Summary

Symptoms

  • Pins, needles and numbness in the thumb, index finger, middle finger and half of the ring fingers
  • Dropping of things
  • A weak grip

Causes

Increase in pressure on the median nerve caused due to –

  • Pregnancy
  • Fractures to the wrist
  • Joint dislocations
  • Rheumatoid arthritis
  • Underactive thyroid
  • Diabetes
  • Menopause
  • Swellings coming from the tendons

Surgery is recommended

  • When non-operative measures like a splint or steroid injections do not provide relief

What is a Carpal Tunnel Syndrome?

Carpal tunnel is a narrow space which lies under a fibrous band of tissue in the palm side of the wrist bones. The median nerve runs through this space along with the tendons that bends the fingers and the wrist.

As the space is limited in the carpal tunnel, any swelling will squash the median nerve; this is what we call as carpal tunnel syndrome.

What are the symptoms of Carpal Tunnel Syndrome?

Some of the symptoms are pins, needles and numbness in the thumb, index finger, middle finger and half of the ring finger. Some people complain of dropping things and a weak grip.

Symptoms are usually worse at night, but daytime activities like driving, answering a phone and holding on to trolley handles can make it worse.

What causes Carpal Tunnel Syndrome?

In most cases it is not clear why carpal tunnel syndrome occurs.

It happens when there is an increase in pressure on the median nerve. This can happen in pregnancy, fractures to the wrist, joint dislocations, rheumatoid arthritis, underactive thyroid, diabetes, menopause and swellings coming from the tendons which are passing through the carpal tunnel.

Why do I need surgery?

If your symptoms are constant and not relieved by non-operative measures like the use of a splint or steroid injections, then surgery may be needed.

If it comes to surgery, this can be done under a local anaesthetic with the patient awake. The local anaesthetic will numb the area and the surgery will take around 15 minutes. Surgery will relieve the pins, needles and numbness and the pain associated with carpal tunnel syndrome.

What are the risks of surgery?

  • Complications are rare but can include infection, which usually settles by taking antibiotics.
  • Hypersensitive scar / pillar pain which will settle down at around 3 months.
  • Damage to nerves or blood vessels
  • Reflex sympathetic dystrophy

Will I feel any pain?

Surgery is done using a local anaesthetic. You may feel some pressure at the surgical site but you should not feel any pain. Discomfort is to be expected after the surgery which can be managed with pain killers. Raising your hand and taking pain killers will help with this pain. Swelling can be prevented by moving your thumb and fingers.

You will have a pressure dressing over your wound which will be reduced usually two to three days after the surgery. Returning to work depends on the type of work you do but it is usually around 2 – 3 weeks after the surgery. You will be given a follow up outpatient appointment around two weeks after the surgery when your stitches will be removed in the clinic and further post operative rehabilitation will be discussed.