I heard that having pain at night with carpal tunnel syndrome is a bad sign. Is this true?

Some studies show that patients with carpal tunnel syndrome (CTS) who wake up at night are less likely to improve over time with treatment. Nighttime symptoms may be a sign of a more severe case of CTS.

Treating any painful musculoskeletal problem early on usually brings about better results than waiting until it becomes a severe problem. Most patients with CTS first notice numbness and tingling in the thumb and first two fingers of the hand. Later they may have
hand and wrist pain, too.

t first symptoms at night go away by changing position or by shaking the hands. The patient with symptoms night and day may start to get muscle atrophy and weakness. Nighttime symptoms may be a sign that the condition has progressed to the point of irreversible nerve damage.

There's good news though. Several studies have shown that wearing splints on the wrists and forearms can reduce symptoms and help restore nerve function. These can be worn at
night to prevent the symptoms. Day and nighttime use may give better results in the long-run.

Reference: 

Robert A. Werner, MD, et al. Randomized Controlled Trial of Nocturnal Splinting for Active Workers with Symptoms of Carpal Tunnel Syndrome. In Archives of Physical Medicine and Rehabilitation. January 2005. Vol. 86. No. 1. Pp. 1-7.

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