Why Is Carpal Tunnel Syndrome Worse At Night?

Pain, tingling, or numbness in the fingers, hand, or wrist may be signs of carpal tunnel syndrome, a condition that arises when a nerve that runs through the wrist (1) becomes compressed. Many people who experience discomfort from Carpal Tunnel Syndrome notice that their symptoms are worse at night. If you’ve ever wondered why carpal tunnel hurts more at night, activities you do during the day may cause pain as the evening approaches. In addition, as carpal tunnel symptoms worsen, getting a restful night’s sleep may become difficult. At this point, many people decide it is time to seek surgical treatment.

“The pain associated with compression of the median nerve– the nerve involved with Carpal Tunnel Syndrome – is a result of the nerve being pinched and not getting enough blood flow,” says orthopedic surgeon Joel Klena, MD, chief of the Division of Hand and Microvascular Surgery for the Geisinger Musculoskeletal Institute in Danville, Pennsylvania.

During the daytime, bending your wrist for an extended period or holding objects in fixed positions may compress your median nerve, gradually leading to carpal tunnel syndrome. People whose work responsibilities require repetitive motions with their hands may also develop carpal tunnel syndrome, particularly if their wrists vibrate on the job (if they operate power tools, for example). By the evening, the cumulative effects of daily use and sleeping with your hands in a cupped, fixed position can exacerbate nighttime pain.

Sleep habits may also increase the risk of developing Carpal Tunnel Syndrome. For example, if you like your bedroom cold, the chillier environment may make it more likely that your wrists may stiffen up. However, your sleep position may also contribute to increased pain if you stay in the same position for prolonged periods, which may prohibit proper circulation. (2)

“At night, when someone suffering from carpal tunnel lies flat, the nerve's ability to get blood flow is further compromised,” Klena says. Quite a number of people sleep with their hands clenched and their wrists bent. All of this results in decreased blood flow and increased pain, often enough to wake you up from a dead sleep.”

Fortunately, it’s possible to take steps to reduce your Carpal Tunnel Syndrome pain at night.

Tips To Decrease Your Carpal Tunnel Pain At Night

Trying to avoid certain positions while sleeping with Carpal Tunnel Syndrome can be challenging: You may be unable to stop curling your hands beneath your head all night. Even if you fall asleep with straightened wrists, you may bend them when you shift around at night.

“Sleeping in a wrist brace is one way to try to prevent night pain from occurring by keeping the wrist from being flexed or bent, although it isn’t a permanent solution,” Klena says.

Putting ice or heat (3) on your wrist during the day may help minimize some cumulative pain from Carpal Tunnel Syndrome, reducing the discomfort you feel at night. For example, if your wrist feels swollen and uncomfortable during the day, try putting ice on for 10 or 15 minutes. If that isn’t helpful, try soaking your hands and wrists in warm water for 10 or 15 minutes.

Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen may help to relieve some Carpal Tunnel Syndrome pain. Because these medications have anti-inflammatory properties, they may help reduce inflammation within the wrist, which may take some pressure off the median nerve.

When these treatments aren’t effective, a doctor may offer something more substantial.

“Steroid injections into the carpal tunnel can also be utilized but typically only provide temporary relief,” Klena says.

Consider surgery to eliminate Carpal Tunnel Syndrome pain and numbness if these remedies aren’t effective anymore.

“[A] time to consider surgery is when intermittent symptoms begin to be present more frequently or even are present at all times,” Klena says. “At this point, the nerve can undergo permanent damage that may not be reversed, even with surgery. Allowing Carpal Tunnel Syndrome to progress to the point where constant numbness is present should be avoided.”