The symptoms are often gradual in onset and often more severe in the dominant hand, presumably because it is used more often. Intermittent numbness or tingling is felt on the thumb, index, middle and ring fingers. This commonly occurs at night during sleep and improves by “shaking it off”. Occasionally, the whole hand may feel as if it has “fallen asleep” or is “swollen”.
Symptoms can occur when holding objects, driving or reading. Patients also complain of intermittent weakness of the grip. In some individuals, the compression of the median nerve may worsen with time, resulting in permanent weakness and wasting of the thumb muscles.
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