Carpal tunnel syndrome

Carpal tunnel syndrome is one of the most common reasons people come to see a hand surgeon. If your hand tingles, goes numb, or wakes you in the night, it can be wearing, but it is well understood and, in most cases, very treatable.

What it is

A nerve called the median nerve passes into the hand through a narrow space at the wrist, the carpal tunnel. When the space becomes tight and the nerve is placed under pressure, the hand can tingle, feel numb, or ache. The thumb, index and middle fingers are most often affected. {{CONFIRM with Holly}}

What you might notice

Tingling or numbness in the fingers, often worse at night or first thing in the morning.
A need to shake or hang the hand to “wake it up”.
Clumsiness, or weakness when gripping or pinching.
Symptoms brought on by driving, holding a phone, or repetitive tasks.

How it is treated

I view surgery as a last resort. Where it is appropriate, we start with simpler measures and only consider an operation if symptoms persist or the nerve is being significantly affected.

Splinting, especially at night, to rest the wrist in a neutral position. {{CONFIRM with Holly}}
A steroid injection can settle symptoms and help confirm the diagnosis. {{CONFIRM with Holly}}
Carpal tunnel release, a small, well-established operation that opens the tunnel and takes the pressure off the nerve. It is typically a day case under local anaesthetic. {{CONFIRM with Holly: technique, e.g. open vs ultrasound-guided / Spirecut™.}}

Recovery & what to expect

A careful assessment. We talk through your symptoms, examine the hand, and discuss whether tests (such as nerve studies) would help. {{CONFIRM with Holly}}
A plan that starts gently. Where possible we try to settle things without surgery first.
The procedure, if needed. Usually a quick day case; you go home the same day. {{CONFIRM with Holly}}
Healing and hand therapy. Simple aftercare, with hand therapy where it helps.

Questions patients ask

Will the tingling go away? Many people get good relief, particularly when it is treated before the nerve is affected for a long time. We will be honest with you about what to expect in your case.

Do I need surgery? Not always. Splints and injections help many people; surgery is considered when symptoms persist or worsen. {{CONFIRM with Holly}}

How soon can I use my hand? Light use returns quickly; we will guide you on heavier activities and work. {{CONFIRM with Holly}}

Carpal tunnel syndrome.