Health & WellbeingGeneralCarpal tunnel – the cause, symptoms and treatment explained
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Carpal tunnel – the cause, symptoms and treatment explained

By Melina - Assistant Editor Feb 17, 2019

Carpal tunnel is a common, painful condition that may need surgery - here we look at diagnosis and treatment

Carpal tunnel syndrome (CTS) is pressure on a nerve in your wrist. It causes tingling, numbness and pain in your hand and fingers. You can often treat it yourself, but it can take months to get better.

How do you get carpal tunnel?

Carpal tunnel syndrome, or CTS, is a painful condition of the thumb and first three fingers which occurs when the median nerve is compressed where it passes through your wrist.

There is no definitive cause for CTS but certain people may be more susceptible:

  • Those with a family history of CTS
  • Pregnant women – although in many instances symptoms are relieved after the birth
  • Women going through the menopause
  • Those whose job involves repetitive motion – gripping, bending or vibrations going through the wrist
  • Those who have suffered a wrist injury.  Health issues such as an underactive thyroid, diabetes or obesity may also contribute to CTS.

Symptoms of carpal tunnel

Symptoms generally start by showing themselves usually at night, or early in the morning, with discomfort or tingling in the thumb and first three fingers of the hand. This can be quite painful and in some cases the hand and forearm can be affected too.

CTS can gradually develop and may eventually affect both hands.

There may be other symptoms:

  • A weakness in the thumb
  • The hand can change colour, become dry, or swell
  • Pain can spread up the arm
  • The burning or prickly feeling can affect the rest of the hand too

How to test and diagnose CTS

If you have any of the symptoms described and they persist, then you should make an appointment with your GP.

Usually, your doctor will ask you about your symptoms and then examine your hand, wrist and arm by tapping or flexing your wrist. Your doctor may also ask you to hold your arm above your head for a minute.

Generally, this is enough for your doctor to make a diagnosis but if there are any underlying causes your GP is worried about or if they want to check the degree of damage then they may:

  • perform an ultrasound scan
  • conduct a nerve test
  • carry out a blood test to consider diabetes

Treatment for carpal tunnel

Treatment will, of course, depend on how bad your symptoms are and how much your nerve is damaged.

Some carpal tunnel symptoms can get better without treatment. You may be able to figure out what makes your symptoms worse and avoid those actions.

Symptoms of CTS in pregnant women more often than not clear up around 6 to 12 weeks after birth; however, if your symptoms are caused by an underlying condition such as diabetes then after this is treated the symptoms should be relieved.

The first recommended treatment for CTS is usually wrist splints. These are relatively cheap and can be bought from any pharmacy. Symptoms should improve within 4 weeks of wearing them. Failing that, your GP may recommend a steroid injection into the wrist, which may be followed by another if your symptoms start to reduce.

An operation could be an alternative option. The procedure, known as carpel tunnel decompression or carpal tunnel release surgery, is where the carpal ligament is cut to relieve pressure on the nerve.

The procedure is either performed through keyhole surgery or via an open incision in the wrist. Both these procedures are performed under local anaesthetic and should not involve an overnight stay in hospital.

CTS treated by surgery usually result in eliminating the symptoms completely but as with any surgery there is always a risk of complications. There could be resulting nerve damage or scarring and it could take a while to recover.

Your hand will be bandaged, is usually kept raised for 2 days after surgery and a sling may have to be worn too. After 2 days you are encouraged to perform light exercises so your hand, elbow and shoulder do not get stiff.

You should also then be able to do some gentle activities but it may take a few weeks before you feel fully recovered.

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Melina - Assistant Editor

Hi I'm Melina, a mother of 3 teenage children and with a particular interest in all things health related. I run a busy household and smallholding alongside my work with Silversurfers, which currently includes dogs, fish, hens, ducks and pigs!

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