Carpal tunnel syndrome: From diagnosis to treatment

If you suspect you have carpal tunnel syndrome, this article by leading consultant orthopaedic hand & wrist surgeon Mr Andrew Rogers provides a detailed look at symptoms, diagnosis and treatment of this condition. Read on to find out more.

What is carpal tunnel syndrome?

Carpal tunnel syndrome (CTS) is a common condition that causes numbness, tingling and weakness in the hand and arm. It occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes compressed or squeezed at the wrist.

What are the symptoms of carpal tunnel syndrome?

Numbness and tingling

One of the earliest symptoms of CTS is numbness and tingling in the thumb, index finger, middle finger and half of the ring finger. This sensation is often described as pins and needles or electric shocks.

Weakness

As CTS progresses, individuals may experience weakness in the hand and a decreased ability to grip objects or perform fine motor tasks such as buttoning a shirt or holding a pen.

Pain and discomfort

Some people with CTS may experience pain or aching in the wrist, hand, or forearm. This pain may radiate up the arm or down into the fingers, particularly at night or during activities that involve repetitive wrist movements.

Symptoms aggravated by certain activities

Symptoms of CTS may worsen with activities that involve bending or flexing the wrist, such as typing on a keyboard, using a computer mouse, gripping tools or driving.

How is carpal tunnel syndrome diagnosed?

Clinical examination

Diagnosis of CTS begins with a thorough medical history and physical examination. Your doctor will assess your symptoms, evaluate your wrist flexibility and strength and perform specific tests to elicit signs of median nerve compression.

Nerve conduction studies

Nerve conduction studies (NCS) are often performed to confirm the diagnosis of CTS and assess the severity of nerve damage. During NCS, electrodes are placed on the skin to measure the speed and strength of electrical signals transmitted along the median nerve.

What are the treatment options for carpal tunnel syndrome?

Non-surgical treatment

• Wrist splinting: Wearing a splint at night to keep the wrist in a neutral position can help alleviate symptoms by relieving pressure on the median nerve.
• Activity modification: Avoiding activities that exacerbate symptoms or performing them in a way that minimises wrist strain can provide relief.
• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections may be prescribed to reduce inflammation and alleviate pain.

Surgical treatment

Carpal tunnel release surgery: For individuals with severe or persistent symptoms, carpal tunnel release surgery may be recommended. During this procedure, the transverse carpal ligament is divided to relieve pressure on the median nerve, alleviating symptoms and restoring hand function.

Ensuring you get the right treatment for carpal tunnel syndrome

Carpal tunnel syndrome is a common condition characterised by numbness, tingling, and weakness in the hand and arm. Diagnosis is based on clinical examination and nerve conduction studies and treatment options include non-surgical interventions such as wrist splinting and activity modification, as well as surgical carpal tunnel release for refractory cases.

Early diagnosis and appropriate management are essential for minimising symptoms and preventing long-term nerve damage. If you suspect you have carpal tunnel syndrome, consult with a healthcare professional for evaluation and personalised treatment recommendations.

Looking for an expert consultation regarding carpal tunnel syndrome? Arrange a consultation via Mr Rogers’ Top Doctors profile.