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Carpal tunnel syndrome

What is Carpal tunnel syndrome

This is used to describe a combination of symptoms and signs that result from the compression of the median nerve in the carpal tunnel. This tunnel is the space located between small bones in the wrist on the back of the hand (dorsum) and a strong ligament called the transverse carpal ligament (on the front or the palmar surface of the hand) holding the ends of the bones together.

What may I notice or complain of?

You may complain of tingling, pins and needles and or numbness in the tips of the fingers especially the thumb, index and middle fingers. There may be associated pain in the wrist or pain that extends upwards towards the elbow. The symptoms can be brought on by normal activities such as driving, combing hair or holding the phone. You may have difficulty doing up your buttons. Patients can also complain of dropping objects or have a feeling of weakness of the hands. Nocturnal or night symptoms can occur and disturb your sleep. You may have observed that you get some relief by shaking your hands and getting it to hang down from the bed. Severe and long standing compression can lead to wasting of the muscles of the hand especially on the ball of the thumb.

 

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How is it treated?

Surgery – this is the definitive treatment and may be recommended after a failed non surgical treatment or in presence of severe symptoms and signs.

 

However before surgery, there are many ways that are used to help relieve symptoms. These include splinting to be worn at nights, anti inflammatory drugs, local steroid injection and advice on a reduction of the activity that worsens the symptoms.


Anaesthesia

This is usually performed under local anaesthesia. It is done as a day case so you can go home the same day.


What to expect post operatively

The operated hand is placed in a bulky dressing with the fingers free.

You can reduce the dressings in 5 days and place a simple plaster over the area.

Hand therapy is useful and one or two sessions may suffice.

Usually there are no stitches to remove as they fall off themselves after a week.

Sometimes, especially if you had long standing symptoms, there may be residual sensory symptoms that can take up to a few months to completely resolve.