What is Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome (CTS) is a common condition caused by pressure on the median nerve as it passes through a narrow space in the wrist called the carpal tunnel. This nerve supplies sensation to the thumb, index, middle, and part of the ring finger, and controls some thumb muscles.
When the nerve is compressed, symptoms can develop gradually and may worsen over time if untreated.
Common Symptoms
Symptoms often affect one or both hands and may include:
- Tingling or “pins and needles” in the thumb, index, middle, and ring fingers
- Numbness, especially at night or on waking
- Hand or wrist pain that may travel up the forearm
- Weakness in the hand or thumb
- Difficulty gripping objects or dropping things
- Relief by shaking or flicking the hand
Symptoms are often worse at night and may interrupt sleep.
Clinical Findings Your Clinician May Identify
On examination, your clinician may find:
- Reduced sensation in the affected fingers
- Weakness or wasting of the thumb muscles (in more advanced cases)
- Symptoms reproduced by wrist positioning tests
- Tenderness or swelling around the wrist
- Reduced grip or pinch strength
Because symptoms can overlap with other nerve or neck conditions, further testing is often required.
Nerve Conduction Studies – An Essential Test
Nerve conduction studies (NCS) are an important part of diagnosing carpal tunnel syndrome.
These tests:
- Confirm the diagnosis
- Measure how well the median nerve is functioning
- Determine the severity of nerve compression
- Help guide treatment decisions
Referral for nerve conduction studies is recommended before considering surgery and when the diagnosis is uncertain.
Treatment Options
Non-Surgical (Conservative) Treatment
These options may be suitable for mild to moderate symptoms:
- Wrist splinting (especially at night)
- Activity modification
- Anti-inflammatory or pain-relieving medication
- Corticosteroid injection into the carpal tunnel
- Managing contributing conditions (such as diabetes or thyroid disease)
Some patients experience good symptom relief, but symptoms may return over time.
Surgical Treatment
Surgery is recommended when:
- Symptoms are severe or persistent
- There is weakness or muscle wasting
- Nerve conduction studies show significant nerve compression
- Non-surgical treatments have failed
Minimally Invasive Open Carpal Tunnel Release
Carpal tunnel release surgery involves relieving pressure on the median nerve by dividing the tight ligament over the carpal tunnel.
Key points:
- Minimally invasive open technique
- Performed safely in the clinic
- Local anaesthetic only – no general anaesthetic required
- Small incision with minimal tissue disruption
- Short procedure time
- Most patients go home the same day
- High success rate for symptom relief
Recovery is usually gradual, with improvement in numbness and tingling often occurring early, and strength returning over weeks to months.
When to Seek Review or Referral
You should seek further assessment if:
- Symptoms are worsening
- You develop hand weakness or muscle wasting
- Night pain is severe or persistent
- Symptoms do not improve with conservative treatment
Early assessment and appropriate referral can prevent permanent nerve damage.
Summary
Carpal tunnel syndrome is common and treatable. Accurate diagnosis, including nerve conduction studies, is essential. Treatment ranges from splinting and injections to minimally invasive surgery performed comfortably under local anaesthetic in a clinic setting.
If you have concerns or ongoing symptoms, speak with your healthcare provider about the most appropriate next step.