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Written by: Advanced Physical Medicine
Carpal tunnel syndrome is a common hand condition that impacts nearly 10 million people in the United States. Caused by pressure on the median nerve that is located in the carpal tunnel, carpal tunnel syndrome can result in a tingling or numbing sensation in the hand. If left untreated, it can result in hand weakness.
One of the most confounding aspects of this condition, however, is the fact that many people report that their symptoms of carpal tunnel syndrome are worse at night.
Understanding Carpal Tunnel Symptoms
Given the fact that carpal tunnel syndrome is one of the most common wrist and hand conditions, it's not surprising that it's frequently diagnosed. However, many people confuse pain in the wrist or hand with carpal tunnel syndrome.
In reality, the most common signs of carpal tunnel syndrome are tingling or numbness in the hand. As the condition progresses, that numbness can lead to weakness, with some people with carpal tunnel syndrome finding that they have a difficult time picking up or holding onto objects.
Why is Carpal Tunnel Worse at Night?
One of the most common complaints among patients who have been diagnosed with carpal tunnel syndrome is that their symptoms flare up and worsen at night, which can make it difficult to get comfortable and get to sleep.
This is not your imagination. Several factors explain why carpal tunnel syndrome symptoms intensify at night:
Wrist position during sleep
This is the most direct cause for most people. When you sleep, you naturally bend your wrists, curl into the fetal position, or tuck your hands under your pillow. That flexed position increases pressure inside the carpal tunnel and compresses the median nerve, which is why so many people wake up in the middle of the night with tingling or numbness in their hand.
Reduced blood flow
You are inactive and resting at nighttime. The lack of blood flow in the area heightens the sensitivity of the median nerve and worsens symptoms.
Fewer distractions
As you wind down and prepare for sleep, you have fewer distractions, which makes it easier to focus on the discomfort and numbness in your hand.
Stress and anxiety
Stress and anxiety tend to increase at nighttime for many people, which can exacerbate feelings of pain and discomfort.
Hormonal shifts
Hormonal changes at night can increase fluid retention in the body, which raises pressure inside the carpal tunnel and worsens symptoms. This is particularly relevant for women experiencing hormonal fluctuations.
How to Sleep with Carpal Tunnel
When carpal tunnel symptoms intensify just as you are lying down, falling asleep can feel impossible. The good news is that adjusting a few habits can make a meaningful difference. Having realistic expectations and working with a physical therapist can help you begin to sleep better with carpal tunnel syndrome.
Best Sleeping Position for Carpal Tunnel
One of the best ways to sleep better with carpal tunnel syndrome is to adjust your sleep positioning. The best sleeping positions for people with carpal tunnel syndrome include:
Sleeping on your back
By sleeping on your back with your legs elevated or propped, you can naturally reduce pressure on the spine. With less pressure on the spine, you can minimize the risk of compressing the nerves in the shoulders, elbows, and wrist, ultimately improving your carpal tunnel syndrome symptoms.
Sleeping on your side
While sleeping on your side can help alleviate carpal tunnel syndrome symptoms, it's important to be aware of the fact that you need to support your body if you are going to sleep on your side. Use pillows to support your legs and knees, and hug a body pillow to avoid going into the fetal position. With proper support, you can sleep comfortably without increasing tunnel pressure in your body.
Avoid sleeping on your stomach or in the fetal position. Both increase wrist flexion and tunnel pressure, which will make symptoms worse.
Tips for Carpal Tunnel Pain Relief at Night
In addition to choosing the proper sleep position for carpal tunnel syndrome, you also can use these tips to minimize pain and improve your comfort:
- Wear a wrist brace to bed. While it may not seem like the ideal sleeping gear, a wrist brace can help you maintain a neutral position in the wrist, which is best for your median nerve.
- Monitor the amount of fluids that you consume. While it's essential to stay hydrated, you will want to avoid retaining fluids which can increase swelling and pressure on the median nerve. Avoiding fluid retention is particularly important for women who are experiencing hormonal fluctuations, which could contribute to their carpal tunnel syndrome symptoms.
Lifestyle Changes to Help With CTS
Beyond working to minimize your carpal tunnel syndrome symptoms at night, you can begin to make lifestyle changes that benefit you as a whole. These lifestyle changes can help you better manage your carpal tunnel syndrome symptoms as well as allow you to live a healthier, more fulfilling life:
- Enjoy a healthy, well-balanced diet on a regular basis. If sleep is difficult for you, consider enjoying foods that are rich in tryptophan during your evening meal, such as turkey, baked potatoes, milk, oatmeal, and eggs.
- Take an evening walk after dinner. Light exercise throughout the day is very beneficial, but an evening walk can allow your body to begin preparing for sleep.
- Begin practicing yoga or incorporate meditation into your bedtime routine. These practices can promote mindfulness and can help you feel more calm and rested when you get into bed.
Treatment for Carpal Tunnel Syndrome
Carpal tunnel syndrome is a gradual condition that gets progressively worse over time, so your treatment plan may vary based on the severity of your symptoms. Common treatments for carpal tunnel syndrome include:
- Physical therapy
- Splinting the wrist
- Medication to reduce inflammation
- Ergonomic changes
Frequently Asked Questions About Carpal Tunnel at Night
Can carpal tunnel go away on its own?
Mild cases of carpal tunnel syndrome can sometimes improve with rest, splinting, and activity modification. However, because it is a progressive condition that tends to worsen over time without intervention, early treatment is generally recommended. Physical therapy can be particularly effective in the early to moderate stages.
How do I know if my wrist pain at night is carpal tunnel or something else?
Carpal tunnel syndrome typically causes tingling, numbness, or a burning sensation in the thumb, index, middle, and ring finger. It tends to wake people up at night and improves temporarily when you shake or move your hand. Pain that is more localized to the wrist joint, or that involves the pinky finger, may point to a different condition and is worth getting evaluated.
Is it okay to wear a wrist brace every night?
Yes, wearing a wrist brace at night is one of the most commonly recommended non-surgical treatments for carpal tunnel syndrome. It keeps the wrist in a neutral position, which reduces pressure on the median nerve while you sleep. If you are unsure whether your brace fits correctly or is the right type for your situation, a physical therapist can assess your needs and recommend the appropriate support.
Request Your Consultation Appointment Today
At Advanced Physical Medicine of St. Charles, we pride ourselves on the fact that we offer our patients personalized physical therapy and chiropractic care. If you are suffering from the signs or symptoms of carpal tunnel syndrome, you may benefit from physical therapy and other complementary, holistic treatment options.
To learn more about carpal tunnel syndrome and the best treatment options available to you, request your appointment at Advanced Physical Medicine of St. Charles today.
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