Brief Answer:
Neck origin should be considered.

Detailed Answer:
I read your question carefully and I understand your concern.

I am a little unsure about the symptoms you describe. Carpal tunnel syndrome may certainly cause numbness of the fingers, but it's the fingers you mention which do not fit. You say it's the last three fingers while normal the median nerve involved in carpal tunnel syndrome involves the first three. The fact it goes up to your arm is not typical, usually up to the elbow (but there are exceptions).
So I would consider other possibilities like mainly a nerve compresion in the neck which may also cause numbness along the area covered by the nerve down to the fingers. For that reason I would have a neck MRI to exclude that possibility.
As for the shoulder issue that is less likely to cause nerve compression.

I remain at your disposal for other questions.

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Brief Answer:
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Detailed Answer:
Thank you for the additional information. I did receive it, but keep in mind that the format of the site is that we have up to 24 hours to answer follow-up questions. Might seem frustrating to wait I imagine, but it is because patients may ask follow up questions at any time and doctors may happen to be engaged with patients in their daily jobs or simply be sleeping (it's 1:35AM where I live now).

As for how the information changes my view. It does make carpal tunnel syndrome more likely, I really wasn't convinced about it before. There still is the issue of the fingers most involved not corresponding, but since it involves the whole hand there may be variations among patients perceptions.

So if the rest of the clinical picture is confidently indicating carpal tunnels syndrome I would skip the MRI I mentioned. By clinical picture I mean it as a whole, with nerve conduction studies showing clear damage of the median nerve in the absence of other anomalies (if you have reports you may perhpas upload them). Also tests such as Tinnel sign (triggering of symptoms by tapping on the nerve in the wrist) or Phalen's sign (triggering of symptoms by maintaining prolonged flexion of the wrist) if positive would strongly support the diagnosis.

If on the other hand nerve conduction studies are inconclusive or show mixed abnormalities, without any of the mentioned tests being positive, then I would ask for a neck MRI to search for nerve root compression.

Let me know if I can further assist you.

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Brief Answer:
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Detailed Answer:
Hello again!

It is true that usually in carpal tunnel syndrome there is pain as there is with peripheral nerve damage in general. However numbness like pain is also a manifestation of peripheral nerve involvement. So it doesn't change the analysis that much, the diagnostic possibilities remain the same, if the rest of the findings I mentioned above (nerve conduction studies etc) indicate carpal tunnel that would remain the likely diagnosis.

Wishing you good health.

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Brief Answer:
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Detailed Answer:
Carpal tunnel doesn't cure itself over time. In some cases there may be improvement by using splinters and steroid shots as they may reduce local inflammation which may contribute to compression. However apart from inflammation there is a mechanical compression component which won't go away unless it is intervened upon, that is why surgery often becomes necessary.

As for surgery providing relief, in most cases yes, it provides relief. In some cases though when left untreated for too long and the nerve has had some degree of permanent damage, numbness may remain. Whether there is such damage in your case should be possible to assess by nerve conduction studies test which I mentioned above.

Wishing you good merry Christmas and a happy New Year :)

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Brief Answer:
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Detailed Answer:
Hello again!

It is one of the safest surgical procedures, as risk free as it gets. It is done under local anesthesia. Usually patients are back home on that same day.

It is an easy procedure with which most neurosurgeons should have no problems with, most orthopedic surgeons as well. In many countries there are also hand surgeons (depends a little upon health system organization, where I live it's mostly neurosurgeons, no hand surgery specialty). So it would be preferable to look for a neurosurgeon with a subspecialty peripheral nerve conditions or an orthopedic surgeon with hand surgery as a subspecialty.

Whether to have surgery right away or to try splints or steroid injections depends on the degree of damage on nerve conduction studies. If mild compression in initial stages non-surgical measures may be attempted first, otherwise surgery.

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Brief Answer:
Best of wishes to you too.

Detailed Answer:
Thank you for taking the time to write. Wishing you a happy (and healthy) New Year.

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