One of the first symptoms of carpal tunnel syndrome is gradual numbness in the areas supplied by the median nerve. This is quickly followed by pain where the nerve gives sensation in the hand. The hand may begin to feel like it's "asleep," especially in the early morning hours after a night's sleep.

Pain may spread up the arm to the shoulder and even to the side of the neck. If the condition progresses, the thenar muscles of the thumb can start to weaken and atrophy, causing the hand to be clumsy when picking up a glass or cup. If the pressure keeps building in the hand, the thenar muscles may begin to shrink (atrophy).

Touching the pad of the thumb to the tips of the other fingers becomes difficult, making it hard to grasp items such as a steering wheel, newspaper, or telephone.