Carpal tunnel syndrome

What is the carpal tunnel?

Illustration of the wrist, showing the position of the transverse carpal ligament, the median nerve, and the carpal bones.The carpal tunnel is a structure in your wrist. Many tendons and nerves pass through this tunnel. A nerve called the median nerve sits in this tunnel with the tendons.

This nerve gives you feeling in the thumb and fingers, and also makes the tendons work properly.

Why does it happen?

We don’t know why carpal tunnel syndrome happens. Anything that reduces the space in and around the carpal tunnel or increases the pressure within it can cause symptoms.

Repetitive activities using the hand and wrist, obesity and pregnancy can all increase your chance of getting carpal tunnel syndrome.

What symptoms may you experience?

You may feel one or more of the following symptoms:

  • Pain, pins and needles, numbness or burning in the thumb, index, middle or half the ring fingers;
  • Tingling or numbness of your entire hand;
  • Weakness in the hand;
  • Pain that shoots from your hands up the arm as far as the shoulder;
  • Your symptoms may be worse at night or first thing in the morning;
  • You may drop things;
  • You may have trouble doing up buttons or writing;
  • Your hands may be are swollen, hot and sweaty.

How to manage carpal tunnel syndrome

  • Speak to your pharmacist or GP about medication that may help your pain.
  • Try a wrist splint at night or when wrists are in a still position.
  • Slightly raise up your arms with pillows or cushions when lying or sitting down – this can help to reduce swelling in the tunnel.
  • Try to pace and modify your day to day activities, and avoid any activity that makes it worse.

How long will it last?

Symptoms of carpal tunnel will go away in some people. Some people will have good and bad times over many years, and some people will have unchanging or worsening symptoms.

What to look out for?

You may have worsening symptoms that require further treatment. If you notice any of the below please contact your GP or physiotherapist:

  • Worsening pain level;
  • Symptoms become constant in nature (not just at night or with prolonged activity);
  • Symptoms of pins and needles or numbness increase; 
  • Any worsening weakness or wasting in the muscle of the hand and thumb.

If your symptoms worsen or do not improve after 3 months of following our advice please contact your GP (for a referral to the Hand Therapy department) or physiotherapist/ hand therapist who can refer you to a specialist.

What are the future treatment options?

If your symptoms worsen or fail to improve your GP or hand therapist / physiotherapist will discuss your options with you. These options include injections and carpal tunnel decompression surgery. Your GP or hand therapist/ physiotherapist can refer you to a specialist hand surgeon.

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