The five common signs of carpal tunnel syndrome

Carpal tunnel syndrome is a common condition.

The condition occurs when the median nerve, one of the major nerves supplying the hand gets compressed as it travels through the carpal tunnel within the wrist. The tunnel itself is a narrow passageway and contains both the median nerve and 9 flexor tendons. 

Carpal tunnel syndrome occurs when the tunnel becomes narrowed and then puts pressure on the nerve.

Studies show that women and older patients are more likely to develop this condition.

Common signs of carpal tunnel syndrome include:

• Pins and needles affecting the thumb, index, middle and part of the ring finger
• A numbness within the hand, sometimes including the fingertips
• Clumsiness when handling small objects
• Sleep disturbance
• A feeling of weakness within the hand

Diagnosis

Your specialist will assess the condition of your neck and upper limbs, to make sure there is no other issue ongoing that may be accounting for your symptoms. 

A nerve conduction test is sometimes also used to aid in the management of your condition.  This test is performed by a neurophysiologist and measures the speed of your nerve impulses across the wrist. If the nerve impulses are slower as the nerve passes into the hand, it may be an indicator of carpal tunnel syndrome.

Treatment

If diagnosed early enough, it can be managed non-surgically such as wearing a wrist splint at night and avoiding certain aggravating activities.  

If you do require surgery, your specialist will discuss this with you, including discussing the benefits and risks.  The main benefits of surgery include symptoms relief and to prevent longstanding damage to the nerve itself. 

As a procedure, carpal tunnel decompression has a reputation for having a very good outcome in the vast majority of patients. This a day case procedure meaning that you will have the procedure and go home on the same day. The actual procedure takes approximately 20 minutes and is performed under local anaesthesia, which means you will be awake during the procedure.

Recovery

You will be sent home with a bandage around the hand and usually will be given a sling.  You may have some mild degree of post-operative surgical pain that can be managed with simple painkillers. Straight after the procedure, you will have the use of your fingertips, for example to fasten a button or zip.

You will have a wound review in our dressing clinic usually 3-4 days after the procedure.  The surgical wound will need to be covered with a simple dressing for up to 2 weeks. The stitches are normally taken out at day 10. 

You will be advised not to drive for approximately one week. In terms of heavy lifting/manual work, this is not usually possible for the first 3 weeks or so. 

You will find that if carpal tunnel syndrome was causing you to have disturbed sleep, in the majority of patients, this issue normally settles within the first week of the procedure. 

Numbness and tingling can take a number of months to settle.

Complications

As with any operation, there are risks but this this is very unusual with this type of procedure. Risks include initial bleeding, wound infection, nerve injury, scar pain and ongoing symptoms.

Your specialist will go through these risks in detail at your appointment.

North West Hand Surgeon, Mr Randeep Mohil, is experienced in carpal tunnel release surgery.

To book a consultation with Mr Mohil, please call 01625 466158 or email info@northwesthandsurgeon.co.uk