It occurs due to a pressure on the median nerve as it travels through the carpal tunnel at the wrist. This compression causes pain, numbness, tingling in the thumb, index finger, middle finger and thumb side of ring finger. Symptoms usually start gradually and at night. Pain may travel up the arm. Carpal tunnel syndrome can be associated with repetitive movements like typing. You may notice that your thumb feels weak or that you have difficulty gripping or holding your cup. These symptoms may start gradually and may be intermittent, with worse pain felt at night. Underlying conditions such as hypothyroidism, obesity, rheumatoid arthritis and diabetes put people at risk to developing carpal tunnel syndrome. It is usually diagnosed after a detailed case history and physical examination. The examination will focus on the wrist, but the doctor will also examine around the shoulder and neck to make an accurate diagnosis. Rest usually a good treatment for carpal tunnel syndrome at early stages and a wrist splint may be useful worn at night. Anti-inflammatory medication may also help. At our SEM Clinic we offer steroid injections to reduce the inflammation but you will have to rest the wrist to make sure the injection is effective.