The carpal tunnel is a narrow passage in the wrist, formed by the wrist bones and a strong ligament across the front. The median nerve and the tendons that bend the fingers pass through it. In carpal tunnel syndrome, the nerve is squeezed inside the tunnel.
Often there is no single cause. Carpal tunnel syndrome is more common in women and during pregnancy, and is associated with diabetes, an underactive thyroid, rheumatoid arthritis, previous wrist fractures and repetitive gripping.
Diagnosis is based on your symptoms and an examination. Nerve conduction studies measure how well the median nerve is working, and help confirm the diagnosis and its severity.
Mild or intermittent symptoms often improve with a wrist splint worn at night, changes to activity, and treatment of any underlying condition. A steroid injection can relieve symptoms, sometimes for a long time.
If symptoms persist, are severe, or there is weakness or constant numbness, carpal tunnel release is recommended. The ligament roofing the tunnel is divided to take pressure off the nerve. It is a short operation, usually done as day surgery under local or regional anaesthetic.
You can use the hand for light activities soon after surgery. Night-time symptoms often improve quickly. Grip strength and comfort in the palm take several weeks to return, so heavy gripping should wait. Where numbness has been present for a long time, recovery of feeling may be slow or incomplete.
Dr S. Baba, Dr L. Rajah, Dr S. Khan.