To understand why carpal tunnel syndrome symptoms are worse at night we need to briefly review what causes carpal tunnel syndrome.
Make sure that you read to the bottom to find some ways to relieve your symptoms at night.
What is the Carpal Tunnel?
The carpal tunnel is a small tunnel formed by wrist bones and connective tissue through which tendons of the hand and a nerve passes through.
The roof of the carpal tunnel is formed from a strong connective tissue layer called the transverse carpal ligament. The floor and the sides of the carpal tunnel is formed from the carpal bones (wrist bones).
Travelling through this carpal tunnel are nine tendons that help to bend the fingers (also known as flexor tendons) and a nerve, called the median nerve. The median nerve helps to transmit information from the brain to move muscles in the hands as well as sends sensory information to the brain.
In Carpal Tunnel Syndrome, the median nerve is compressed as it passed through the carpal tunnel.
Median Nerve Compression
Anything that causes swelling of the wrist, can predispose someone to developing carpal tunnel syndrome. The symptoms that result are a direct effect of compression and injury to the nerve.
In particular, when the median sensory nerves are damaged it causes the most common symptoms of tingling, numbness, and pain. These sensory symptoms are usually intermittent when they first start, but they eventually become more and more frequent. Ultimately the symptoms become constant.
Over time, the median motor nerves can also become damaged, which results in weakness of the hand.
Nighttime Symptoms are Common
As I said earlier, carpal tunnel syndrome symptoms are often intermittent when they first start. They come and go. Most commonly, these symptoms seem to be most the prevalent at night.
The reason for this is because at night, many people sleep with their wrists bent. When you bend your wrist, it further narrows the carpal tunnel and thereby compresses the nerve.
Oftentimes, people will be wake up because of their symptoms. Frequently, thereafter, they will report that their symptoms resolve with either shake out their hands or hanging their arms off of the side of the bed.
Improving Carpal Tunnel Syndrome Symptoms
Carpal tunnel syndrome needs to be fixed before it gets to the point that it damages the actual nerves. To improve your chances of recovery, you need to prevent your wrist from being bent. Most commonly, you will be recommended to wear a neutral wrist brace at night. This brace will prevent you from subconsciously bending your wrist at night.
To further increase your chances of recovery, it is better to wear a neutral wrist brace 24/7 (even during the daytime). Of course there will be certain activities that you cannot perform while wearing a brace such as washing dishes or activities that require wrist motion. Simply take off your brace for these particular activities.
I recommend wearing your brace 24/7 for at least 4 weeks and after that switching to wearing it only at night.
Do not be dismayed if the brace doesn’t improve your symptoms immediately. Nerves take time to recover…a lot of time. Be diligent with wearing the brace and give it a good 4 weeks of consistent wearing before you decide if it is improving or not.
Be sure that when you are wearing the brace, it is neither to tight nor too loose. Your wrist should be kept in a neutral position, but shouldn’t be so tight that it causing compression onto the wrist itself.