What is carpal tunnel syndrome?
At the wrist, the carpal tunnel is a narrow passage through which the median nerve runs; this nerve travels from the forearm into the hand and gives feeling to the thumb, index and middle fingers. According to the UK's NHS, carpal tunnel syndrome happens when the tissues in this tunnel swell and squeeze the median nerve. It causes tingling, numbness and pain in the hand and fingers.
It is nerve pain: to better understand this type of pain, read Neuropathic pain: recognising nerve pain, and for care options see our Neuropathic pain page. This article focuses on symptoms and everyday life.
Carpal tunnel: what are the symptoms?
The NHS describes:
- an ache or pain in the fingers, hand or arm;
- tingling or pins and needles;
- numbness in the hand;
- a weak thumb or difficulty gripping.
These symptoms often start slowly, come and go, and are usually worse at night. Many people shake their hand on waking to ease the tingling.
Causes and risk factors
The NHS lists in particular:
- work or hobbies that mean you repeatedly bend your wrist or grip hard, for example with vibrating tools;
- pregnancy;
- other conditions, such as arthritis or diabetes;
- a parent, brother or sister with carpal tunnel syndrome;
- a previous wrist injury.
Carpal tunnel and pregnancy. According to the NHS, the syndrome sometimes gets better by itself within a few months, particularly when it is linked to pregnancy. Talk to your midwife or doctor about it.
Carpal tunnel, thumb arthritis or something else?
Hand pain is not always carpal tunnel syndrome. Pain at the base of the thumb, especially when pinching, opening a jar or turning a key, points more to thumb-base arthritis: see our Hand osteoarthritis page. Tingling that starts in the neck and runs down the whole arm can come from a nerve root in the neck: see Neck pain. The two sometimes coexist: a medical examination sorts them out.
According to the NHS, the diagnosis is usually made from your symptoms and an examination of your hand. If in doubt, the doctor may request a nerve conduction test, which measures how fast the electrical signal travels along the nerve.
Carpal tunnel: what to do day to day?
A splint at night. The NHS recommends a splint that keeps the wrist straight while you sleep, to relieve pressure on the nerve. You may need to wear it for up to 6 weeks before it starts to feel better.
Cut down on what keeps it going. The NHS advises cutting down on anything that makes you bend your wrist often or grip hard, such as vibrating tools or repeated movements at work or when playing an instrument. Take breaks, alternate tasks and keep your wrist straight at the keyboard.
Hand exercises. According to the NHS, there is a small amount of evidence that hand exercises can ease symptoms. A physiotherapist or occupational therapist can show you how.
Painkillers. The NHS notes that they may help in the short term but do not treat the cause: do not rely on them alone. Medication is discussed with your doctor or pharmacist.
What about medical treatments?
If a splint does not help, a steroid injection into the wrist may be recommended, according to the NHS; symptoms can come back after a few months. If the syndrome is getting worse and other treatments have not worked, your doctor may refer you to a specialist to discuss surgery. According to the NHS, the operation takes around 20 minutes, without an overnight stay, and getting back to normal activities can take a month.
Warning signs: when to seek help without delay
Go to the emergency department immediately if you have:
- sudden weakness or numbness in an arm, a leg or the face, or sudden difficulty speaking (these signs are not related to carpal tunnel syndrome and can point to a problem in the brain);
- severe wrist pain after a fall, with deformity or marked swelling.
See your doctor soon if:
- the numbness becomes constant;
- your thumb is losing strength or the muscle at the base of your thumb seems to be getting smaller;
- symptoms are getting worse or do not settle despite home measures.
In the vast majority of cases, none of these signs is present.
Looking beyond the wrist
The first consultation lasts 1.5 to 2 hours (CHF 182). Bring your medical file, your test results (nerve conduction test, reports) and the list of your medications. We review your situation and build your plan together. Follow-up is then adapted to your progress. We work alongside your GP and the other professionals who care for you, in particular your physiotherapist or occupational therapist.
Which approaches can play a part at Centre Algos?
Depending on your situation, several approaches can be combined, alongside medical care:
- Naturopathy: sleep, diet, weight and daily rhythm, to work on habits that can influence pain.
- Functional biology and micronutrition: a review of diet and nutritional needs, taking your related conditions and medications into account.
- Percutaneous hydrotomy: micro-injections under the skin. After assessment, when no warning signs are present and in agreement with your medical care, it can be discussed as a complementary option; it can bring relief, with no guaranteed result. We explain how it works, its limits and its contraindications; results vary from person to person. If hydrotomy is part of your plan, price on quotation, set at the first consultation according to your situation.
Everyone responds differently: the aim is to live your days and nights better, without promising a result.
When to seek help
What is happening in your case
This text gives general guidance. What keeps your tingling going, in your particular daily life, deserves a real conversation rather than a generic answer.
A question before you decide? Book a free 10-minute call to see whether our approach suits you.
