What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a common condition affecting people of all ages. The most common symptom is an altered sensation in the fingers (such as numbness and/or pins and needles) that worsens at night or in the mornings.

Symptoms of Carpal Tunnel Syndrome

Some people experience similar sensory changes when driving or holding their mobile phone. Clumsiness can occur when completing delicate activities like fastening buttons and shoelaces. Some people report pain in the wrist, hand or forearm.

Causes of Carpal Tunnel Syndrome

Carpal tunnel syndrome is a type of ‘compression neuropathy’, whereby a nerve (the median nerve) is compressed at the palm side of the wrist.

Carpus is the Greek word for wrist, and the term carpal therefore relates to the wrist. The median nerve travels towards the fingers through a short tunnel in the wrist, where a thick ligament covers the nerve and neighbouring tendons.

Wrist position (especially at night) can increase the pressure within this ‘carpal tunnel’ and compression of the nerve produces symptoms in the fingers. Although the little finger is not typically affected in carpal tunnel syndrome, it is not uncommon for patients to report numbness in all fingers. Numbness in the little finger may represent a condition called cubital tunnel syndrome.

There are other causes of finger numbness, and a thorough assessment is required to help identify the cause.

Treatment for Carpal Tunnel Syndrome

Non-surgical treatment options include wrist splintage, physiotherapy and, sometimes, steroid injection (e.g. cortisone).

Surgical treatment is carpal tunnel decompression (also termed release), whereby the overlying ligament is released through a short incision on the palm side of your wrist. Carpal tunnel surgery is usually performed under local anaesthesia. 

Further Reading

• Read more from NHS Lothian.

• Read more detailed information from NHS Inform.

• Read more information from the British Society for Surgery of the Hand.