Carpal Tunnel Syndrome (CTS) occurs when pressure from one of the ligaments in the wrist creates enough pressure to affect the blood supply to the nerve for the thumb, index and middle fingers (median nerve). This can result in the sensation of pain, tingling or numbness in these fingers. Symptoms can be worse in the evening or certain activities such as driving, cycling or reading, and may vary between individuals.
Diagnosis is through our consultants taking your medical history, discussing your current symptoms and how they developed and physical examination of your hand and wrist, your elbow and neck may be examined too as these can also be a cause of CTS symptoms. If there is uncertainty you may have an ultrasound scan and you may be asked to have a nerve conduction study (this is a test carried out at a separate time to your consultation by a neurophysiologist).
Treatment options
Treatment options available for the CTS are:
Watch and wait: Symptoms will likely increase and not resolve
Splint: A wrist splint is worn mainly at nighttime to prevent the symptoms from causing night-time waking.
Steroid injections: These can be provided in The Hand to Elbow Clinic (often at the same time as your consultation). Typically, these relieve the symptoms in the short term. If the symptoms respond well to the injection further injections may be provided in the future (but rarely more than 2-3 injections in total).
Surgery: Known as a Carpal Tunnel Release surgery, this surgery is usually carried out under local anaesthetic. The ligament causing the excess pressure is released so that the blood supply and nerve have more space. Our audits show more than 90% of patients have good or excellent results. The success of results is in part dependent on the severity and duration of the original symptoms. Risks of surgery will be discussed if you proceed with a carpal tunnel release surgery.
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