Carpal tunnel syndrome almost always develops gradually. Symptoms usually appear over time and get progressively worse.

Carpal tunnel syndrome has fairly distinctive symptoms, but there are other neuropathies (nerve disorders) or degenerative conditions, such as hand osteoarthritis, that it may resemble. It is important to receive an accurate diagnosis from a physician in order to determine the right treatment protocol.

See Is My Hand and Wrist Pain Caused by Carpal Tunnel Syndrome or Something Else?

Hallmark Symptoms and Signs of Carpal Tunnel Syndrome

Symptoms of carpal tunnel syndrome typically include one or more of the following:

  • Burning, tingling, or numbness in the palm and the fingers, especially in the thumb, index, and middle fingers
  • Tingling and numbness in the hand and wrist, particularly at night or first thing in the morning. The sensation leads to the desire to “shake out” the hand.
  • Aching pain on the inside of the wrist and possibly in the whole hand
  • Shooting pains in the wrist that travel up the forearm, although rarely beyond the elbow
  • Weakness in the hands and fingers that results in trouble gripping or holding objects
  • Numbness and tingling triggered by holding the hand and wrist still in a specific position, such as when driving or reading
  • Numbness and tingling triggered by repetitive motions of the hand and wrist, such as knitting or painting
  • Pain in both hands—however, it often appears first and/or is worse in the dominant hand
  • Feelings of tightness or swelling in the hand
  • Feeling changes in hand temperature (hands feeling too hot or too cold)
  • In advanced cases, the muscles at the base of the thumb may atrophy and shrink

See Carpal Tunnel Syndrome vs. Soft Tissue Inflammation


Acute carpal tunnel syndrome—in which symptoms appear quickly—is rare. It’s usually related to fractures or vascular disorders in the wrist.

See Guide to Wrist Anatomy


Those who have symptoms matching the description of carpal tunnel syndrome should discuss it with their doctor, who can perform specific diagnostic tests to confirm a diagnosis.

See 6 Myths and Truths About Carpal Tunnel Syndrome

Dr. Ethan Rand is a physiatrist specializing in spine and sports injuries at Kaiser Permanente, Los Angeles Medical Center. He previously practiced in the Department of Rehabilitation Medicine at Weill Cornell Medicine in New York City, where he also served as an Assistant Professor.