Carpal Tunnel Syndrome
Tendons in the wrist swell and press on the nearby nerve, causing numbness or abnormal sensation.
The finger-bending tendons and a nerve pass through a tunnel under a ligament across the wrist. Heavy hand use makes the tendons swell and compress the nerve.
Common causes
01
Poor wrist posture and repetitive finger movement
02
Jobs that demand a strong grip
03
Fracture or dislocation around the wrist
04
Hormonal or metabolic changes such as pregnancy or thyroid imbalance
Signs to watch for
- Numbness and burning pain in the palm
- Reduced dexterity and abnormal sensation from numbness
- If it continues, the thumb muscle weakens and shrinks, wrist movement becomes awkward and weakness can follow
How we diagnose
X-ray
The basic first test. Further tests may be added for a definite diagnosis.
MRI
Shows soft tissue that X-ray cannot, such as muscles, ligaments, discs, cartilage, nerves and blood vessels.
How we treat it
Mild cases are treated conservatively. If symptoms are mild and there is no muscle wasting, we use anti-inflammatory medication, splinting and injections.
Non-surgical injection therapy
Prolotherapy injects directly into weakened ligaments or tendons to reinforce the fibrous tissue, or a hyaluronic acid injection, a main component of joint fluid, is placed into weakened cartilage.
Extracorporeal shockwave therapy
Used across orthopedics, physical therapy and sports medicine, shockwave therapy aids recovery without surgery or painkillers and suits many conditions that cause acute or chronic pain.
Arthroscopy
Through a minimal incision under about 5 mm, an arthroscope with a tiny camera and special instruments is inserted into the joint. It shows areas that are hard to see on X-ray, allowing accurate diagnosis and treatment at the same time.
When surgery is consideredSurgery cuts the ligament compressing the median nerve. It usually takes under 30 minutes and can be done through a very small incision with an arthroscope or special instruments, so pain after surgery is much reduced.