Carpal Tunnel Syndrome Guide

What are the symptoms of Carpal Tunnel Syndrome?

The symptoms of carpal tunnel syndrome include:

• An ache or pain in your fingers, hand or arm
• Numbness, tingling or pins and needles in your hand
• A weak thumb or difficulty gripping.

These symptoms often start slowly and come and go. They're usually worse at night.

What causes Carpal Tunnel Syndrome?

Carpal tunnel syndrome (CTS) is pressure on a nerve in your wrist. You can often treat it yourself, but it can take months to get better.

How is it diagnosed?

Diagnosis is usually made from the patient’s history and a simple examination without the need for further investigations. If there is uncertainty around the diagnosis, you may need a referral for a test of the nerves in your wrist (nerve conduction test).

How can I manage my condition?

Mild Carpal Tunnel syndrome often gets better without any treatment. Stopping the activities that are aggravating the symptoms, trialling exercises and wearing a wrist splint overnight can all help.

On occasion a Corticosteroid Injection (CSI) can be used to help settle swelling in your wrist to ease the symptoms.

If all conservative management has failed to help with your symptoms, you may be referred to Orthopaedics where they may consider decompression surgery.

To help decide on options available, NHS England have produced a clinical decision aid tool which helps to explain the options in further detail.

Wearing 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 may need to wear a splint for up to six weeks before it starts 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.

Painkillers

Painkillers like paracetamol or ibuprofen may help Carpal Tunnel pain short term, but there's little evidence to say they can treat the causes, so it's important not to rely on them.

Hand exercises

There’s a small amount of evidence to suggest hand exercises help ease the symptoms of Carpal Tunnel Syndrome.

Start position:
Stand with your arm out to your side, your elbow bent to 90 degrees, your wrist flexed and fingers pointing towards your head. Tilt your head away from your arm.

Action:
In a co-ordinated and rhythmical manner, extend your elbow, wrist and fingers while tilting your head towards your arm. Reverse the movements to return to the starting position.

Key points:
You should feel a gentle stretching or pulling sensation.

Start position:
Hold your arm out in front of you with your palm up and elbow straight.

Action:
Use your other hand to extend the wrist and fingers until a stretch is felt and hold for the desired length of time. Hold for 20 seconds.

Start position:
Hand held out in front of you or on a table with the palm down and fingers together

Action:
Spread your fingers as wide as possible before returning to the start position.

Start position:
Hand and fingers outstretched.

Action:
Touch the tip of your thumb on the bottom of the little finger (at the joint). Return to the starting position.

Start position:
Hand and fingers outstretched.

Action:
Make a fist and return to the starting position. Repeat for the required repetitions.

Start position:
Hand holding a soft, squeezable object such as putty.

Action:
Attempt to form a fist by squeezing against the resistance. Continue for the required amount of time or repetitions.

Our patients matter

Mersey Care NHS Foundation Trust listens and responds to patients and their carers to help improve the services we deliver.

If you have any comments, compliments or concerns you can speak with a member of staff or contact our Patient Advice and Liaison Service (PALS) and Complaints Team

Telephone: 0151 471 2377 
Freephone: 0800 328 2941 
Email: palsandcomplaints@merseycare.nhs.uk