Carpal Tunnel Syndrome

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What is it?​

Carpal tunnel syndrome occurs when the median nerve is compressed within a narrow passage at the wrist called the carpal tunnel. This tunnel is bounded by wrist bones on three sides and a thick ligament on the palm side. Swelling of the tendon linings inside the tunnel increases pressure and interferes with nerve blood flow.

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Symptoms and progression​

Patients typically experience numbness, tingling or burning in the thumb, index and middle fingers, often worse at night. As the condition progresses, weakness of pinch grip and clumsiness with fine tasks can occur, and constant numbness may develop in advanced cases.

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Diagnosis​

Diagnosis is based on history and physical examination. Nerve conduction studies are often used to confirm the diagnosis and assess severity, particularly before surgery or when symptoms are atypical.

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Non‑surgical treatment​

Night splinting to keep the wrist in a neutral position is often first‑line. Activity modification and steroid injection may provide temporary or lasting relief in some patients.

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Surgery – carpal tunnel release​

When symptoms persist or nerve function is threatened, surgery is recommended. Carpal tunnel release involves dividing the tight ligament forming the roof of the tunnel, thereby increasing space for the nerve. This can be performed through a small open incision or endoscopic technique. Night‑time symptoms often improve quickly, but tenderness in the palm and grip weakness may take several weeks to months to settle. Heavy manual work is usually restricted initially. Risks include infection, bleeding, scar sensitivity, pillar pain, nerve irritation and incomplete symptom resolution.

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What does the rehabilitation/recovery involve?

To find out more about rehabilitation and recovery after surgery please see our Rehabilitation Protocols here.

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