Symptoms of carpal tunnel syndrome usually start gradually.  Common symptoms include frequent burning, tingling, or itching numbness in the palm of the hand and the fingers, especially the thumb and the index and middle fingers.  The symptoms of carpal tunnel can first appear during the night (in one or both hands), since many people sleep with flexed wrists. A person with carpal tunnel syndrome may wake up feeling the need to "shake out" the hand or wrist.  As symptoms worsen, it can become difficult to grab or grasp objects.

Some people who experience carpal tunnel report useless and swollen fingers, even though little or no swelling is apparent. Some people are unable to tell the difference between hot and cold by touch.  Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks.  In chronic and/or untreated cases, the muscles at the base of the thumb may waste away.  Symptoms of carpal tunnel syndrome often develop as follows:

• Restricted blood circulation is a contributing factor to chronic carpal tunnel syndrome. Therefore, one of the early symptoms includes cold hands and warm forearms due to constriction of blood circulation in and around the carpal tunnel.
• Burning pain radiates up the center of the forearm and can travel as far as the shoulder and neck.
• Overall decreasing grip strength as the hand muscles atrophy due to pain and lower levels of hand activity.
• Clumsiness with hands. Routinely dropping objects or the inability to make a fist.
• Loss of fine motor skills in the hand. Difficulty writing, tying a shoe, working a mouse, picking up objects, buttoning a shirt or coat, threading a needle, etc.
  
• Weak hands and inability to support one's self with hands when balancing or climbing.
• Inhibited hand and wrist movement due to pain, and numb tingling hands or tingling fingers.
• Loss of feeling in the hand or fingers.
• Swollen sensations in the hand or fingers.
• Finger pain, finger numbness and/or finger clumsiness particularly in the thumb and/or in the index or middle fingers.
• Constant aching of the upper shoulder and neck as pain stimulates the nerve path up to the nerve center in the brain.
• Hand dysfunction can lead to lost earnings, time away from work and loss of self esteem as a contributor at work and at home, some suffers even experience depression.

When to seek medical help
In order to evaluate possible symptoms of carpal tunnel syndrome, you may first want to consult your family doctor.  Your doctor will want to investigate both the symptoms themselves as well as conditions that may be contributing to carpal tunnel syndrome. Call your doctor if you:

• Cannot pinch your thumb and index finger together, or your pinch is weak.
• Cannot use your thumb normally (diminished thumb strength).
• Have problems at work because of pain in your fingers or hand.

Your symptoms may be mild or only occur from time to time, but if the carpal tunnel syndrome gets worse, symptoms may become continuous. Your hand muscles may become weakened, making it difficult to grip objects or perform other manual tasks. For severe cases, the thumb muscles may start to waste away or the median nerve may be permanently damaged.  So how do doctors diagnose carpal tunnel syndrome?  To learn more about diagnosing carpal tunnel syndrom read the next section How to Diagnose Carpal Tunnel Syndrome now.