This is a common condition that causes intermittent numbness and tingling of the thumb, index, middle and part of the ring finger and on occasions involves all fingers. It can wake the patient at night and may come on after driving or telephone calls with that hand. One or both hands may be affected. It is caused by the compression of the median nerve at the wrist, and if left untreated may cause permanent numbness and because the same nerve supplies some of the thumb muscles may also lead to weakness of the thumb.
What causes carpal tunnel syndrome?
In most cases there is no obvious cause, but it may be due to diabetes, in patients with Rheumatoid Arthritis, in those with a poorly functioning thyroid or arthritis of the neck. It can also be seen with those who have had broken wrists in the past.
What can be done about it?
A steroid injection and a wrist splint (particularly at night) may help the majority of patients who are usually symptom free for 6 months or more. Repeat injections can be done at this stage or surgery.
This is day case procedure taking about 30 minutes. Local anaesthetic is injected into the wrist and an incision about 2 cms long made, allowing release of the tight ligament compressing the contents of the wrist.
How long does it take to recover?
A bandage allows moderate hand use afterwards and is removed 10-14 days later when the stitches will also be removed. If there has been permanent numbness of the fingers for many months before surgery, sensory recovery of the fingers are unlikely to return completely.
What can go wrong?
Surgery for carpal tunnel release is generally very safe and the results predictable with very good patient satisfaction. However no surgery is without potential risks, which will be discussed in detail by Mr Colville at the consultation.