Carpal tunnel syndrome

The nerve passes through the carpal tunnel, a canal in the wrist that carries all the tendons of the hand. If these tendons are swollen, the nerve is squeezed and becomes trapped.

Carpal tunnel syndrome can happen at any age. It is most common in patients who perform repetitive tasks with the hand and wrist such as computer keyboard and mouse use. One or both hands can be affected and symptoms can be worse at night, disturbing sleep.

Carpal tunnel syndrome symptoms

These can include pain, as well as pins and needles in your hand. You may have aching that can extend up the arm, weakness in the hand and difficulty gripping. Also, you may feel tingling and numbness in the thumb, index and middle fingers.

What causes carpal tunnel syndrome?

The causes of this carpal tunnel syndrome can vary. There may be excess fat or fluid in the canal that causes it to narrow – fluid retention during pregnancy can do this. Or it may have narrowed after a break or arthritis in the wrist. Some work-related tasks, such as those using vibrating tools, can make the condition worse.

We can quickly diagnose the syndrome with a nerve conduction test, which tells us how compressed the nerve is.

Treatment for carpal tunnel syndrome

Wearing a splint on the wrist at night can relieve carpal tunnel syndrome. Short-term relief can also be gained from an injection of a steroid. Using appropriate keyboards and trackball mouse devices while doing computer work can also relieve symptoms. However, if symptoms persist, surgery is the best option for long-term relief.

What happens during carpal tunnel release surgery?

Carpal tunnel release is usually performed using a local anaesthetic so that you feel nothing and a light sedation so you remain relaxed. The procedure takes about twenty minutes. Your surgeon will make a small incision (cut) in your wrist. They will then cut the flexor retinaculum - the ligament that forms the top of the carpal tunnel - relieving the pressure on the median nerve. The incision will be closed using sutures (stitches). Some surgeons will perform this procedure endoscopically - inserting a tiny camera into the incision to examine your wrist and cut the ligament.

After the operation

Carpal tunnel release is usually done on an outpatient basis meaning you will do home the same day as the procedure. You may go home with a splint or heavy bandage on your wrist. Once these are removed you will begin exercises and physiotherapy to regain movement in your wrist and arms. 

Most people make a good recovery and return to normal activities following carpal tunnel release. As with any surgery there can be complications:

• Pain
• Bleeding
• Infection of the surgical site (incision)
• Scarring

Specific complications in carpal tunnel release include:

• Continued numbness in fingers
• Tenderness around scar
• Aching in the wrist
• Return of numbness and pain
• Complex regional pain syndrome – a rare, but chronic (long-term) condition that causes a burning pain in one of the limbs