Carpal Tunnel Syndrome

Carpal tunnel syndrome is caused by compression of the median nerve at the wrist. It can cause numbness, tingling and weakness in the hand, mainly on the palm side.

Common symptoms include numbness, tingling, pain, and reduced strength or dexterity. They usually affect the thumb, index finger, middle finger and part of the ring finger; the fifth finger, or little finger, is generally spared.

No. When symptoms are mild or the diagnosis is uncertain, nonsurgical treatment may be considered first. Surgery is considered according to the severity and duration of symptoms, examination findings, response to previous treatment and, when performed, test results.

Surgery may be recommended when symptoms persist despite nonsurgical treatment, relief is only temporary, tests show significant nerve changes, or there is constant numbness, loss of strength or wasting of the muscles at the base of the thumb.

Not always. Many cases can be diagnosed from the clinical history and examination of the hand. Nerve conduction studies and electromyography may be useful when the diagnosis is uncertain, to assess severity, exclude compression elsewhere or identify another nerve condition.

The operation releases the ligament compressing the median nerve. Increasing the available space in the carpal tunnel reduces pressure on the nerve.

The stated operating time is approximately 20 to 30 minutes. The total time at the treatment unit may be longer because of preparation, anaesthesia and observation after the procedure.

The operation may be performed under local anaesthesia or a brachial plexus block, with or without sedation. A hospital stay is not usually required, and the anaesthetic plan is tailored to the individual patient.

The scar is located in the middle of the base of the palm. Pillar pain is pain or tenderness around the base of the palm and wrist, particularly when pressing or leaning on the hand, and it may continue for several weeks or months while the tissues recover.

Risks include infection, bleeding, wound-healing problems, nerve irritation or injury, and pillar pain. Nerve injury is uncommon, but no surgical procedure is entirely free of complications.

Early finger movement is usually encouraged to reduce swelling and stiffness. Light use can be resumed gradually; normal hand use is often possible at around 10 days, while significant exertion should be avoided until about 6 weeks or until your surgeon advises otherwise.

Routine splinting and supervised hand therapy are not required for every patient after carpal tunnel release. They may be recommended individually if there is stiffness, persistent pain, weakness or another specific rehabilitation need.

This depends on comfort, hand movement and the demands of the activity. People with light duties can usually return sooner than those doing manual, repetitive or heavy work. Driving should resume only when you can control the vehicle safely and perform an emergency manoeuvre without limitation.

Strength may take around 3 to 4 months to recover. Numbness and tingling may improve gradually over several months. In severe or long-standing cases, recovery may take 6 to 12 months and may not be complete.

The result is usually long-lasting. Recurrence can occur but is uncommon; if it happens, further assessment and sometimes additional treatment may be required.