Consultant – Gavin Brigstocke

What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome (CTS) is a condition when the median nerve is compressed as it passes through a short tunnel at the wrist resulting in pain, tingling and numbness in the hand. CTS most commonly affects middle aged women but can occur in anyone. Symptoms are often worse at night or first thing in the morning. It may be provoked by activities that involve gripping an object. In the early stages numbness and tingling are intermittent and sensation does return to normal. As the condition worsens altered sensation may become permanent and wasting of the muscles at the base of the thumb may occur.

The diagnosis of CTS is usually clear from symptoms and signs alone. Nerve conduction studies may be used to confirm the diagnosis if the clinical findings are equivocal.

What treatments are available?
Non-operative measures including exercises, night splints and steroid injections may be beneficial with mild or moderate CTS. If the symptoms progress surgery is usually required. The short procedure involves opening the roof of the tunnel to release the pressure on the nerve. The surgery is usually performed under local anaesthetic.

What are the outcomes?
Surgery usually results in a satisfactory resolution of symptoms. Night pain and tingling disappear within days. In severe cases improvement of the constant numbness and muscle weakness may be slow or incomplete. The scar in the palm will be firm to touch and sometimes tender for 3-6 months after surgery. This will routinely settle with time and can often be aided by massaging the scar.

Further information:
https://www.bssh.ac.uk/patients/conditions/21/carpal_tunnel_syndrome