Carpal Tunnel Syndrome

There are some factors that can increase your likelihood of developing carpal tunnel syndrome:

• pregnancy
• work or hobbies where you repeatedly bend your wrist or grip hard, e.g. using electric tools
• conditions including diabetes and arthritis
• family history of carpal tunnel syndrome (a parent, brother or sister with carpal tunnel syndrome)
• previous wrist injury

Being overweight can also increase your chance of developing carpal tunnel syndrome. Being a healthy weight can help to reduce this risk, follow the links below to find out what support is available for healthy lifestyle services:

• NHS-Better Health
• Plymouth – OneYouPlymouth

Carpal tunnel syndrome sometimes clears up by itself in a few months, particularly if you have it because you are pregnant.

In up to 1 in 4 cases of carpal tunnel syndrome that are not treated, symptoms go within 12 months or so. There are some steps you can take to help relieve any discomfort you might be experiencing, and several further treatment options that can be discussed with your GP.

Wear a wrist splint

A wrist splint is something you wear on your hand to keep your wrist straight. It helps to relieve pressure on the nerve.

You wear it at night while you sleep. You’ll have to wear a splint for at least 4 weeks before you start to feel better.

You can buy wrist splints online or from pharmacies.

Stop or cut down on things that may be causing it

Stop or cut down on anything that causes you to frequently bend your wrist or grip hard, such as using vibrating tools for work or playing an instrument. If you are overweight, losing some weight may help your symptoms. You can find out more on healthy living here.

If your carpal tunnel syndrome is part of a more general medical condition (such as arthritis) then treatment of that condition may help your carpal tunnel syndrome symptoms.

Painkillers

Painkillers like paracetamol or ibuprofen may offer short-term relief from carpal tunnel pain. However, there’s little evidence to suggest they can treat the cause of carpal tunnel syndrome so it’s important not to rely on them.

Exercises to help carpal tunnel

The link below explains a bit more about carpal tunnel and includes some exercises that can be helpful.

• Versus Arthritis: Simple exercises for carpal tunnel

Alternative treatment

There is a small amount of evidence to suggest hand exercises, yoga and acupuncture help ease the symptoms of carpal tunnel syndrome.

Not treating may be an option

This is because it can get better on its own.

If a wrist splint hasn’t helped, your GP might recommend a steroid injection into your wrist. This brings down swelling around the nerve, easing the symptoms of carpal tunnel syndrome. One research trial found that a single steroid injection eased symptoms in about 3 in 4 cases. However, steroid injections are not always a cure and symptoms did return for some patients in this study, over the following year. It is sometimes worth having a second steroid injection if the symptoms return after the first.

Treatment at your local hospital

If your carpal tunnel syndrome is getting worse and other treatments haven’t worked, your GP might refer you to a specialist to discuss surgery.

Surgery cures carpal tunnel syndrome in up to 9 out of 10 patients. You and your specialist will decide together if it is the right treatment for you. An injection numbs your wrist, so you won’t feel pain (local anaesthetic) and a small cut is made in your hand. The carpal tunnel inside your wrist is cut so it no longer puts pressure on the nerve.

The operation takes around 20 minutes, and you won’t have to stay in hospital overnight. Significant complications of surgery occur in about one in every twenty-five cases. It can take 3-6 weeks after the operation to get back to normal activities.

A non-surgical option may be the best option for you if your symptoms are mild – for example, if your symptoms come and go and mainly consist of tingling, pins and needles or some mild discomfort. A wrist splint or steroid injection may be the most effective non-surgical treatment for you.

If you try either wrist splints or steroid injection, and do not receive any relief after 12 weeks, you should revisit your GP. You should also make an appointment with your doctor if you are in a lot of pain, or if you are experiencing problems sleeping due to pain at night.

You should see your doctor if you have constant numbness in any part of your hand, or if you have any weakness of the muscles next to the thumb. These symptoms mean that the nerve is not working well and is at risk of permanent damage.

Surgery gives the best chance of long-term cure. It is quite a common operation. However, in view of there being some risk of complications from surgery and the fact that it takes time to recover after surgery, then it is not appropriate unless symptoms continue (persist) despite other treatments, or if symptoms are severe and the nerve is in danger of permanent damage. Therefore, a local commissioning policy has been developed by experts who have studied the evidence for different treatments.

Please note that not all patients will be appropriate for surgery. You can read the local commissioning policy here.