Carpal Tunnel Syndrome
Carpal Tunnel Syndrome: At a Glance
What it is: Carpal tunnel syndrome is caused by compression of the median nerve as it passes through the wrist.
How it affects people: It often leads to pain, numbness, tingling, or weakness in the hand and fingers, especially the thumb, index, middle, and ring finger.
Key concern: Persistent numbness, pins and needles, or loss of grip strength may signal long-term nerve damage if untreated.
Diagnosis: Confirmed through clinical examination, nerve conduction studies, and imaging where necessary.
Treatment options: Wrist splints, physiotherapy, steroid injection, or carpal tunnel release surgery in severe cases.
Outlook: With early treatment, most patients recover fully and regain hand function.
What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome (CTS) develops when the median nerve is compressed within a narrow passage in the wrist called the carpal tunnel. This space is formed by bones and the transverse carpal ligament, which can tighten and increase pressure on the nerve.
It is one of the most common peripheral nerve compression disorders, affecting people who use their hands repetitively for work, sport, or daily activities.
Types of Carpal Tunnel Syndrome
Doctors often describe carpal tunnel syndrome based on its severity and underlying cause:
By Severity
Mild carpal tunnel syndrome: Causes intermittent tingling or numbness in the fingers, especially at night or during repetitive activity.
Moderate carpal tunnel syndrome: Numbness or weakness becomes more persistent, often interfering with daily activities. Nerve conduction studies may confirm compression.
Severe carpal tunnel syndrome: Long-term nerve compression leads to muscle weakness, loss of grip strength, and sometimes permanent nerve damage if untreated.
By Cause
Idiopathic (no clear cause): The most common form, often related to repetitive wrist use or age-related narrowing of the tunnel.
Secondary carpal tunnel syndrome: Linked to other conditions such as arthritis, diabetes, thyroid disease, pregnancy, or trauma that increase pressure within the wrist.
Symptoms of Carpal Tunnel Syndrome
Carpal tunnel symptoms may include:
Hand numbness and tingling in the thumb, index, middle, and ring finger
Pain in the wrist, palm, or forearm
Weak grip or dropping objects
Pins and needles that are worse at night
Symptoms that worsen with bending your wrist or repetitive movements
Emergency signs needing urgent review:
Severe weakness of the hand
Loss of sensation in the fingers
Sudden worsening of wrist pain or swelling
Causes of Carpal Tunnel Syndrome
Carpal tunnel causes are linked to increased pressure on the median nerve within the wrist. Common factors include:
Repetitive hand or wrist movements
Wrist injuries or fractures
Arthritis, particularly rheumatoid arthritis, which can inflame the wrist joint
Fluid retention, such as during pregnancy
Medical conditions like diabetes or thyroid disease
In some cases, putting pressure on the nerve occurs without a clear underlying cause.
Reducing Your Risk
You can reduce the risk of developing or worsening carpal tunnel syndrome by:
Maintaining good posture and wrist alignment at work
Avoiding prolonged, repetitive strain without breaks
Using ergonomic equipment and supportive splints where needed
Managing medical conditions such as diabetes or arthritis
Getting a Diagnosis
Diagnosis usually starts with a physical examination to assess grip strength, reflexes, and sensation.
Tests may include:
Nerve conduction study to measure electrical activity and confirm nerve compression
Electromyography (EMG) to assess muscle response
Ultrasound or MRI scan in complex cases to check the wrist joint and surrounding soft tissues
To formally diagnose carpal tunnel syndrome, specialists combine clinical findings with these tests
Accurate carpal tunnel diagnosis ensures the right treatment plan is selected.
Treatment Options for Carpal Tunnel Syndrome
Most patients with carpal tunnel syndrome respond well to early, non-surgical treatment. Surgical intervention is only considered when symptoms persist or worsen despite these measures.
Wrist Splints
Wearing a wrist splint, particularly at night, keeps the wrist in a neutral position and helps relieve pressure on the median nerve.
Physical Therapy
Targeted exercises and manual therapy techniques can strengthen the wrist and hand, improve flexibility, and reduce inflammation.
Steroid Injections
Corticosteroid injections may reduce swelling and relieve nerve compression, offering temporary symptom relief in moderate cases.
Pain Management
Anti-inflammatory medications, nerve blocks, or specialist pain management strategies can help reduce pain and restore function.
Lifestyle Changes
Simple adjustments, such as improving posture, modifying wrist movements, and taking regular breaks, can prevent recurrence and ease strain on the affected area.
Surgical Intervention
In more severe or persistent cases, carpal tunnel release surgery may be performed to relieve pressure on the median nerve. The procedure is carried out under local anaesthesia, and most patients experience rapid recovery and lasting improvement in strength, sensation, and hand function.
Mr Kailaya-Vasan, an experienced neurosurgeon in London specialising in peripheral nerve surgery and neurovascular surgery, provides both non-surgical and advanced surgical options for carpal tunnel syndrome, ensuring each patient receives safe and effective treatment tailored to their condition.
Living with Carpal Tunnel Syndrome
With treatment, most people return to normal activities without long-term problems. Patients may still experience mild stiffness or weakness during recovery, but rehabilitation exercises and hand therapy help restore strength.
Tips for living with carpal tunnel syndrome include:
Taking regular breaks from repetitive hand use
Using ergonomic keyboards, tools, or wrist supports
Practising stretching and muscle relaxation techniques
Following a structured treatment plan developed with a specialist
Book a consultation with Mr Ahilan Kailaya-Vasan
Receive a clear diagnosis and a tailored treatment plan from a leading consultant neurosurgeon. Appointments are available at top London hospitals, with remote options for international patients.
Seeking a second opinion?
If you have already received a diagnosis elsewhere, Mr Kailaya-Vasan can provide an independent review of your scans and medical notes, and explain the safest and most effective next steps.
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It is a condition caused by median nerve compression in the wrist, leading to numbness, tingling, and weakness in the hand and fingers.
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Typical symptoms include numbness, pain, and tingling that are often worse at night.
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Diagnosis is based on a clinical exam and tests such as a nerve conduction study or imaging scans.
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Treatment options range from splints and physiotherapy to steroid injection and carpal tunnel surgery.
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Surgery is considered when conservative care fails, or when there is ongoing weakness, nerve damage, or severe pain.
FAQs about Carpal Tunnel Syndrome
If you have any further questions, please get in touch.