Carpal tunnel syndrome


Carpal tunnel syndrome is a common condition which causes pain and numbness in the hand and in particular the thumb and middle fingers. It does not affect the little finger.


Carpal tunnel syndrome is a compression neuropathy of the median nerve. The median nerve supplies sensation to the thumb, index, middle and part of the ring fingers on the palmar surface of the hand. When it enters the hand, it passes through a tunnel created by the bones of the wrist and the ligament which supports them. In the tunnel are the flexor tendons of our fingers covered in synovium. If for whatever reason this synovium becomes inflamed and swollen, it results in nerve compression.


When the nerve is compressed, the initial symptoms are numbness in the hand. This may be temporary at first and may trouble you at night, waking you, or perhaps while doing something as simple as driving the car. It may progress to pain in long-standing cases.


Carpal tunnel syndrome is usually diagnosed clinically by your history and examination findings. If there is doubt then you will have nerve conduction studies which look for subtle changes in the nerve function.


Initially this may be treated by rest, restriction of the activity which makes the symptoms worse and occasionally a cortisone injection into the tunnel. All of these measures may only provide temporary relief. Carpal tunnel syndrome is usually and very effectively treated by carpal tunnel decompression.

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Carpal tunnel decompression