Carpal Tunnel Syndrome
Carpal tunnel syndrome occurs when the median nerve in the wrist is compressed, causing numbness, tingling, or pain in the thumb, index, middle, and part of the ring finger. It often develops gradually and can be triggered by repetitive wrist movements, certain health conditions, or wrist anatomy. Symptoms can often be managed with splints, exercises, or medical treatment.
Overview | Symptoms & Causes | Diagnosis | Treatment Options
The Carpal Tunnel
The carpal tunnel is a narrow passageway on the palm side of your wrist, formed by bones and a strong band of connective tissue called the transverse carpal ligament. It houses the median nerve, which provides sensation to the thumb, index, middle, and part of the ring finger, as well as tendons that help bend the fingers.
Carpal tunnel syndrome occurs when the median nerve is compressed within this tunnel. This compression can lead to symptoms such as numbness, tingling, and weakness in the hand and fingers. Over time, it may affect grip strength and hand function if left untreated.
Understanding Carpal Tunnel Syndrome
Carpal tunnel syndrome happens when the median nerve is squeezed, leading to changes in sensation and function in the hand. Symptoms can vary in intensity and may come and go, often worsening at night or with repetitive hand movements.
- Numbness or tingling, especially in the thumb, index, middle, and part of the ring finger
- A “pins and needles” or burning sensation in the hand or fingers
- Weakness in the hand or a tendency to drop objects
- Pain or discomfort that can radiate up the forearm
- Difficulty with fine motor tasks, such as buttoning clothes or writing
These symptoms may fluctuate but usually worsen over time if the underlying compression is not addressed.
Causes and Risk Factors
Carpal tunnel syndrome occurs when the median nerve is compressed as it passes through the wrist. This can happen for a variety of reasons, and several factors may increase the risk:
| Repetitive hand movements | Frequent wrist and hand use, especially gripping or bending, increases pressure on the median nerve. |
| Medical conditions | Diabetes, thyroid disorders, obesity, and inflammatory conditions like rheumatoid arthritis can raise risk. |
| Wrist injuries or anatomy | Fractures, dislocations, or naturally smaller carpal tunnels can predispose to nerve compression. |
| Age & sex | More common in women; risk increases with age. |
| Pregnancy | Hormonal changes and fluid retention can temporarily narrow the carpal tunnel. |
Diagnosing Carpal Tunnel Syndrome
Diagnosis usually begins with a clinical assessment. Your healthcare provider will take a detailed history of your symptoms, including when they occur and what makes them worse, and perform a physical examination of your hand, wrist, and arm. They will look for signs such as numbness, tingling, or weakness in the thumb, index, middle, and part of the ring finger, and may assess muscle strength and sensation.
Imaging may be used to confirm the diagnosis or rule out other conditions:
| Ultrasound | A non-invasive scan that visualizes the median nerve and surrounding structures. It can detect swelling or compression of the nerve and identify any anatomical abnormalities contributing to symptoms. |
| MRI | Provides a detailed view of soft tissues in the wrist, including the median nerve, tendons, and ligaments. MRI is typically reserved for complex cases or when there is suspicion of other conditions causing nerve compression. |
| Nerve Conduction Study | Measures how quickly electrical signals travel through the median nerve. It helps confirm the diagnosis, assess severity, and can guide treatment decisions, especially if surgery is being considered. |
Treatment Options
Treatment depends on the severity of symptoms and how long they have been present.
| Conservative measures | Wearing a wrist splint, especially at night, can help keep the wrist in a neutral position and reduce pressure on the median nerve. Activity modification, avoiding repetitive strain, and hand/forearm stretches or exercises can also improve symptoms. |
| Medications | Over-the-counter pain relief or anti-inflammatory medications can help manage discomfort, particularly during flare-ups. |
| Steroid injections | Steroid injections into the carpal tunnel can reduce inflammation and relieve pressure on the median nerve for moderate to severe symptoms. |
| Surgery | If symptoms persist or there is significant nerve compression, a surgical procedure called carpal tunnel release may be recommended. This involves cutting the ligament over the carpal tunnel to relieve pressure on the nerve. Recovery usually involves physiotherapy to restore hand strength and function. |
How can Lanthorn help?
Ultrasound Hand & Wrist - £300
Ultrasound is a quick, non-invasive way to visualise the median nerve and surrounding structures. It can show swelling of the nerve, assess its mobility, and help rule out other causes of wrist pain or numbness.
Ultrasound-guided Steroid Injection - £450
Ultrasound-guided steroid injections can reduce inflammation and relieve pressure on the median nerve. This can be particularly helpful for patients with persistent symptoms not fully controlled by conservative measures.
MRI Wrist - £350
MRI provides a detailed view of the soft tissues, including the median nerve, tendons, and ligaments. It may be used in more complex cases to assess the severity of compression or if surgery is being considered.
