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Dear doctor, the pain and tingling in my right hand has gotten worse recently. What can I do to fix it?

17 October 2017

Q: I’m suffering from pain, tingling and numbness in my right hand which has gotten worse over the past few weeks. It now keeps me awake at night and it hurts when I drive or use my phone. What can I do to fix it?

A: The symptoms you describe are commonly due to Carpal Tunnel Syndrome (CTS) in which the median nerve (one of the main nerves in the hand) is squashed at the wrist. Pain and tingling is often felt in the thumb and adjoining three fingers - the little finger is usually spared.

The symptoms are usually worse at night but can be provoked by “gripping” activities such as driving, reading or using the telephone. Initially, symptoms are intermittent but numbness can become continuous and thumb muscles can waste away causing weakness and difficulties in performing delicate tasks such as doing up buttons.

The median nerve passes, together with tendons to the fingers, through a short tunnel of bone and ligaments at the wrist. Any condition that causes swelling or thickening of the tunnel or tendons can predispose to median nerve compression, and so CTS can be associated with; diabetes, thyroid problems, rheumatoid and osteoarthritis, and wrist fractures. The condition is more common in women and can occur in pregnancy (which usually resolves following birth) but men can also be affected. Often no cause can be found.

CTS can be temporary, however if it persists, treatments such as wrist splints and steroid injections are usually recommended initially. Surgery is often necessary for patients if these treatments fail to alleviate the symptoms and they are affecting your daily life. This is performed under a local anaesthetic (patient is awake) as a day case procedure and it takes 20-25 minutes. The patient is encouraged to move the fingers immediately and use the hand normally as soon as the stitches have been removed, after 7-14 days.

It is important to establish a diagnosis and exclude other causes so if you are experiencing continuous discomfort, I would recommend you see a specialist.

Mr Christopher Hobbs is a Consultant Orthopaedic Surgeon practising at Spire Portsmouth Hospital.

 

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.

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