Carpal tunnel syndrome is caused by pressure on the median nerve where it passes through a tunnel at the front of the wrist. The classic picture is numbness and tingling in the thumb, index, middle and half the ring finger, worse at night, waking you and relieved by hanging the hand out of bed or shaking it. Many people also notice dropping things, or difficulty with buttons and keys.
Phillipa Frankland has a particular clinical interest in hands, which is worth knowing, because hand and wrist problems are frequently treated generically.
More information
Is it definitely the wrist
Not always, and this is where an assessment earns its keep. Numbness in the hand can also come from the neck, from the elbow, or from a more general nerve condition, and the pattern of which fingers are affected is one of the most useful clues. Treating the wrist when the problem is in the neck is a common and avoidable waste of months.
What treatment involves
For mild to moderate symptoms, a wrist splint worn at night is one of the most effective simple treatments and often makes a substantial difference within weeks. Alongside that, we look at aggravating activities and at how the nerve moves, and treat any contributing problem further up the arm.
When to think about surgery
Carpal tunnel release is a genuinely effective operation, and it is the right answer when symptoms are severe, when there is constant numbness or muscle wasting at the base of the thumb, or when conservative treatment has not worked. If any of that applies we will tell you and write to your GP rather than continuing to treat.
Pregnancy and other causes
Symptoms in pregnancy are common and often settle after birth. Thyroid problems, diabetes and rheumatoid arthritis also contribute, which is worth raising with your GP.
