What is carpal tunnel syndrome?
Carpal Tunnel Syndrome is a condition where the median nerve which runs from your neck down your arm into your hand becomes compressed at the wrist. This compression occurs in a narrow passage called the carpal tunnel, leading to symptoms in the hand and fingers.
Symptoms
- Tingling, numbness, or burning in the thumb, index, middle, and ring fingers.
- Pain in the hand, wrist, or forearm.
- Symptoms worse at night or early morning.
- Weakness in the hand or difficulty gripping.
- Dropping objects or clumsiness.
- In severe cases, muscle wasting at the base of the thumb.
Causes and risk factors
- Repetitive hand or wrist movements (e.g. typing, using tools).
- Pregnancy (due to fluid retention).
- Diabetes.
- Underactive thyroid.
- Rheumatoid arthritis.
- Wrist injuries or fractures.
- Obesity.
- Family history of CTS.
Diagnosis
CTS is diagnosed through:
- Medical history and symptom pattern.
- Physical examination, including nerve compression and sensation tests.
- Nerve conduction studies (NCS) may be used to confirm diagnosis and assess severity in some people where symptoms are not typical.
Self-care and management
1. Wrist splinting
- A night splint keeps the wrist in a neutral position.
- Helps reduce pressure on the nerve.
- Often the first line of treatment.
2. Activity modification
- Avoid repetitive gripping or wrist strain
- Take regular breaks from typing or tool use
3. Pain relief
- Use paracetamol or ibuprofen as needed – please consult your local pharmacist.
- Topical anti-inflammatory gels may help.
4. Steroid injections
- A corticosteroid injection into the carpal tunnel can reduce inflammation.
- Often effective, but symptoms may return.
Surgical treatment
If symptoms are severe or persistent:
- Carpal tunnel release surgery may be recommended.
- Involves cutting the ligament to relieve pressure on the nerve.
- Usually done under local anaesthetic.
- Most people recover well with improved symptoms.
When to seek medical advice
- Symptoms persist beyond 6 weeks despite self-care. Consider seeing your GP or self-referring to the MSK service.
- Constant pain or numbness interferes with daily activities – Consider seeing your GP.
- You experience weakness or muscle wasting – Consider seeing your GP.