Conditions
Carpal tunnel syndrome: symptoms, relief and a video doctor visit
Carpal tunnel syndrome happens when the median nerve is squeezed at the wrist, causing tingling, numbness or pain in the thumb, index and middle fingers, especially at night. It often improves with a wrist splint at night and changes at work. We see you by video in Puerto Rico: the doctor evaluates, diagnoses and treats.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Sudden numbness or weakness on one side of the face, arm or leg
- Confusion, trouble speaking, seeing or walking, or a sudden severe headache
- You cannot move your wrist, hand or a finger, or they look deformed
- A hot, red, swollen wrist with a fever
Help lines
At a glance
Carpal tunnel syndrome
Common symptoms
- Tingling or numbness in the thumb, index finger, middle finger and part of the ring finger
- Hand numbness at night that wakes you up
- Wrist or hand pain that can travel up to the elbow
- A weaker grip or trouble carrying bags
- Clumsiness: dropping things or trouble with buttons
- In advanced cases, the muscle at the base of the thumb looks smaller
- Other names
- Median nerve entrapment · Median neuropathy at the wrist
- Usual test
- Hand exam; in-person nerve studies when needed
- Treatment
- A wrist splint at night, work changes and anti-inflammatories
- Possible complication
- Permanent nerve damage with weakness and numbness
On this page(8)
What is carpal tunnel syndrome?
The carpal tunnel is a narrow passage in the wrist that carries the median nerve and several tendons. When something swells or narrows it, the nerve is squeezed and you get tingling, numbness, pain or weakness in the hand.
It is most common between ages 30 and 60 and in women. It is linked to repeating the same hand and wrist motion and to vibrating tools (drills, jackhammers); that load is common in factory and construction work. Pregnancy and menopause (fluid retention), extra weight, diabetes, an underactive thyroid (hypothyroidism), rheumatoid arthritis and wrist fractures or arthritis also raise the risk.
How we treat carpal tunnel syndrome by video
You see Dr. Diana Nieves Castro, a Puerto Rico–licensed general practice physician with several years of emergency-department experience, in English or Spanish. We evaluate, diagnose and treat: the doctor asks which fingers go numb, at what time of day, what work you do and what conditions you have, and guides you through simple hand tests on camera, such as bending your wrists for a minute.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. Because diabetes and an underactive thyroid are risk factors, if needed we give you a lab order for a lab near you, for example for hemoglobin A1c (blood sugar) and thyroid (TSH). See type 2 diabetes and hypothyroidism.
Nerve studies (electromyography and nerve conduction), cortisone injections and surgery are done in person: if you need them, we refer you. If you need a doctor’s note or temporary changes at work, the note is included after your visit.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your visit in 3 steps
Request a visit online 24/7 — we confirm your time by email or text This is how you see a doctor online with us.
Request your visit.
Book a visit and choose "Doctor visit". You pay by card when you request it.
See the doctor by video.
We send you a secure video link. It works on your phone, tablet or computer.
Get your plan.
A splint, changes at work, a lab order if needed and, if appropriate, the doctor prescribes and we send your prescription to your pharmacy.
What the visit costs
A doctor visit costs US$79, the same price for every age, with no membership. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. A doctor’s note is included. We do not bill insurance; the lab, the pharmacy and any nerve studies charge separately. See all prices. The service is run by The Health Initiative, a nonprofit.
Carpal tunnel syndrome symptoms
Symptoms can affect one or both hands:
- Tingling or numbness in the thumb, index finger, middle finger and part of the ring finger
- Hand numbness at night that wakes you up
- Wrist or hand pain that can travel up to the elbow
- A weaker grip or trouble carrying bags
- Clumsiness: dropping things or trouble with buttons
- In advanced cases, the muscle at the base of the thumb looks smaller
Carpal tunnel treatment
MedlinePlus recommends starting with:
- A wrist splint at night for several weeks; if that is not enough, during the day too.
- Not sleeping on your wrists.
- Warm or cold compresses a few times a day.
- Changes at work: a keyboard low enough that your wrists do not bend upward, frequent breaks, and less time with vibrating tools.
- Anti-inflammatories such as ibuprofen or naproxen, as the label directs; they usually give only temporary relief.
Symptoms often improve without surgery, but more than half of cases eventually need it. Left untreated, the nerve can be damaged and the weakness or numbness can become permanent. So if you lose strength, start dropping things or the numbness spreads, we refer you for nerve studies and a specialist evaluation.
If the tingling is also in your feet, or in both hands along with other symptoms, it may have another cause. Read about numbness and tingling.
When to go to the ER
Rule out a stroke first. Call 911 right away if numbness or weakness comes on suddenly, especially on one side of the face, arm or leg, or comes with confusion, trouble speaking, seeing or walking, or a sudden severe headache. The CDC uses BE FAST: Balance, Eyes, Face drooping, Arm drifting, Speech and Time to call 911. Do not drive to the hospital: call 911.
Also go to the ER if you cannot move your wrist, hand or a finger after an injury, or they look deformed. See when to go to the ER.
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
Why do my hands go numb at night?
Can carpal tunnel syndrome get better without surgery?
What test confirms carpal tunnel syndrome?
What else can cause wrist pain?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-10-02 · Updated: 2026-10-02
Sources (3)
- Carpal tunnel syndrome (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- Wrist pain (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- Signs and Symptoms of Stroke (CDC) (opens in a new tab) (accessed 2026-10-02)