What is carpal tunnel syndrome?
Carpal tunnel syndrome is the most common nerve compression condition in the upper limb. The median nerve passes from the forearm into the hand through a narrow tunnel at the wrist. When pressure in this tunnel increases, the nerve is compressed, causing numbness, tingling and pain in the thumb, index, middle and half of the ring finger.
Common symptoms
- Numbness or pins and needles in the fingers, often waking you at night
- Tingling when driving, holding a phone or reading
- Clumsiness or dropping objects
- Aching in the hand or forearm
- In long-standing cases, weakness and wasting of the muscles at the base of the thumb
Diagnosis
The diagnosis is usually made from your story and examination findings. Nerve conduction studies are often arranged to confirm the diagnosis and grade the severity, which helps guide treatment.
Non-surgical treatment
Mild or early symptoms may settle with:
- Night splinting of the wrist in a neutral position
- Activity modification
- A corticosteroid injection into the carpal tunnel, which can give temporary relief and help confirm the diagnosis
Carpal tunnel release surgery
When symptoms are persistent, severe, or there are signs of nerve damage, surgery is the established treatment. Carpal tunnel release divides the ligament forming the roof of the tunnel, taking the pressure off the nerve.
- Usually performed as day surgery under local or regional anaesthesia
- The operation itself typically takes around 15–20 minutes
- Night symptoms commonly improve following surgery
- Light use of the hand begins immediately; heavier gripping is restricted for a few weeks
Long-standing numbness and muscle wasting recover more slowly, and sometimes incompletely — which is why timely treatment matters.
Recovery
Most patients return to desk-based work within days to a fortnight and heavier manual work in around 4–6 weeks. Hand therapy can assist with scar management and rebuilding grip strength.