CTS symptoms usually start gradually and include tingling, numbness, or itching in the palm and the fingers or pain in the wrist that feels like an electric shock and radiates up the arm to the shoulder or down into the palm or and fingers. It can occur in one or both hands but is most likely to happen in your dominant hand (i.e. your right hand if you are right handed). Initially, symptoms may be worst upon waking in the morning because many people sleep with their wrists flexed which puts pressure on the carpal tunnel. You may wake up feeling like you need to “shake out” your hands to get them feeling normal. This feeling may also occur after gripping something such as a steering wheel or a phone.

The median nerve is responsible for relaying sensations from the palm, thumb, index finger, and half of the ring finger (the pinky and the other half of the ring finger use the ulnar nerve). Thus, when the median nerve is compressed in CTS, the symptoms occur in these areas, as well as the wrist and sometimes the forearm. 

As the condition progresses symptoms tend to become more frequent and more severe. Additionally, new symptoms may arise including a sense of weakness in the hands and decreased grip strength that may make it difficult to form a fist, grasp small objects, or perform other manual tasks. There can also be a tendency to drop objects and a constant loss of feeling in some fingers. In severe untreated cases, the muscles in the palm may waste away.