Carpal tunnel syndrome

What is it?

Carpal tunnel syndrome occurs when there is an increased pressure on the median nerve on the front of the wrist. It causes tingling, numbness and pain in your hand and fingers.

Symptoms include:

• Tingling or pins and needles particularly in the thumb, index and middle fingers
• An ache or pain in your fingers, hand or arm
• Numb hands
• Tingling or pins and needles particularly in the thumb, index and middle fingers

Symptoms are generally worse at night – causing waking from sleep and a need to shake the hand to get relief.

Diagnosis and treatment options

Your consultant will examine you and ask you to demonstrate certain movements to check how well your hand and wrist is working. In obvious cases no further tests may be required, but your consultant may arrange nerve conduction studies.

Treatments for carpal tunnel syndrome include:

Splint

A night time splint can often help mild symptoms and on occasion settle the condition with no further intervention.

Injection

Steroid injections are a common treatment for carpal tunnel syndrome. The steroid reduces swelling in your wrist which relieves the pressure on the median nerve and can help relieve pain. The injection can be performed in the clinic or under ultrasound guidance.

Surgery

In cases that have not settled with the above measures or in more severe cases, surgery may be considered. The surgery is performed under local anaesthetic as a day case. The surgeon relieves the pressure on the nerve by incising the tight ligament that compresses the nerve on the front of the wrist.

The surgery only takes 10 minutes and a light bandage is applied. Often absorbable sutures are used and the wound needs to be kept dry and covered for 10 days. Most symptoms improve in the first week and a return to normal activities should occur within a few weeks.