Carpal tunnel syndrome

What is carpal tunnel syndrome (CTS)?

This is a common condition which results from compression of the median nerve at the wrist.  The median nerve supplies some of the fingers and the thumb with sensation and some small muscles for movement in the hand.  The compression causes pins and needles, weakness and clumsiness and sometimes pain.  Often symptoms are worse at night. 

The diagnosis of CTS is often confirmed by clinical examination and nerve conduction studies.  The latter is an electrical test which evaluates the effectiveness of the nerve in conducting its messages.  The results will tell the doctor how severe the compression is and whether the symptoms are, indeed CTS or one of a number of other conditions with similar symptoms.

What can I do about my CTS?

CTS can be managed conservatively or by surgery depending on the severity.  Mild and moderate cases may find benefit from referral to a hand therapist who may make or fit splints, teach exercises to glide the nerve, strengthen the muscles and provide education about the condition.

Corticosteroid injections can be of benefit for inflammatory compressions and may be offered by the doctor if it is appropriate.  It is important that the injection is done by a specialist as these cannot be repeated too many times.

More severe cases may require surgery. 

Should I have surgery?

If your CTS is severe or causing significant functional difficulties it may be indicated.  Surgery involves opening the carpal tunnel to relieve pressure and is usually done as a day case.  It is a relatively simple procedure which is effective in most cases.  Nerves are very irritable and therefore it is often several months before you get the full benefit of the decompression.

What happens after surgery?

You will need to keep the hand elevated for a few days and the wound clean and dry until it has healed.  You will be able to use the hand for many things almost immediately after surgery.  A hand therapist will be able to guide you through post operative exercises and with management of the scar as it matures.