Carpal tunnel syndrome (CTS) arises when the median nerve is compressed at the wrist.
Symptoms and Diagnosis
Patients commonly report pain, numbness, tingling or weakness in the hand. The symptoms are usually most pronounced at night or in the early hours of the morning.
The diagnosis can generally be made from the symptoms and the physical examination. In some cases nerve conduction studies are required in order to confirm it.
Treatment
Treatment begins with the least invasive measures and proceeds as follows.
- Wrist Splint
- A splint holds the wrist straight while the fingers remain in their natural flexed position. Worn at night in particular, it is among the most effective means of relieving the symptoms.
- Yoga and Hand Therapy
- These reduce the symptoms and are among the effective treatments for carpal tunnel syndrome.
- Steroid Injection
- This has an established place in current practice. It should be borne in mind, however, that the symptoms may return once the effect of the injection has worn off.
- Oral Steroids
- Less effective than injection, and carrying a greater risk of side effects.
- Simple Analgesics
- Paracetamol or ibuprofen may provide relief alongside the other measures.
- Surgery
- Recommended for patients who do not benefit from medical and supportive treatment. The operation divides the ligament compressing the median nerve within the carpal tunnel, thereby relieving the nerve.
Carpal Tunnel Syndrome in Pregnancy
Carpal tunnel syndrome is common in pregnancy. A splint helps to relieve the symptoms during this period, and in most cases the symptoms subside after delivery.