Numbness or burning pain in the fingers after sleep that causes waking is one of the symptoms of carpal tunnel syndrome. The pain and sensory numbness in the thumb, index and middle finger are caused by compression of the median nerve. Initially, it is often characterized by sensory dysfunction in the fingers, and often wakes up with numbness or burning pain several hours after falling asleep, which is relieved by activity. Many diseases can present with symptoms similar to those of carpal tunnel syndrome, such as numbness and pain in the fingers. Therefore, attention should be paid to differentiation to prevent misdiagnosis. The clinical manifestations of carpal tunnel syndrome are mainly numbness, tingling or burning-like pain in the index, middle and ring fingers with compression of the median nerve, which increases at night after daytime labor and even wakes up with pain during sleep; localized pain often radiates to the elbow and shoulder; poor thumb abduction muscle strength, and occasional sudden loss of hand when carrying objects or end objects. Examination: pain increases when pressing or tapping the transverse carpal ligament and dorsal extension of the wrist joint; in cases with long duration of disease, there may be atrophy of the greater interphalangeal muscle. Numbness and pain in the wrist, palmar surface of the hand, thumb, index finger and middle finger, or accompanied by inflexible hand movements and weakness; painful symptoms are aggravated at night or early in the morning, and may radiate to the elbow and shoulder, and are alleviated by daytime activities and hand shaking; sensation in the above mentioned areas is diminished or disappears; or even hand muscle atrophy and paralysis occurs. If this occurs and is not relieved for several days in a row, experts suggest that one must go to a regular hospital to see a doctor as soon as possible in order to make an early diagnosis and take measures. Clinically, some patients may suffer from atrophy of the muscles under the thumb due to long-term lesions; even intermittent skin whitening and cyanosis may occur; in severe cases, cyanosis of the thumb and index finger, fingertip necrosis or atrophic ulcers may occur, becoming irreversible. Carpal tunnel syndrome occurs in the age of 30 to 50 years, and is five times more common in women than in men. The pain and sensory numbness of the thumb, index and middle finger are caused by compression of the median nerve. Initially, it often manifests as sensory dysfunction of the finger end, often waking up with numbness or burning pain a few hours after sleep, and relieving after activity. In a small number of patients, neurotrophic disorders occur due to the long duration of the disease, with atrophy of the masseter muscle, intermittent skin whitening and cyanosis, and in severe cases, cyanosis of the thumb and index finger, finger tip necrosis or atrophic ulcers. On examination, the palmar aspect of the wrist may be tapped, causing numbness and pain in the median nerve innervation area, which is positive for Tinel’s sign. In some patients, abnormal finger sensation increases after 60 seconds of extreme flexion of the wrist joint, which is a positive Phalen test. The symptoms can be induced by applying pressure to the distal limb veins using a sphygmomanometer on the upper arm. If carpal tunnel syndrome is suspected, the following tests should be performed to clarify the diagnosis: 1. Tinel’s sign: If the thumb, index and middle finger have radiating pain when tapping the median nerve at the proximal edge of the carpal ligament, the test is positive. 2. Wrist flexion test: rest both elbows on the table, forearms perpendicular to the table, and both wrists naturally palmarly flexed. At this point, the median nerve is pressed against the proximal edge of the transverse carpal ligament, and pain soon appears in people with carpal tunnel syndrome. 3.Cortisone test: Inject hydrocortisone into the carpal tunnel, if the pain is relieved, it will help to confirm the diagnosis. 4, Tourniquet test: Inflating the sphygmomanometer above the systolic pressure for 30 to 60 seconds that can induce finger pain is positive. 5.Wrist extension test: maintain the wrist in the hyperextended position, and if the pain appears soon, it is positive. 6.Finger pressure test: If finger pressure at the median nerve pressure point at the proximal edge of the transverse carpal ligament can induce finger pain, the test is positive. 7. Median nerve conduction speed: Normally, the conduction speed of the median nerve is shorter than 5 microseconds from the proximal transverse carpal ligament to the motor fibers between the thumb to palmar muscles or the short thumb extension muscles. If it is longer than 5 microseconds, it is abnormal. Carpal tunnel syndrome of up to 20 microseconds indicates damage to the median nerve. Surgical treatment should be considered for conduction times greater than 8 microseconds.