Carpal tunnel syndrome is a condition that occurs due to pressure on a nerve located in your wrist. This can cause pins and needles and numbness, or pain in your fingers. While it is usually treatable, recovery can take weeks to months. There are a number of different treatments available to relieve these symptoms. Read on for everything you need to know about carpal tunnel syndrome.
What is carpal tunnel syndrome?
Carpal tunnel syndrome is a common condition affecting the hand. The median nerve supplies the thumb index middle and half of the ring finger in most people. In carpal tunnel syndrome, the median nerve gets squashed as it passes from the forearm into the hand leading to pins and needles, numbness, and pain in the fingers. IIf the nerve remains compressed for a long period of time permanent damage can occur.
Carpal tunnel syndrome symptoms
There are some classic symptoms of carpal tunnel syndrome. Numbness or tingling in any of your fingers but most commonly the thumb, index, middle, and thumb side of your ring finger. The symptoms are usually worse at night and when gripping objects such as a steering wheel. Patients often find that they shake their hands to “get the blood back into them”.
Carpal tunnel syndrome causes
The compression of the median nerve as it passes from the forearm into the wrist is the cause of this condition. In most cases, no specific reason for the compression is found but it is more commonly seen in people with diabetes, wrist arthritis, or thyroid problems. It is also common in pregnancy but may resolve following delivery of the baby.
What will happen if you don’t treat carpal tunnel?
If left untreated the condition will often progress leading to permanent numbness and wasting of the small muscles in the thumb. This can severely compromise the function of the hand and may be irreversible.
If you are worried that you might be experiencing symptoms associated with carpal tunnel syndrome, you must go to a doctor or a hand and wrist specialist.
Carpal tunnel syndrome clinical tests
A general practitioner or hand surgeon will most often be able to diagnose carpal tunnel syndrome by listening to your symptoms and asking a few simple questions. They will confirm the diagnosis with some examination tests including testing the feeling in your fingers, the strength of your thumb muscles, and trying to bring on your symptoms either by pressing on the carpal tunnel or by bending your wrist into a certain position.
If the history and examination are not clear or if the doctor wants to assess how badly the nerve is damaged they may ask for nerve conduction studies. These test how quickly the electricity can travel in your nerve.
Carpal tunnel syndrome exercises
There are a few exercises that you can try to ease carpal tunnel syndrome symptoms and prevent them from returning after treatment. These should be done for around 6-8 weeks until you feel an improvement in your symptoms.
Firstly, you can rest your elbow on a table with your arm pointing up and your wrist straight. Then, gently bend your wrist forward and hold it at maximum extension for five seconds. Then do the same with your wrist bent backward. This should be done in three sets of 10. You could also try the wrist lift exercise. Here, you simply place your palm on a table and lift the fingers upwards. Then place your other hand over your knuckles and push downwards as the other hand pulls up. Swap hands and repeat the same process.
Other exercises you can use include flexing your wrist downwards and using your other hand to stretch your hand towards the body. Finger bends can also be used, as well as wrist stretches with weights and hand squeezes using a rubber ball.
Carpal tunnel syndrome treatment
There are a number of treatment options for carpal tunnel syndrome. Part of the reason symptoms are worse at night is that most people sleep with their wrists flexed. This reduces the space in the carpal tunnel by 30% and therefore squashes the nerve. Many people’s symptoms resolve simply by sleeping with their wrist held in neutral by a soft splint..
An injection of local anaesthetic and steroids into the mouth of the carpal tunnel relieves symptoms in approximately 60-70% of patients and for many of these patients, the relief will last a number of years. This works by reducing swelling and relieving the pressure on the median nerve. Injections are quick to perform and recover from. They have a low complication rate but often the symptoms recur.
Surgical release of the carpal tunnel is the most successful technique for relieving symptoms and preventing progression. Success rates for relieving symptoms are in the reams of 90%
It is a simple procedure performed as a day case under local anaesthetic. The procedure only takes around 20 minutes but the recovery takes a little longer. The wound will take 2 weeks to heal, it takes around 4-6 weeks to get back to full activities, and can take up to 3 months for you to regain full grip strength.
For more information about causes and symptoms as well as the latest treatments, please visit our carpal tunnel syndrome page.
If you suffer from carpal tunnel syndrome, then please book an appointment with one of our hand surgeons so we can provide you with the most suitable advice and treatment.
