the hand stress by:

• Switching hands periodically
• Changing your stance 
• Alternate your arm angle or position
• Protect your hands with cushioned gloves

This is a BIG help. Therapists instruct patients to use 4 core stretching exercises for carpal tunnel syndrome. They work to relieve this disorder because the stretches are designed to loosen adhesions on flexor tendons and also lubricate them.

Best of all, these 4 core stretching exercises take only a minute to complete in total! Therefore, perform them at least every hour you work with your hands:

1. Prayer Stretch (for treating the entire length of your flexor tendons)
2. Stop Stretch (for treating the wrist joint)
3. Finger Interlace Stretch (for treating the finger muscles)
4. Thumb Stretch (for treating the thumb)

There's perhaps no more aggressive -- and effective -- technique for eliminating carpal tunnel syndrome than massage. However, the massage must be a particular type.

Myofascial release massage works exceptionally well. It twists and kneads the flexor tendons and the surrounding tissues just below the skin. This action destroys adhesions which cause inflammation and swelling - and ultimately carpal tunnel symptoms.

But there's more to myofascial release massage than breaking up adhesions. This massage also:

• Enhances blood circulation to facilitate the healing process.
• Drains fluid that builds up inside your wrist joint and causes excess pressure.