HealthInfo West Coast-Te Tai Poutini
Carpal tunnel syndrome
Mate kāwititanga o te ringa
The carpal tunnel is a narrow passage in your wrist, through which your median nerve and the tendons to your thumb and fingers pass.
If you have carpal tunnel syndrome, it means there is pressure on your median nerve. This causes symptoms like numbness or tingling in your thumb and fingers (but not normally your little finger) or the palm of your hand.
You may have pain in your wrist, which can shoot into your fingers, or sometimes up to your elbow. Your muscles might be weak, especially if you have to grip something. Your symptoms may be particularly bad at night, or when doing the same task for a long time, like long-distance driving.
Carpal tunnel syndrome is quite common and affects women more than men. It can happen in one or both wrists.
Causes of carpal tunnel syndrome
Anything that causes swelling in the carpal tunnel can cause carpal tunnel syndrome. We do not always know why this swelling happens. But there are some conditions that are linked to carpal tunnel syndrome. They include:
- pregnancy
- being overweight
- fluid retention
- diabetes and hypothyroidism
- rheumatoid arthritis and connective tissue diseases
- wrist wounds or broken bones.
Carpal tunnel syndrome can sometimes happen after forceful or repetitive movements of your wrist or hand.
Diagnosing carpal tunnel syndrome
Your general practice team will ask you about your symptoms and examine your wrist and hand. You do not usually need any tests.
If you need to see a specialist, they may test how your median nerve is working by using nerve conduction studies. Nerve conduction studies measure how well and how quickly your nerves conduct electrical signals. This can help if it is not obvious that you have carpal tunnel syndrome.
Self-care for carpal tunnel syndrome
You can try a few things yourself to help make your carpal tunnel syndrome better.
- Lose weight if your BMI is higher than 30.
- Work with your general practice team to manage any associated conditions. These include diabetes, hypothyroidism, fluid retention, rheumatoid arthritis or connective tissue diseases.
- Avoid or reduce repetitive or heavy hand and wrist activities such as pruning, house building, wringing out wet clothes or holding heavy trays and dishes.
Treating carpal tunnel syndrome
There are several treatments for carpal tunnel syndrome, depending on how severe it is.
Wrist splints
Some people find a wrist splint that stops their wrist from curling up helps prevent or reduce their night pain and numbness.
You can buy a suitable wrist splint from most physiotherapists, pharmacies, sports shops or online.
When buying a wrist splint, make sure it has a metal or plastic piece at the front to stop your wrist curling up. Also make sure it fits comfortably.
For a more specific splint, you may want to see a private hand therapist who can make a splint for you. You will need to pay for the consultation and materials.
Steroid injections
Steroid injections often ease the pain and symptoms of carpal tunnel syndrome. For some people, the relief is long-lasting. Especially if you have not had carpal tunnel syndrome for long, or you have a mild case.
If you have had it for longer than 6 months or have severe symptoms, steroid injections are only likely to give temporary relief. Local specialists say that most people should have no more than 3 steroid injections in their lifetime.
Your general practice team will either give the injection themselves or refer you to another general practice team or specialist for this treatment.
Surgery
If you still have symptoms after the treatments above, you can be referred for carpal tunnel surgery. This is usually done by a plastic surgeon or an orthopaedic surgeon.
Carpal tunnel release (or decompression) is generally very effective. Some symptoms can get better immediately after the operation, but numbness can take longer to improve.
The surgery is usually done under a local anaesthetic injection, which numbs the area being operated on. This is very safe and effective. It also has fewer risks than having a general anaesthetic (when you go to sleep).
If your work is found to have caused your carpal tunnel syndrome, ACC may cover the cost of surgery.
HealthInfo recommends the following pages
- ACC – Knowing about your carpal tunnel syndrome
A 2-page PDF with information about carpal tunnel syndrome and tips for managing it.
- Patient.info – Carpal tunnel syndrome
A UK site with more detailed information about carpal tunnel syndrome.
Written by HealthInfo clinical advisers. Last reviewed November 2024.
Sources
See also:
Review key: HICTS-12821
