Orthopaedics & Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS)

Carpal Tunnel Syndrome affects an estimated 7% to 16% of people in the UK, with women being twice as likely as men to develop the condition. Symptoms of Carpal Tunnel Syndrome are often manageable for some, but for others CTS can significantly impact daily activities, sleep, and even your ability to work, particularly in roles that involve repetitive hand movements.

What is Carpal Tunnel Syndrome?

The carpal tunnel is a narrow passageway in the wrist, formed by small wrist bones (carpal bones) and a strong band of connective tissue (the transverse carpal ligament). Running through this space is the median nerve, along with several tendons that help move your fingers.

Carpal Tunnel Syndrome occurs when this median nerve becomes compressed or irritated, typically due to inflammation or narrowing within the tunnel. This pressure disrupts nerve function, leading to pain, tingling, and weakness in the hand and fingers.
 

The median nerve controls sensation and movement in the thumb, index finger, middle finger, and part of the ring finger. (Note: If symptoms involve the little finger, another condition—Cubital Tunnel Syndrome—may be the cause.)

What Causes Carpal Tunnel Syndrome?

CTS can be caused by a combination of anatomical, medical, and lifestyle-related factors.

1. Anatomical Factors

• A naturally narrow carpal tunnel (may run in families)
• Wrist fractures or dislocations
• Arthritis affecting the wrist
• Fluid retention, particularly in pregnancy

2. Underlying Medical Conditions

• Diabetes
• Hypothyroidism
• Rheumatoid arthritis
• Tenosynovitis (inflammation of tendon sheaths)
• Growths such as cysts or tumours

3. Occupational and Lifestyle Factors

• Repetitive hand and wrist movements (e.g. typing, hairdressing, manual labour)
• Long-term use of vibrating tools
• Hobbies that involve fine hand movements (e.g. gaming, crafting, playing instruments)

What are the Symptoms of Carpal Tunnel Syndrome?

CTS can vary in severity and tends to worsen over time if left untreated.

Mild to Moderate Symptoms

• Tingling or numbness in the thumb, index, middle, or ring fingers
• Pain or discomfort in the hand and wrist, often worse at night
• Difficulty gripping or holding objects
• Symptoms that come and go initially

Severe Symptoms

• Constant numbness or tingling that doesn’t improve with rest
• Muscle wasting at the base of the thumb (thenar muscle)
• Significant hand weakness or frequent dropping of objects
• Risk of permanent nerve damage if not addressed

How is Carpal Tunnel Syndrome Treated?

Early diagnosis is key, as several other conditions can mimic CTS. Treatment options vary based on the severity of your symptoms:

Non-surgical Treatments

• Wearing a wrist splint, especially at night
• Targeted exercises to improve flexibility and strength
• Over-the-counter or prescribed pain relief
• Corticosteroid injections to reduce inflammation

These methods are often effective in mild to moderate cases.

Surgical Treatment: Carpal Tunnel Decompression / Release

If symptoms persist or worsen, Carpal Tunnel Release surgery may be recommended. This is a routine procedure, usually carried out under local anaesthetic, and typically takes around 30 minutes.

What Does the Procedure Involve?

A small incision is made near the wrist, allowing the surgeon to cut the transverse carpal ligament. This relieves pressure on the median nerve, creating more space within the tunnel.

Recovery and Aftercare

Most people recover quickly, particularly if surgery is done early in the condition’s progression. Post-operative care may include:

• Taking prescribed or over-the-counter pain medication
• Avoiding heavy or repetitive use of the hand for a few days
• Keeping the surgical site clean and dry
• Attending physiotherapy if advised
• Doing specific hand and wrist exercises to rebuild strength and mobility

Those with long-standing symptoms may need a longer recovery period and could have some lasting effects, although symptoms are usually less severe after surgery.

Getting Help

If you think you may have Carpal Tunnel Syndrome, we would advise seeking help early.  Delaying treatment can result in long term nerve damage.  Haven Medical carry out Carpal Tunnel decompression surgery from their Day Surgery theatre in Canford Cliffs.

Steroids and local anaesthetics can be injected into or around joints for numerous painful conditions such as arthritis, carpal tunnel syndrome, frozen shoulder and Morton’s neuroma. These injections can reduce inflammation, offer pain relief and help encourage a better range of motion and activity, helping you get back on track.

• Osteoarthritis – knee, shoulder

• Carpal Tunnel Syndrome

• Lateral Epicondylitis (Tennis Elbow)

• Medial Epicondylitis (Golfer’s elbow)

• Plantar fasciitis (Policeman’s heel)

• Trochanteric bursitis (lateral hip pain)

• Frozen shoulder

• Trigger finger

• Morton’s neuroma (a damaged nerve between the toes that is often painful)

• Gout