What is it?

Carpal tunnel syndrome is a condition in which a nerve in your wrist is under pressure (compressed). This causes pain, tingling or numbness, mainly in your hand and fingers. Carpal tunnel syndrome is most common in women between 40 and 60, but men can get it too.

The carpal tunnel is a channel in your wrist. The bones of your wrist are arranged in a semi-circle that forms the sides and base of this channel. A tough band of tissue, known as the transverse carpal ligament, forms the roof.
The tendons that you use to flex your fingers and thumbs pass through your carpal tunnel. So does your median nerve, which supplies feeling and controls muscles in your hand and thumb. If this nerve comes under pressure and is compressed, it can lead to the symptoms of carpal tunnel syndrome.

Diagnosis of carpal tunnel syndrome

Your GP will ask you about your symptoms and your medical history. They’ll examine you and may carry out the following tests.

• Phalen test: your GP will ask you to rest your elbows on a table and then flex your wrists (or they may hold your wrist). If you get any pain or numbness within a minute, you may have carpal tunnel syndrome.
• Tinel test: your GP will tap or press on your median nerve in your wrist to see if you get any tingling in your fingers.
• Median nerve compression test: your doctor will ask you to stretch out your elbow and hold your palm upwards. They’ll hold your wrist and press on the carpal tunnel. If you feel symptoms within 30 seconds, it’s likely you have carpal tunnel syndrome.

Your GP may be able to diagnose carpal tunnel syndrome just by examining you and asking about your symptoms. But you might need to have some further tests, which may include the following.

• Nerve conduction test: this can show if there’s any damage to your median nerve.
• Ultrasound: this uses sound waves to produce an image of the inside of your wrist. This will enable your doctor to look at the area around your median nerve in your hand.

Treatment of carpal tunnel syndrome

There are carpal tunnel syndrome treatments available, including carpal tunnel surgery. Treatment helps to relieve your symptoms by reducing the pressure on your median nerve. As well as pain relief, this might also stop your condition from getting any worse.

If you only have mild symptoms, they may improve without any treatment after about six months, especially if you’re pregnant or under 30.

Wrist splints for carpal tunnel syndrome

Wrist splints can help to keep your wrist straight and reduce pressure on the compressed nerve. This often relieves the symptoms of carpal tunnel syndrome.

Your doctor will usually advise you to wear wrist splints at night for at least a month. You can wear splints during the day as well, but you may find that they get in the way as you go about your day.

Medicines for carpal tunnel syndrome

Medicines used to treat carpal tunnel syndrome include the following

• Steroid injections directly into your carpal tunnel can help with pain relief. Although your pain may get a little worse for a couple of days after the injection, you should get relief from symptoms after that. Some people find that their symptoms return within a year. See our FAQs for more information.
• Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen might help to relieve your pain and inflammation.

Carpal tunnel surgery

If your symptoms are severe or other treatments haven’t worked for you, your specialist doctor or surgeon may suggest you have carpal tunnel surgery (also called carpal tunnel release surgery). See our Related information to find out what’s involved.
Carpal tunnel surgery is thought to be more effective than splinting and steroid injections at treating carpal tunnel syndrome.

Carpal tunnel release surgery (carpal tunnel decompression) involves

Carpal tunnel release surgery (carpal tunnel decompression) involves cutting your carpal ligament. This ligament is connected to bones in your wrist to form the carpal tunnel. Several tendons and your median nerve run through this tunnel to your fingers. If the pressure builds up in the carpal tunnel, your median nerve can’t work properly and causes tingling, numbness or pain. Dividing the carpal ligament releases the pressure and eases your symptoms.

Side-effects of carpal tunnel release surgery

Side-effects are the unwanted, but often mild and temporary problems you may expect to happen as a result of surgery. Carpal tunnel surgery can cause some side-effects. These may include:

• pain and discomfort along with the cut on your hand
• stiffness in your hand
• swelling – keeping your hand up should help to reduce this
• a noticeable scar that will gradually fade
• your scar feeling tender after the operation – this usually settles down within a few months
• having a weaker grip than you had before surgery – this should return to normal as your hand heals