I have been diagnosed with carpal tunnel. the thumb and first two fingers on my right hand are going numb during the night. when i wake up and the blood starts flowing back i have excruciating pain. can't this cause damage to my hand?

Yes. : Yes. Carpal tunnel syndrome is structural. A normal tunnel that tendons and nerves pass through to the hand is tighter or looser in individuals based on genetics--just like loose or tight joints. Those of us with tight tunnels gradually develop carpal tunnel syndrome. The end result is permanent nerve damage (weakness, atrophy, numbness). It's nothing you are doing that is causing this. You are just starting to notice that you have the disease. It is a very slowly progressive disease and you might be able to manage the symptoms with wrist splints at night for years. When you start getting numb in spite of the splints or when the numbness lingers for more than 5-10 minutes, then it's time to have surgery.

Carpal : Carpal tunnel implies that the blood supply to the median nerve s compromised. If it is a transient temporary thing then it will not cause "damage" however if it is a chronic long term problem then there can be permanent loss of sensation and muscle function. If you like you can call this "damage" but i hate the word damage or nerve damage as it connotates a problem the can't be treated. When in fact even sever carpal tunnel that may not get full recovery can be treated but expectations have to be spelled out and appreciated.

Carpal : Carpal tunnel syndrome involves numbness, tingling and pain. If it goes on too long, the main nerve involved (median nerve) can be slowly starved of blood flow, causing permanent injury. This could be permanent numbness or permanent muscle weakness and paralyzed thumb muscle (atrophy). I've attached a video showing you the thumb muscle atrophy that can happen.