Carpal tunnel syndrome occurs when the median nerve is compressed as it passes through the wrist. This nerve provides sensation to the thumb, index and middle fingers and contributes to hand strength and coordination.
Symptoms often develop gradually, beginning with numbness or tingling in the fingers, particularly at night or during repetitive hand use. Over time, this can affect grip strength and everyday activities.
Common symptoms include:
• Numbness or tingling in the thumb, index and middle fingers
• Pain that may radiate into the forearm
• Symptoms that are often worse at night
• Weakness in the hand or reduced grip strength
• Difficulty handling small objects
• A feeling of clumsiness in the hand
In more advanced cases, there may be wasting of the muscles at the base of the thumb.
Common symptoms include:
• Numbness or tingling in the thumb, index and middle fingers
• Pain that may radiate into the forearm
• Symptoms that are often worse at night
• Weakness in the hand or reduced grip strength
• Difficulty handling small objects
• A feeling of clumsiness in the hand
In more advanced cases, there may be wasting of the muscles at the base of the thumb.
Diagnosis is usually made through a detailed clinical assessment, including a discussion of your symptoms and examination of the hand and wrist.
If required, further investigations may include:
• Nerve conduction studies to assess how well signals travel along the nerve
• Imaging such as X-rays to rule out arthritis or previous injury
These tests help confirm the diagnosis and guide treatment decisions.
reatment depends on the severity of symptoms and how they affect your daily life.
Non-surgical treatment may include:
If symptoms persist or become more severe, surgical treatment may be recommended.
When non-surgical treatments are no longer effective, carpal tunnel release surgery may be recommended.
The procedure involves releasing the ligament that forms the roof of the carpal tunnel. This reduces pressure on the median nerve and allows it to recover.
The operation is typically performed under local anaesthetic, meaning you remain awake but the hand is fully numbed. It usually takes around 15 minutes to complete.
After surgery, a bulky dressing is usually applied for the first 48 hours. This is then replaced with a lighter dressing until the stitches are removed at around 10 days.
Recovery timelines vary depending on your activity level:
• Office-based work: approximately 2 weeks
• Light manual work: around 4 weeks
• Heavy manual work: up to 6 weeks
Driving is typically possible after 7–10 days, once you feel comfortable and safe to control the vehicle.
Most patients can return to sport within 6 weeks, although more physically demanding activities may require a longer recovery period.
As with any surgical procedure, there are potential risks, although these are uncommon.
Possible complications include:
• Infection (around 1%), usually treated with antibiotics
• Swelling or stiffness, which may take time to settle
• Scar sensitivity, particularly in the palm
• Nerve irritation or injury (rare)
• Pillar pain (discomfort around the scar area), typically improving within a few months
• Recurrence of symptoms (uncommon)
• Residual numbness, particularly if symptoms were severe before surgery
Very rarely, a condition known as complex regional pain syndrome (CRPS) can occur, leading to prolonged pain and sensitivity.
You should seek medical advice if you experience persistent numbness, tingling or weakness in your hand, particularly if symptoms affect sleep or daily activities.
Early assessment is important, as prolonged nerve compression can lead to permanent changes, including loss of sensation, weakness or muscle wasting if left untreated.
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