Carpal Tunnel Syndrome
What is carpal tunnel syndrome?
Carpal tunnel syndrome occurs when the median nerve is compressed as it passes through a narrow tunnel at the wrist. The nerve supplies feeling to the thumb, index and middle fingers and part of the ring finger, and also helps control some thumb muscles.
Common symptoms include tingling, numbness or pain in the hand, often worse at night. Some people notice a weaker grip, clumsiness or that they drop things.
When might treatment be needed?
Mild symptoms may settle or respond to simple measures. Assessment is sensible if symptoms repeatedly disturb your sleep, persist despite a night splint, or are accompanied by weakness or loss of feeling.
Diagnosis is often based on your symptoms and examination. Nerve conduction studies may be arranged when the diagnosis or severity needs clarification.
Treatment and recovery
Treatment depends on the severity and duration of your symptoms. Options can include adjusting aggravating activities, wearing a wrist splint at night and a steroid injection to reduce pressure around the nerve.
If symptoms are severe, long-standing or not improved by other treatment, carpal tunnel release may be recommended. The ligament forming the roof of the tunnel is divided to give the nerve more room. This is commonly a day-case procedure under local anaesthetic.
Recovery and aftercare
Most people can begin gentle hand use within a few days, following the advice given after treatment. Keep the wound and dressing protected and attend any planned follow-up.
Tingling may improve quickly, while grip strength, scar tenderness and long-standing numbness can take longer to settle. Where nerve compression has been severe for a long time, sensation or strength may not recover completely.
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