Carpal tunnel syndrome

Carpal tunnel syndrome (CTS) affects the median nerve in your wrist. The median nerve helps control feeling and movement in part of your hand and thumb. It runs into your hand via the carpal tunnel – a channel formed by a ligament that connects your small bones in your wrist.

CTS occurs when pressure builds up in the carpal tunnel, squeezing your median nerve and causing hand and wrist pain, numbness, tingling and weakness. Carpal tunnel symptoms often get worse over time and can affect your ability to manage everyday tasks like typing or handling tools.

CTS affects about one in 20 people and is three times more common in women than men, especially among older people. There’s a range of treatments available, including surgery if your symptoms are severe and long-lasting.

Carpal tunnel symptoms include:

• Numbness in your hand or thumb
• Pain in your hand, arm or shoulder
• Pins and needles in your hand
• Weakness in your grip
• Wrist pain
• Trigger finger

Your symptoms are likely to get worse the more you use your wrist. You may find your hand or wrist pain is worse at night and stops you from sleeping well.

See your GP if you have pain, numbness or tingling in your hand or wrist that’s lasted for some time and is getting worse. Your doctor will ask about your symptoms and medical history, and examine your wrist. They may use carpal tunnel syndrome tests such as:

• Tinel’s test – lightly tapping the nerve on the palm side of your wrist
• Phalen’s test – bending your wrist so your palm is pushed towards your forearm for one minute

If these tests cause you to feel pins and needles or tingling, then it’s a sign of CTS.

If they need further confirmation or to rule out other conditions, your doctor may refer you for an ultrasound scan or a nerve conduction test.

It isn’t always clear what causes pressure to build up in the carpal tunnel and cause painful symptoms. You’re more likely to get carpal tunnel symptoms in the hand you use more. Having a job or hobby that involves repeatedly bending your wrist or gripping objects is a risk factor too.

CTS is also more common if you’re:

• Closely related to someone with CTS
• Diagnosed with another condition such as arthritis or diabetes
• Female and over 50 or male over 75
• Obese
• Pregnant

CTS sometimes goes away by itself. If it doesn’t, treatments to ease carpal tunnel symptoms include:

• Hand exercises or yoga
• Using your hand less
• Over-the-counter painkillers
• Wearing a wrist splint
• Steroid injections

If these don’t work, carpal tunnel surgery is a successful treatment for carpal tunnel symptoms. Carpal tunnel surgery is a quick procedure to cut a ligament in your carpal tunnel and relieve pressure on your median nerve.