Acute Carpal Tunnel Syndrome

Understanding Acute Carpal Tunnel Syndrome

Acute carpal tunnel syndrome is the quick onset of severe carpal tunnel syndrome. It is not very common and is typically caused from fracture-dislocations around the wrist. Acute carpal tunnel syndrome can also be related to vascular disorders and hemorrhagic conditions concerning the wrist.

Carpal Tunnel Syndrome

The wrist contains a narrow vessel that is made of ligaments and bones through which the median nerve and the flexor tendons pass. The median nerve provides feeling and sensation to several fingers, specifically the index finger, middle finger, thumb, and part of the ring finger. The flexor tendons assist in making finger movements smooth.

Any trauma at all in the wrist area, or internal conditions that cause the ligaments, tendons, or muscles to become inflamed, will compress and can put tremendous force on the median nerve. This type of compression of the nerves may reduce feeling in the hand or fingers and can cause tingling feelings or numbing sensations.

These sensations can all happen simultaneously or they can occur more intermittently. Grip strength will decrease and weakness of the hand will occur.

Acute Carpal Tunnel Syndrome

Repetitive hand movements typically cause carpal tunnel syndrome to develop over the course of time. Acute carpal tunnel syndrome is more severe because it is the result of an injury or trauma around the wrist area. This damage increases pressure directly in the carpal, which reduces the blood flow to the median nerve.

The median nerve becomes too vulnerable to function in a proper manner, which results in acute carpal tunnel syndrome.

Early Onset of Acute Carpal Tunnel Syndrome

Symptoms are usually the most overwhelming at night. Patients will often awaken by tingling or numbness and will feel the need to shake the hand that is affected. This is known as the “flick sign” and can happen sporadically at first. As a result, it becomes more difficult to talk on a cell phone or drive.

After Progression of Acute Carpal Tunnel Syndrome

The duration and intensity of the symptoms may increase as time progresses. Weakness is often experienced and patients may find themselves dropping things occasionally.

Due to the increase in sensory loss, those diagnosed with more severe acute carpal tunnel syndrome may actually experience less pain, because more of their sensory perception is not being used.

Late in the Development of Acute Carpal Tunnel Syndrome

Sensations in the affected hand and fingers are drastically decreased. Thumb weakness and atrophy of the thenar eminence can also occur in more advanced cases.

Acute Carpal Tunnel Syndrome Causes

There are many reasons acute carpal tunnel syndrome can develop, but it is uncommon. Breaks involving the wrist are the most common cause. Other causes are dislocation of the wrist, blood clotting defects, gout, and cell tumors.

Dislocation or fracture of the wrist

Wrists can dislocate or fracture when a person falls and lands on their hands, depending on age and fitness ability.

Blood Clotting Defects

A blood-clotting defect can result in wrist area hemorrhage that is often uncontrollable. Minor injuries can also cause blood-clotting defects.


Gout often results in excruciating inflammation in the joints and can develop into carpal tunnel syndrome.

Cell Tumors

Giant tumors that are beneath the tendon sheath around the median nerve can cause acute carpal tunnel syndrome.

Treatment should be sought immediately for those with acute carpal tunnel syndrome in order to reduce future pain in the area.

Treatment of Acute Carpal Tunnel Syndrome

It is best to start with nonsurgical options if the pain is manageable, and there are many of these available. The best results have been found with steroid injection, oral steroids, or splinting. These options can bring relief for patients with mild cases.

Options for temporary relief are also available for those who cannot or do not want to pursue surgery right away. Physical therapy can be a great option for children, patients who are pregnant, or those who are experiencing hyperthyroidism.

Temporary relief options usually begin to assist with the pain best after two to six weeks of treatment and are working at their peak when they have been implemented for three months. If various options for temporary relief do not begin to respond after six weeks, other methods of relief should be sought after.

Surgical decompression can treat acute cases in the hopes of avoiding further injury to the nerves. If other courses of action do not help with pain due to the severity of the diagnosis, surgery may be necessary.

Last Reviewed:
July 02, 2017
Last Updated:
October 16, 2017
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