Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is a common condition that arises when there is compression of the median nerve at the wrist. The median nerve and nine flexor tendons run from the forearm to the hand. The carpal tunnel is a narrow passageway surrounded by bones and ligaments on the palm of the hand. Anything that compresses or irritates the median nerve in the carpal tunnel may lead to Carpal Tunnel Syndrome. When the pressure increases on the nerve, it may disturb the way the nerve works, resulting in numbness, tingling and pain in the hand and fingers. 

Causes

The cause of Carpal Tunnel Syndrome is unknown. Pressure on the nerve may occur in a number of different circumstances. This may include: joint dislocations, fractures and arthritis; thickening of the cover of the flexor tendons and maintaining the wrist in a bent position for a prolonged period. Carpal Tunnel Syndrome may be more common in pregnancy, due to fluid retention. Medical conditions such as thyroid conditions and diabetes are also associated with Carpal Tunnel Syndrome.

Symptoms

Carpal Tunnel Syndrome may present in a variety of different ways. Tingling, pins and needles or numbness in the thumb or fingers are some of the more common symptoms. Pain and numbness are often worse at night and may cause difficulty sleeping. Driving a car or utilising a mobile phone are other activities that cause numbness or tingling to be more pronounced. Weakness or reduced hand function may also occur. This may be due to the numbness of the fingers or due to loss of power in some of the thumb muscles. In severe cases, sensation may be permanently lost and the muscles at the base of the thumb decrease in size (thenar atrophy).

Diagnosis

Dr Watson will assess your hand and determine whether your signs and symptoms are consistent with Carpal Tunnel Syndrome.

Nerve conduction studies may be required to confirm the diagnosis and site of compression.

Treatment Options

Non surgical treatment options will be explored to manage and reduce symptoms. These include activity modification to rest the hands or to change the position of the wrist in certain activities that exacerbate the condition. Splints may be helpful to support the wrist and relieve mild symptoms. Injections of corticosteroids may be suitable in certain circumstances. In ongoing or severe cases surgery may be required. This would involve dividing the ligament (or roof of the carpal tunnel) to allow for more room for the nerve in the carpal tunnel. This would generally be performed as a day procedure case.